R.N. Charrel

First cases of autochthonous dengue fever and chikungunya fever in France: from bad dream to reality!

Following the outbreak of autochthonous chikungunya fever in humans in northern Italy, first reported 3 years ago (1) we have now witnessed two independent cases of autochthonous transmission of dengue fever and two cases of chikungunya fever in south-eastern France during September 2010. This worrying trend has raised serious concern among the health authorities, as Aedes albopictus, the Asian tiger mosquito, is the most likely transmission vector of both viruses, and this mosquito species is known to be spreading widely throughout many regions of southern Europe. The two cases of dengue fever occurred in patients (a 64-year-old male and an 18-year- old male) living in Nice in the same neighbourhood and know- ing each other. The two cases of chikungunya fever occurred in 12-year-old female patients also living in the vicinity of each other in Frejus, and attending the same high school. Both pre- sented with high fever, headache, lombalgia and arthralgia. These two patients lived in the same neighbourhood as the unique laboratory-documented imported case of the county, affecting a 7-year-old female patient returning from Asia. All four cases resulted in mild, self-resolving infections. The virological identification of these four cases of arbo- viral disease, with no travel history, and within the recorded area of dissemination of A. albopictus, along the 180-km region of the Mediterranean coast from Menton to Toulon (2): (i) demonstrates the first cases of autochthonous trans- mission of both viruses (dengue and chikungunya) in France; (ii) implies that A. albopictus, which is resident in this region, is the most likely competent vector for dengue virus (http:// www.sante-sports.gouv.fr/apparition-des-premiers-cas-auto chtones-de-dengue-en-france-metropolitaine.html); and (iii) raises important issues to be resolved in time for the next mosquito season, namely the adaptation of surveillance systems and the implementation of countermeasures to limit dispersal of the viruses and to limit the number of human cases of dengue or chikungunya fever. How alarmed should we be in Europe? Imported cases of dengue and chikungunya fever have long been reported in infected viraemic travellers (3) returning from tropical regions where the viruses are endemic or transiently epi- demic. Indeed, dengue virus ranks second only to the malar- ial parasite as an agent of systemic febrile illness in travellers to the tropics who are returning to Europe (4). However, during the past 5-10 years, the perceived risk of infection in Europe, particularly with these two arboviruses, has increased. This is because a competent mosquito vector was not previously present at a sufficient density in Europe to be able to initiate and generate secondary human cases of chikungunya or dengue fever among human populations. With the establishment and amplification of A. albopictus in Europe, and these cases of dengue and chikungunya fever in France, the perceived risk of epidemics caused by these viruses or other emerging arboviruses has increased dramati- cally. Consequently, in an attempt to prevent and monitor the appearance of autochthonous cases, the French authori- ties have elaborated a surveillance programme targeting both viruses in returning travellers during the summer period of vector activity (http://www.circulaires.gouv.fr/pdf/2010/05/cir_

Complete Coding Sequence of Zika Virus from a French Polynesia Outbreak in 2013

ABSTRACT Zika virus is an arthropod-borne Flavivirus member of the Spondweni serocomplex, transmitted by Aedes mosquitoes. We report here the complete coding sequence of a Zika virus strain belonging to the Asian lineage, isolated from an infected patient returning from French Polynesia, an epidemic area in 2013/2014.

Evolutionary relationship between Old World West Nile virus strains: Evidence for viral gene flow between africa, the middle east, and europe

Little is known about the genetic relationships between European and other Old-World strains of West Nile virus (WNV) and persistence of WNV North of Mediterranean. We characterized the complete genomes of three WNV strains from France (horse-2000), Tunisia (human-1997) and Kenya (mosquito-1998), and the envelope, NS3 and NS5 genes of the Koutango virus. Phylogenetic analyses including all available full-length sequences showed that: (1) Koutango virus is a distant variant of WNV; (2) the three characterized strains belong to lineage 1, clade 1a; (3) the Tunisian strain roots the lineage of viruses introduced in North America. We established that currently available partial envelope sequences do not generate reliable phylogenies. Accordingly, establishing a large WNV sequence database is pivotal for the understanding of spatial and temporal epidemiology of this virus. For rapid completion of that purpose, colinearized E-NS3-NS5 gene sequences were shown to constitute a valuable surrogate for complete sequences.

Hepatitis GB Virus C in Patients on Hemodialysis

To the Editor: A new group of Flaviviridae viruses — hepatitis GB virus C (HGBV-C)1 and hepatitis G virus (HGV)2 — has recently been described. Patients infected with these viruses have persistent ...

Circulation of Respiratory Viruses Among Pilgrims During the 2012 Hajj Pilgrimage

This study suggests a rapid acquisition of respiratory viruses among pilgrims during their stay in the Kingdom of Saudi Arabia and highlights the potential of the spread of these infections into the pilgrims home countries upon their return.

Classification of hepatitis C virus variants in six major types based on analysis of the envelope 1 and nonstructural 5B genome regions and complete polyprotein sequences.

The phylogenetic status of recently described isolates of hepatitis C virus (HCV) from Vietnam, Thailand and Indonesia (previously classified as types 7, 8, 9, 10 and 11) was re-analysed by the neighbour-joining method instead of the unweighted pair-group method with arithmetic mean (UPGMA) that was first used by the discoverers of these strains. The analysis of complete amino acid sequences and of nucleotide sequences of the envelope 1 (672 nt) and nonstructural 5B (1092 nt) genomic regions permitted the re-assignment of the type 7, 8, 9 and 1 1 isolates to type 6, and that of type 10 strains to type 3. Finally, this study made possible the classification of the previously described HCV strains (including these South-East Asian isolates) in six major types and at least 30 subtypes. It confirms that analysis of the E 1 and NS5B genomic regions using the neighbour-joining method is a reliable tool for the assignment of most new isolates.

