EFSA J. 2025 Aug 29;23(8):e9624. doi: 10.2903/j.efsa.2025.9624. eCollection 2025 Aug.
In 2025, and as of 6 August 2025, 6 countries in Europe reported 202 locally acquired human cases of WNV infection with known place of infection. The earliest and latest date of onset were respectively on 2 June 2025 and 2 August 2025. Locally acquired cases were reported by (168), (26), (3, of which 1 with unknown place of infection), (3), (1) and (1). In Europe, 10 deaths were reported. Case numbers reported so far this year are slightly above the average for the past decade in the same period (163). However, these figures remain lower than those seen in 2024 and 2018-years when virus circulation was particularly intense, with 382 and 385 cases reported by this point in the year, respectively. As of 6 August, locally acquired human cases of West Nile virus (WNV) infection have been reported in 40 regions across six countries. This compares with 108 regions (11 countries) during the same period in 2024 and 68 regions in 2018 (seven countries). All six countries have previously reported human cases of WNV. Italy is currently experiencing a significant outbreak, with 168 confirmed human infections, including 10 fatalities. For the first time in Italy, the provinces of Latina (ITI44) and Frosinone (ITI45) have reported human cases. Similarly, Romania has reported its first cases in Sălaj County (RO116). As observed in previous years, most cases were among males aged 65 years and older. The hospitalisation rate was high compared with previous years, with 100% of cases hospitalised this year compared to 93% in the past decade. That most cases are hospitalised is most likely due to the nature of WNV surveillance, which tends to predominantly capture the most severe cases. The case fatality rate so far this year is 7%, which is comparable to the 11% observed in the previous decade. Neurological manifestations were reported in 56% of cases this year compared to 66% in the previous decade. In general, a dominance of neurological cases is expected, as cases with more severe symptoms are more likely to be diagnosed. From the veterinary perspective, 16 WNV outbreaks among equids and 20 outbreaks among birds have been reported in Europe in 2025. The earliest start date of an outbreak among equids and birds was on 15 January 2025 in Germany and 16 February 2025 in Italy, while the latest onset of an outbreak among equids and birds was, respectively, on 29 July 2025 in Italy and 29 July 2025 in Austria. Outbreaks among equids were reported by (11), (2), (1), (1) and (1). Outbreaks among birds were reported by (19) and (1). In the Animal Disease Information System (ADIS) database no information was provided on the exact equid species reported, whereas species details were available for birds. The following bird species were associated with the reported outbreaks: common magpie (4), common kestrel (4), carrion crow (3), herring gull (3), hooded crow (3), common moorhen (1), rock dove (1), and unidentified Columbidae (1). In June and July 2025, the monthly number of outbreaks in equids slightly exceeded the 10-year mean (2015-2024) of June and July, while the monthly count for outbreaks in birds from March to July 2025 fell below the historical monthly mean, with a marked decline in July 2025. In 2024, up to 6 August, 38 and 132 outbreaks were reported in equids and birds, respectively, which is notably higher than the number of outbreaks reported during the same period in 2025. As of 6 August 2025, outbreaks in birds and/or equids have been reported in 23 regions across six countries. This compares with 47 regions (eight countries) during the same period in 2024 and 16 regions (three countries) in 2018. All six countries reported WNV outbreaks in birds and/or equids in 2024 and in prior years, reflecting endemic WNV activity in these territories. However, as of 6 August, outbreaks in birds and/or equids were reported for the first time to ADIS in the following three Italian provinces: Foggia (ITF46), L'Aquila (ITF11), and Lecco (ITC43). Additionally, equid outbreaks were reported for the first time by Greece in Aetolia-Acarnania (EL631) and Kavala (EL515), and by Spain in Almería (ES611). Reports of WNV outbreaks during the winter, when mosquito activity is minimal, should be carefully evaluated as they raise questions about the timing of infection. Two such reports - one outbreak in equids reported by Germany in January, and one in birds reported by Italy in February - warrant cautious interpretation, as they may reflect residual detection (e.g. lingering antibodies or viral RNA from infections acquired in the year before) rather than active transmission in 2025. Three countries - Italy, Greece and Hungary - reported both WNV human cases and outbreaks in equids and birds. As of 6 August 2025, Italy accounted for 83% of all reported human cases and all reported outbreaks in equids and birds, underscoring the significant WNV activity in the country. This is likely due to favourable climate conditions and ecological hotspots (e.g. wetlands, agricultural areas) that support WNV transmission by influencing mosquito vector populations and host dynamics. Intensive surveillance in Italy may also contribute to high detection rates of human cases and outbreaks in birds and equids. The identification of WNV cases in humans and animals within previously unaffected areas underscores the ongoing geographic expansion of the virus, which is most likely due to environmental, climatic and ecological changes. In addition, increased surveillance or monitoring sensitivity and raised awareness in these areas might play a role in the detection of the cases. Owing to delays in diagnosis and reporting, as well as the fact that most of the WNV infections are asymptomatic or subclinical, the case numbers provided in this report likely underestimate the true number of cases. Of note, the seasonal surveillance in humans primarily focuses on capturing laboratory-confirmed cases, which contributes to the diagnostic delay. Given the favourable weather conditions for WNV transmission in Europe, we expect that the number of human cases and outbreaks in equids and birds will continue to raise in the coming weeks. In previous years, the peak of transmission was observed in August-September. Both ECDC and EFSA will follow-up closely on the situation in Europe, in particular regarding severity indicators.
