Zoonotic Arbo-and Respiratory Virus (ZARV) program, Centre for Viral Zoonoses (CVZ), University of Pretoria, Pretoria, South Africa.
Department of Paraclinical Sciences, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa.
PLoS Negl Trop Dis. 2022 Jan 3;16(1):e0010020. doi: 10.1371/journal.pntd.0010020. eCollection 2022 Jan.
The Old world Alphavirus, Middelburg virus (MIDV), is not well known and although a few cases associated with animal illness have previously been described from Southern Africa, there has been no investigation into the association of the virus with human illness. The current study aimed to investigate possible association of MIDV infection with febrile or neurological manifestations in hospitalized or symptomatic patients fromGauteng, South Africa.
This study is a descriptive retrospective and prospective laboratory based study. Archived cerebrospinal fluid (CSF) samples submitted to the National Health Laboratory Service (NHLS), Tshwane Academic division for viral investigation from public sector hospitals in Gauteng as well as EDTA (ethylenediaminetetraacetic acid) whole blood samples from ad hoc cases of veterinary students, presenting with neurological and febrile illness, were selected and screened for the presence of alphaviruses using real-time reverse transcription(rtRT) PCR.Virus isolations from rtRT-PCR positive samples were conducted in Vero cell culture and used to obtain full genome sequences. Basic descriptive statistical analysis was conducted using EpiInfo.
MIDV was detected by rtRT-PCR in 3/187 retrospective CSF specimens obtained from the NHLS from hospitalised patients in the Tshwane region of Gauteng and 1/2 EDTA samples submitted in the same year (2017) from ad hoc query arbovirus cases from veterinary students from the Faculty of Veterinary Science University of Pretoria.Full genome sequences were obtained for virus isolates from two cases; one from an EDTA whole blood sample (ad hoc case) and another from a CSF sample (NHLS sample).Two of the four Middelburg virus positive cases,for which clinical information was available, had other comorbidities or infections at the time of infection.
Detection of MIDV in CSF of patients with neurological manifestations suggests that the virus should be investigated as a human pathogen with the potential of causing or contributing to neurological signs in children and adults.
旧世界阿尔巴病毒，米德尔堡病毒（MIDV）并不为人所知，尽管以前在南非曾有几例与动物疾病相关的病例描述，但尚未对该病毒与人类疾病的关联进行调查。本研究旨在调查 MIDV 感染与南非豪登省住院或有症状患者发热或神经系统表现之间的可能关联。
这是一项描述性回顾性和前瞻性基于实验室的研究。从豪登省公立医院的国家卫生实验室服务（NHLS），比勒陀利亚学术分部提交的存档脑脊液（CSF）样本以及兽医学生出现神经系统和发热性疾病的特殊情况下的 EDTA（乙二胺四乙酸）全血样本，选择并使用实时逆转录（rtRT）PCR 筛选用于检测阿尔法病毒。从 rtRT-PCR 阳性样本中进行病毒分离，并在 Vero 细胞培养中进行，以获得全长基因组序列。使用 EpiInfo 进行基本描述性统计分析。
在豪登省 Tshwane 地区 NHLS 从住院患者获得的 187 份回顾性 CSF 标本中的 3 份和同年（2017 年）从比勒陀利亚兽医科学大学兽医学院特殊查询虫媒病毒病例提交的 1 份 EDTA 样本中，通过 rtRT-PCR 检测到 MIDV。从两个病例（一个来自 EDTA 全血样本（特殊病例），另一个来自 NHLS 样本）获得了病毒分离物的全长基因组序列。在有临床信息的 4 个 Middelburg 病毒阳性病例中，有 2 个在感染时患有其他合并症或感染。
在有神经系统表现的患者的 CSF 中检测到 MIDV 表明，该病毒应作为人类病原体进行调查，有可能导致或导致儿童和成人出现神经系统症状。