COMPARATIVE SEQUENCE ANALYSIS OF AMERICAN, EUROPEAN AND ASIAN ISOLATES OF VIRUSES IN THE GENUS COLTIVIRUS

In this study, the basis for the classification of virus isolates grouped within the genus Coltivirus, family Reoviridae, is discussed. Sequences of dsRNA segments from American (segments 9-12), European (segment 12) and Asian (segments 7-12) isolates were characterized and polythetic criteria were defined for their taxonomic classification. These criteria (including sequence analysis) permitted the different species to be distinguished and classified into two groups. In both groups, subgroups were defined according to the degree of homology between the genomic sequences. American and European isolates are classified within group A, which includes subgroups A1 (Colorado tick fever virus species) and A2 (Eyach virus species). Asian isolates are classified in group B, which includes subgroups B1 (JKT-7075 virus species) and B2 (JKT-6423 virus species). The proteins encoded by the sequenced genomic segments were analysed. This allowed the identification of dsRNA binding domains in the proteins encoded by segment 8 of subgroup B1 isolates and segment 12 of subgroup B2 isolates. A conserved pattern of amino acids in segment 7 of group B isolates matched sequences found in the catalytic domains of protein kinases.

Arenaviruses and hantaviruses: From epidemiology and genomics to antivirals

The arenaviruses and hantaviruses are segmented genome RNA viruses that are hosted by rodents. Due to their association with rodents, they are globally widespread and can infect humans via direct or indirect routes of transmission, causing considerable human morbidity and mortality. Nevertheless, despite their obvious and emerging importance as pathogens, there are currently no effective antiviral drugs (except ribavirin which proved effective against Lassa virus) with which to treat humans infected by any of these viruses. The EU-funded VIZIER project (Comparative Structural Genomics of Viral Enzymes Involved in Replication) was instigated with an ultimate view of contributing to the development of antiviral therapies for RNA viruses, including the arenaviruses and bunyaviruses. This review highlights some of the major features of the arenaviruses and hantaviruses that have been investigated during recent years. After describing their classification and epidemiology, we review progress in understanding the genomics as well as the structure and function of replicative enzymes achieved under the VIZIER program and the development of new disease control strategies.

Isolation, genetic characterization, and seroprevalence of Adana virus, a novel phlebovirus belonging to the Salehabad virus complex, in Turkey.

ABSTRACT A new phlebovirus, Adana virus, was isolated from a pool of Phlebotomus spp. (Diptera; Psychodidae) in the province of Adana, in the Mediterranean region of Turkey. Genetic analysis based on complete coding of genomic sequences indicated that Adana virus belongs to the Salehabad virus species of the genus Phlebovirus in the family Bunyaviridae. Adana virus is the third virus of the Salehabad virus species for which the complete sequence has been determined. To understand the epidemiology of Adana virus, a seroprevalence study using microneutralization assay was performed to detect the presence of specific antibodies in human and domestic animal sera collected in Adana as well as Mersin province, located 147 km west of Adana. The results demonstrate that the virus is present in both provinces. High seroprevalence rates in goats, sheep, and dogs support intensive exposure to Adana virus in the region, which has not been previously reported for any virus included in the Salehabad serocomplex; however, low seroprevalence rates in humans suggest that Adana virus is not likely to constitute an important public health problem in exposed human populations, but this deserves further studies. IMPORTANCE Until recently, in the genus Phlebovirus, the Salehabad virus species consisted of two viruses: Salehabad virus, isolated from sand flies in Iran, and Arbia virus, isolated from sand flies in Italy. Here we present the isolation and complete genome characterization of the Adana virus, which we propose to be included in the Salehabad virus species. To our knowledge, this is the first report of the isolation and complete genome characterization, from sand flies in Turkey, of a Salehabad virus-related phlebovirus with supporting seropositivity in the Mediterranean, Aegean, and Central Anatolia regions, where phleboviruses have been circulating and causing outbreaks. Salehabad species viruses have generally been considered to be a group of viruses with little medical or veterinary interest. This view deserves to be revisited according to our results, which indicate a high animal infection rate of Adana virus and recent evidence of human infection with Adria virus in Greece.

Impact of diagnostic procedures on patient management and hospitalization cost during the 2000 and 2005 enterovirus epidemics in Marseilles, France

Enteroviruses are frequent aetiological agents of central nervous system infections in humans. In 2000 and 2005, two large outbreaks of Echovirus 30 (a member of species human enterovirus B) were observed in the University Hospitals of Marseilles (France). Between the two epidemics, the diagnostic protocols for enterovirus infection were modified, moving from viral cultures and classic RT-PCR in 2000 to real-time RT-PCR in 2005. We compared some viral and epidemiological characteristics of the 2000 and 2005 outbreaks with special attention to diagnostic procedures and to the subsequent clinical management of patients. Despite similar virological and epidemiological characteristics during both outbreaks, our results show that real-time RT-PCR techniques used in 2005 noticeably shortened the period of time necessary to deliver diagnostic results and suggest that this was associated with a decrease in the duration of hospitalization for positive cases. In conclusion, this study suggests that the improvement of enterovirus diagnosis had a major financial impact on the management of the 2005 epidemic in Marseilles and may constitute an interesting example of how new diagnostic methods in microbiology can be self-financed through improvement in patient management.