First mosquito-borne West Nile virus infection in Germany

    

    

Doctors newspaper online, 28.09.2019

    

        
        
        

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Fall in Saxony

BERLIN. For the first time, an infection and disease transmitted by mosquitoes in Germany has become known with the West Nile Virus (WNV): The person from Saxony was suffering from encephalitis, reports the Robert Koch Institute (RKI). She had recovered in the meantime.

The National Reference Center for Tropical Infectious Diseases at the Bernhard Nocht Institute for Tropical Medicine (BNITM) detected an infection with WNV. "The risk of further cases is decreasing as the number of mosquitoes declines in the autumn. In the coming summers, however, we must reckon with further West Nile virus infections, "RKI President Professor Lothar H. Wieler is quoted in the statement. "Fortunately, most of the cases are mild."

West Nile viruses are originally from Africa. The pathogens are transmitted by mosquitoes between birds, but also mammals (especially horses) and humans can be infected by mosquito bites, recalls the RKI. Transfers are also possible through blood transfusions. Human infections are about 80 percent without symptoms, almost 20 percent with mostly mild and nonspecific symptoms such as fever or rash.

Only less than 1 percent of those affected – usually older people with pre-existing conditions – experience meningitis or, more rarely, encephalitis. There are no vaccines or specific therapy for humans yet. Infections can be prevented by personal mosquito repellent.

Due to migratory birds and mosquitoes, the virus has migrated to more northern regions and can be spread there during the mosquito season. In recent years, there have been recurrent outbreaks in southern and central Europe and the Black Sea riparian states. In 2018 and 2019, scientists from the Friedrich-Loeffler-Institut (FLI) and the BNITM found more than 70 wild and zoo birds that died of WNV infections in Germany, especially in eastern Germany.

WNV is transmitted by native mosquitoes of the genus Culex. "Obviously, the unusually warm summer of the last two years caused by climate change has contributed to WNV establishing itself north of the Alps," says Professor Jonas Schmidt-Chanasit, Head of Virus Diagnostics at BNITM.

Infections with the West Nile virus are notifiable. Since 2018, the RKI has recommended physicians in the affected regions to have patients with encephalitis of unclear origin screened for West Nile viruses. Even with increased occurrence of fever with and without skin rashes, the virus must be considered as a trigger. The laboratory diagnostics should as far as possible take over a special laboratory. (eb)

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