Molecular Virology Unit, Microbiology and Virology Department, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy.
Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy.
Viruses. 2021 Jan 29;13(2):209. doi: 10.3390/v13020209.
Phleboviruses transmitted by phlebotomine sandflies are endemic in the Mediterranean basin. (TOSV), (SFSV), and (SFNV) are responsible of summer fever, with well-known pathogenic potential for humans ranging from asymptomatic to mild fever, in addition to neuro-invasive infections during summer. Although TOSV, in particular, is a significant and well-known human pathogen, SFVs remain neglected, with many gaps in the relevant knowledge. Sero-epidemiological studies and case reports recently showed a geographical wider distribution than previously considered, although the real incidence of phleboviruses infections in the Mediterranean area is still unknown. Here we retrospectively evaluated the circulation of phleboviruses during summer seasons between 2007 and 2019 in 649 patients showing neurological symptoms using both molecular and serological approaches. We found that 42/649 (6.5%) subjects experienced phlebovirus infection and only 10/42 cases were detected by molecular assays, whereas the other 32/42 were identified using serological approaches, including neutralization assays. During the 2013 summer, an outbreak in the Lombardy region is described because the prevalence of phlebovirus infection reached 37.2% (19/51 subjects). Interestingly, only 5/19 (26.5%) reported traveling in endemic areas. Of note, no cross-neutralization was observed between different strains tested, showing the possibility to be reinfected by newly discovered phlebovirus strains. In conclusion, phlebovirus infections are still inadequately considered by physicians and are generally underestimated. However, based on our results, sandfly fever viruses should be routinely included in diagnostic panels during summer period, including in Northern Italy.
通过白蛉传播的沙蝇病毒在地中海盆地流行。（TOSV）、（SFSV）和（SFNV）是夏季发热的罪魁祸首，对人类的致病性潜在风险从无症状到轻度发热不等，此外在夏季还会引起神经侵袭性感染。尽管 TOSV 特别是一种重要且众所周知的人类病原体，但 SFV 仍然被忽视，相关知识存在许多空白。最近的血清流行病学研究和病例报告显示，其地理分布范围比以前认为的更广，尽管地中海地区沙蝇病毒感染的真实发病率仍不清楚。在这里，我们使用分子和血清学方法回顾性评估了 2007 年至 2019 年夏季期间 649 例出现神经系统症状患者中沙蝇病毒的循环情况。我们发现 42/649（6.5%）患者发生了沙蝇病毒感染，其中只有 10/42 例通过分子检测方法检出，而其他 32/42 例通过血清学方法，包括中和试验检出。在 2013 年夏季，描述了一次在伦巴第地区爆发的疫情，因为沙蝇病毒感染的患病率达到 37.2%（51 例患者中的 19 例）。有趣的是，只有 5/19（26.5%）报告曾前往流行地区旅行。值得注意的是，在测试的不同菌株之间没有观察到交叉中和，表明有再次感染新发现的沙蝇病毒株的可能性。总之，沙蝇病毒感染仍然被医生低估，通常被低估。然而，根据我们的结果，在夏季期间，包括在意大利北部，应常规将沙蝇热病毒纳入诊断组合中。
