Pathog Glob Health. 2014 Apr;108(3):148-57. doi: 10.1179/2047773214Y.0000000137.
A West Nile (WN) fever epidemic occurred in the region of Monastir, Tunisia, between August and October 2003.
We attempt to describe the epidemiology, clinical presentation, and outcome of patients with confirmed West Nile virus (WNV) infection.
Three groups of specimens were prepared. One was made up of serum only (n = 43), the other of cerebrospinal fluid (CSF) only (n = 30), and the third group was made up of both (n = 40). These specimens were obtained from 113 patients. A serological diagnosis and evidence of WNV genome by nested reverse-transcriptase polymerase chain reaction (nRT-PCR) and TaqMan reverse transcription-polymerase chain reaction (RT-PCR) were carried out.
Thirty-eight cases (33.6%) were serologically positive. Results of nRT-PCR showed a total of 10 positive cases of WNV (8.8%) detected in group 1 (n = 1/43), group 2 (n = 5/30), and group 3 (n = 4/40) whereas the PCR TaqMan showed 18 positive samples (15.9%) found in group 1 (n = 3/43), group 2 (n = 9/30), and group 3 (n = 6/40). All TaqMan PCR positive cases were nRT-PCR positive. In addition, four serologically probable cases were confirmed by TaqMan PCR. The attempts to isolate WNV by cell culture were unsuccessful. Considering the results of TaqMan assay and the serological diagnosis, WNV infection was confirmed in a total of 42 patients. The main clinical presentations were meningoencephalitis (40%), febrile disease (95%), and meningitis (36%). Eight patients (19%) died. The highest case-fatality rates occurred among patients aged ≧55 years. The phylogenetic analysis revealed that isolates of WNV were closely related to the Tunisian strain 1997 (PAH001) and the Israeli one (Is-98).
West Nile virus is a reemerging global pathogen that remains an important public health challenge in the next decade.
2003 年 8 月至 10 月，突尼斯莫纳斯提尔地区发生了西尼罗河（WN）热疫情。
我们试图描述经确认感染西尼罗河病毒（WNV）患者的流行病学、临床表现和转归。
准备了三组标本。一组仅为血清（n=43），另一组仅为脑脊液（CSF）（n=30），第三组为两者都有（n=40）。这些标本取自 113 名患者。进行了血清学诊断和通过巢式逆转录聚合酶链反应（nRT-PCR）和 TaqMan 逆转录聚合酶链反应（RT-PCR）检测 WNV 基因组的证据。
38 例（33.6%）血清学阳性。nRT-PCR 结果显示，在第 1 组（n=1/43）、第 2 组（n=5/30）和第 3 组（n=4/40）中总共发现了 10 例 WNV（8.8%）阳性病例，而 PCR TaqMan 显示第 1 组（n=3/43）、第 2 组（n=9/30）和第 3 组（n=6/40）中发现了 18 个阳性样本（15.9%）。所有 TaqMan PCR 阳性病例均为 nRT-PCR 阳性。此外，通过 TaqMan PCR 确认了 4 例血清学可能病例。通过细胞培养分离 WNV 的尝试均未成功。考虑到 TaqMan 检测和血清学诊断的结果，共有 42 例患者确诊为 WNV 感染。主要临床特征为脑膜脑炎（40%）、发热性疾病（95%）和脑膜炎（36%）。8 例（19%）患者死亡。发病率最高的病例发生在年龄≧55 岁的患者中。系统发育分析显示，WNV 分离株与 1997 年突尼斯株（PAH001）和以色列株（Is-98）密切相关。
西尼罗河病毒是一种重新出现的全球病原体，在未来十年仍将是公共卫生的重要挑战。
