Mosquito-borne viruses in western Europe: a review.

Several mosquito-borne arboviruses belonging to the genera Alphavirus, Flavivirus, and Bunyavirus have been reported to occur in mosquitoes and to infect humans and other vertebrates in western Europe. These zoonotic viruses circulate in nature either in an Aedes-mammal, Anopheles-mammal, or Culex-bird transmission cycle. Infected humans normally do not contribute to the virus circulation. West Nile virus (Flavivirus) caused an outbreak of fever, malaise, pain in eyes and muscles, and headache and encephalitis in southern France during 1962-1965, and an outbreak of encephalitis with a high case-fatality rate in Romania during 1996. West Nile virus has been isolated from birds, horses, and mosquitoes in Portugal, France, the former Czechoslovakia, and Romania. These data, together with reports of antibodies to West Nile virus in birds, domestic mammals, and humans in several other countries, show virus activity in southern and central Europe. Sindbis virus (Alphavirus) caused outbreaks of fever, rash, and arthralgia in northern Europe during 1981-1982, 1988, and 1995. Two California group viruses (Bunyavirus), Tahyna virus and Inkoo virus, have been identified in western Europe. Tahyna virus causes fever and respiratory symptoms and sometimes also central nervous system involvement. It occurs in most countries of central and southern Europe, and is most common in central Europe. Inkoo virus has not been associated with disease in humans in western Europe although Russian studies indicated that it can cause encephalitis. Inkoo virus occurs in northern Europe, especially in the far north. Batai virus of the Bunyamwera-group (Bunyavirus) occurs in southern, central, and northern Europe, most frequently in central Europe. The antibody prevalence in humans generally is very low, indicating that the potential of this virus as a human pathogen is probably low in Europe. The Lednice virus (Bunyavirus) has been reported only from the former Czechoslovakia and Romania, and apparently is not transmitted to humans. In addition to the six mosquito-borne viruses documented in western Europe, there is serological evidence of infection with a Semliki Forest complex virus (Alphavirus) in central and southern Europe. Although mosquito-borne viruses presently are not considered to be the cause of major health problems in western Europe, the morbidity caused by Sindbis virus, and the morbidity and mortality caused by West Nile virus, merit further studies on the ecology, epidemiology, and medical importance of these viruses. The California group of viruses and a virus of the Semliki Forest complex may be the cause of unrecognized health problems in western Europe. Specific sampling of potential vectors for virus isolation, detailed characterization of virus strains, and the use of fully characterized strains for serological diagnosis will help to elucidate the present and future potential of mosquito-borne viruses as human pathogens in Europe.