2025年,截至8月6日,欧洲6个国家报告了202例有明确感染地点的本地感染西尼罗河病毒(WNV)的人类病例。最早和最晚发病日期分别为2025年6月2日和8月2日。报告本地感染病例的国家有(168例)、(26例)、(3例,其中1例感染地点不明)、(3例)、(1例)和(1例)。在欧洲,报告了10例死亡病例。今年迄今为止报告的病例数略高于过去十年同期的平均水平(163例)。然而,这些数字仍低于2024年和2018年——这两年病毒传播特别强烈,当年此时分别报告了382例和385例病例。截至8月6日,六个国家的40个地区报告了本地感染西尼罗河病毒的人类病例。相比之下,2024年同期有108个地区(11个国家)报告了病例,2018年有68个地区(7个国家)报告了病例。所有六个国家此前均报告过WNV人类病例。意大利目前正在经历一次重大疫情,有168例确诊的人类感染病例,包括10例死亡病例。意大利首次在拉齐奥省(ITI44)和弗罗西诺内省(ITI45)报告了人类病例。同样,罗马尼亚在萨拉伊县(RO116)报告了首例病例。如前几年所观察到的,大多数病例发生在65岁及以上的男性中。与前几年相比,住院率较高,今年100%的病例住院,而过去十年为93%。大多数病例住院很可能是由于WNV监测的性质,该监测往往主要捕获最严重病例。今年迄今为止的病死率为7%,与前十年观察到的11%相当。今年56%的病例报告有神经症状,而前十年为66%。一般来说,预计神经病例会占主导,因为症状更严重的病例更有可能被诊断出来。从兽医角度来看,2025年欧洲报告了16起马属动物WNV疫情和20起鸟类疫情。马属动物和鸟类疫情最早开始日期分别为2025年1月15日的德国和2月16日的意大利,而马属动物和鸟类疫情最晚发病日期分别为2025年7月29日的意大利和奥地利。报告马属动物疫情的国家有(11起)、(2起)、(1起)、(1起)和(1起)。报告鸟类疫情的国家有(19起)和(1起)。在动物疾病信息系统(ADIS)数据库中,未提供所报告马属动物的确切物种信息,而鸟类的物种详细信息是可用的。与报告的疫情相关的鸟类物种如下:喜鹊(4起)、普通红隼(4起)、小嘴乌鸦(3起)、银鸥(3起)、冠小嘴乌鸦(3起)、黑水鸡(1起)、岩鸽(1起)和未鉴定的鸽科(1起)。2025年6月和7月,马属动物疫情的月数量略超过2015 - 2024年6月和7月的十年平均值,而2025年3月至7月鸟类疫情的月数量低于历史月平均值,2025年7月明显下降。2024年截至8月6日,马属动物和鸟类分别报告了38起和132起疫情,明显高于2025年同期报告的疫情数量。截至2025年8月6日,六个国家的23个地区报告了鸟类和/或马属动物疫情。相比之下,2024年同期有47个地区(8个国家)报告了疫情,2018年有16个地区(3个国家)报告了疫情。所有六个国家在2024年及此前年份均报告过鸟类和/或马属动物的WNV疫情,反映出这些地区存在WNV地方流行活动。然而,截至8月6日,意大利的以下三个省份首次向ADIS报告了鸟类和/或马属动物疫情:福贾(ITF46)、拉奎拉(ITF11)和莱科(ITC43)。此外,希腊在埃托利亚 - 阿卡纳尼亚(EL631)和卡瓦拉(EL515)首次报告了马属动物疫情,西班牙在阿尔梅里亚(ES611)首次报告了马属动物疫情。在蚊子活动极少的冬季报告WNV疫情时应仔细评估,因为这引发了关于感染时间的问题。两份这样的报告——德国1月报告的一起马属动物疫情和意大利2月报告的一起鸟类疫情——需要谨慎解读,因为它们可能反映的是残留检测(例如前一年感染残留的抗体或病毒RNA)而非2025年的活跃传播。三个国家——意大利、希腊和匈牙利——报告了WNV人类病例以及马属动物和鸟类疫情。截至2025年8月6日,意大利占所有报告人类病例以及所有报告的马属动物和鸟类疫情的83%,凸显了该国显著的WNV活动。这可能是由于有利的气候条件和生态热点地区(如湿地、农业区),通过影响蚊媒种群和宿主动态来支持WNV传播。意大利的强化监测也可能导致人类病例以及鸟类和马属动物疫情的高检出率。在以前未受影响地区发现人类和动物的WNV病例凸显了该病毒正在进行的地理扩张,这很可能是由于环境、气候和生态变化。此外,这些地区监测或监测敏感性的提高以及意识的增强可能在病例检测中发挥了作用。由于诊断和报告的延迟,以及大多数WNV感染无症状或为亚临床感染这一事实,本报告提供的病例数可能低估了实际病例数。值得注意的是,人类的季节性监测主要侧重于捕获实验室确诊病例,这导致了诊断延迟。鉴于欧洲有利于WNV传播的天气条件,我们预计未来几周人类病例以及马属动物和鸟类疫情的数量将继续上升。在前几年,传播高峰出现在8 - 9月。欧洲疾病预防控制中心(ECDC)和欧洲食品安全局(EFSA)都将密切关注欧洲的情况,特别是关于严重程度指标。