Alhan Özlem, Koç Meliha Meriç, Batırel Ayşe, Yılmaz Emel, Ersöz Gülden, Aydın Mehtap, Doğan Merve Üstüner, Konya Hande Hazır, Kayabaş Üner, Kuşçu Ferit, Karakoç Zehra Çağla, Özdemir Meryem Şahin, Elibol Ali Okay, Kazak Esra, Karaca İdil, Kuşkucu Mert Ahmet, Ergönül Önder
Infectious Diseases and Clinical Microbiology, Koç University Hospital, İstanbul, Türkiye.
Infectious Diseases and Clinical Microbiology, Başakşehir Çam and Sakura City Hospital, İstanbul, Türkiye.
Eur J Clin Microbiol Infect Dis. 2025 Apr 28. doi: 10.1007/s10096-025-05135-3.
Türkiye experienced its largest West Nile virus (WNV) infection outbreak in 2024. We described the clinical and laboratory features of human cases with WNV infection collected from eleven tertiary hospitals in Türkiye in 2024.
The clinical characteristics of the patients were gathered using a structured form in the retrospective study. According to the ECDC case definition of WNV infections, the patients were classified as 'confirmed' or 'probable' cases. The odds ratio (OR) and 95% confidence interval (CI) for possible mortality predictors in WNV infections were calculated using multivariate logistic regression analysis. p < 0.05 was considered statistically significant.
The mean age of the 51 patients was 63.3 ± 13.6 years, and 37 (72.5%) were male. Twenty-six cases (51%) were confirmed, and 49% were probable WNV infection. Forty-eight patients (94.1%) had WNV neuroinvasive disease: 24 (47%) were diagnosed with meningoencephalitis, 20 (39.2%) with encephalitis, one (2%) with meningitis, and seven (13.7%) with acute flaccid paralysis. Twenty patients (39.2%) had movement disorders (tremor, myoclonus, bradykinesia, or rigidity). The case fatality rate was 17.6%. In multivariate analysis, older age (OR: 1.09, CI: 1.03-1.19, p = 0.042) and secondary bacterial infection during hospitalization (OR: 10, CI: 1.55-64.95, p = 0.015) were associated with fatality.
We highlighted the increasing number of cases and diagnostic challenges by describing the highest number of the patients with WNV infections in Türkiye. Raising awareness among healthcare professionals, facilitating access to diagnostic tests, and developing rapid, reliable, and easily applicable tests would enable early diagnosis and help improve outcomes.
土耳其在2024年经历了最大规模的西尼罗河病毒(WNV)感染疫情。我们描述了2024年从土耳其11家三级医院收集的WNV感染人类病例的临床和实验室特征。
在回顾性研究中,使用结构化表格收集患者的临床特征。根据欧洲疾病预防控制中心(ECDC)的WNV感染病例定义,将患者分类为“确诊”或“可能”病例。使用多因素逻辑回归分析计算WNV感染中可能的死亡预测因素的比值比(OR)和95%置信区间(CI)。p < 0.05被认为具有统计学意义。
51例患者的平均年龄为63.3±13.6岁,其中37例(72.5%)为男性。26例(51%)为确诊病例,49%为可能的WNV感染。48例患者(94.1%)患有WNV神经侵袭性疾病:24例(47%)被诊断为脑膜脑炎,20例(39.2%)为脑炎,1例(2%)为脑膜炎,7例(13.7%)为急性弛缓性麻痹。20例患者(39.2%)有运动障碍(震颤、肌阵挛、运动迟缓或僵硬)。病死率为17.6%。在多因素分析中,年龄较大(OR:1.09,CI:1.03 - 1.19,p = 0.042)和住院期间继发细菌感染(OR:10,CI:1.55 - 64.95,p = 0.015)与死亡相关。
通过描述土耳其WNV感染患者数量最多的情况,我们强调了病例数量的增加和诊断挑战。提高医疗专业人员的认识、促进诊断测试的可及性以及开发快速、可靠且易于应用的测试将有助于早期诊断并改善结果。