Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Dec;24(50):1900051.
doi: 10.2807/1560-7917.ES.2019.24.50.1900051.

Toscana, West Nile, Usutu and tick-borne encephalitis viruses: external quality assessment for molecular detection of emerging neurotropic viruses in Europe, 2017

Chantal Reusken  1   2 , Cecile Baronti  3 , Ramona Mögling  1 , Anna Papa  4 , Katrin Leitmeyer  5 , Remi N Charrel  3
Affiliations

Toscana, West Nile, Usutu and tick-borne encephalitis viruses: external quality assessment for molecular detection of emerging neurotropic viruses in Europe, 2017

Chantal Reusken et al. Euro Surveill. 2019 Dec.

Abstract

BackgroundNeurotropic arboviruses are increasingly recognised as causative agents of neurological disease in Europe but underdiagnosis is still suspected. Capability for accurate diagnosis is a prerequisite for adequate clinical and public health response.AimTo improve diagnostic capability in EVD-LabNet laboratories, we organised an external quality assessment (EQA) focusing on molecular detection of Toscana (TOSV), Usutu (USUV), West Nile (WNV) and tick-borne encephalitis viruses (TBEV).MethodsSixty-nine laboratories were invited. The EQA panel included two WNV RNA-positive samples (lineages 1 and 2), two TOSV RNA-positive samples (lineages A and B), one TBEV RNA-positive sample (Western subtype), one USUV RNA-positive sample and four negative samples. The EQA focused on overall capability rather than sensitivity of the used techniques. Only detection of one, clinically relevant, concentration per virus species and lineage was assessed.ResultsThe final EQA analysis included 51 laboratories from 35 countries; 44 of these laboratories were from 28 of 31 countries in the European Union/European Economic Area (EU/EEA). USUV diagnostic capability was lowest (28 laboratories in 18 countries), WNV detection capacity was highest (48 laboratories in 32 countries). Twenty-five laboratories were able to test the whole EQA panel, of which only 11 provided completely correct results. The highest scores were observed for WNV and TOSV (92%), followed by TBEV (86%) and USUV (75%).ConclusionWe observed wide variety in extraction methods and RT-PCR tests, showing a profound absence of standardisation across European laboratories. Overall, the results were not satisfactory; capacity and capability need to be improved in 40 laboratories.

Keywords: arbovirus; central nervous system; diagnostic capacity; emerging; encephalitis; external quality assessment, Toscana virus, TOSV, Usutu, USUV, West Nile, WNV, tick-borne encephalitis, TBE; meningitis.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Number of laboratories per country that provided results for Toscana virus, external quality assessment for molecular detection of emerging neurotropic viruses, Europe (n = 32 laboratories)
Figure 2
Figure 2
Number of laboratories per country that provided results for West Nile virus, external quality assessment for molecular detection of emerging neurotropic viruses, Europe (n = 48 laboratories)
Figure 3
Figure 3
Number of laboratories per country that provided results for Usutu virus, external quality assessment for molecular detection of emerging neurotropic viruses, Europe (n = 28 laboratories)
Figure 4
Figure 4
Number of laboratories per country that provided results for tick-borne encephalitis virus, external quality assessment for molecular detection of emerging neurotropic viruses, Europe (n = 42 laboratories)
See this image and copyright information in PMC

References

    1. Glaser C, Bloch K. Encephalitis: why we need to keep pushing the envelope. Clin Infect Dis. 2009;49(12):1848-50. 10.1086/648420 - DOI - PubMed
    1. Papa A, Kotrotsiou T, Papadopoulou E, Reusken C, GeurtsvanKessel C, Koopmans M. Challenges in laboratory diagnosis of acute viral central nervous system infections in the era of emerging infectious diseases: the syndromic approach. Expert Rev Anti Infect Ther. 2016;14(9):829-36. 10.1080/14787210.2016.1215914 - DOI - PubMed
    1. Reusken CBEM, Ieven M, Sigfrid L, Eckerle I, Koopmans M. Laboratory preparedness and response with a focus on arboviruses in Europe. Clin Microbiol Infect. 2018;24(3):221-8. 10.1016/j.cmi.2017.12.010 - DOI - PubMed
    1. Alkan C, Bichaud L, de Lamballerie X, Alten B, Gould EA, Charrel RN. Sandfly-borne phleboviruses of Eurasia and Africa: epidemiology, genetic diversity, geographic range, control measures. Antiviral Res. 2013;100(1):54-74. 10.1016/j.antiviral.2013.07.005 - DOI - PubMed
    1. Marchi S, Trombetta CM, Kistner O, Montomoli E. Seroprevalence study of Toscana virus and viruses belonging to the Sandfly fever Naples antigenic complex in central and southern Italy. J Infect Public Health. 2017;10(6):866-9. 10.1016/j.jiph.2017.02.001 - DOI - PubMed

MeSH terms

Supplementary concepts

LinkOut - more resources