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. 2024 Dec 25;17(1):15.
doi: 10.3390/v17010015.

Epidemiology and Ecology of Toscana Virus Infection and Its Global Risk Distribution

Xue-Geng Hong  1   2 , Mei-Qi Zhang  1 , Fang Tang  3 , Si-Hui Song  1 , Jia-Yi Wang  1 , Zhen-Yu Hu  4 , Li-Ming Liu  5 , Xiao-Ai Zhang  1 , Yi Sun  1 , Li-Qun Fang  1 , Wei Liu  1   4
Affiliations

Epidemiology and Ecology of Toscana Virus Infection and Its Global Risk Distribution

Xue-Geng Hong et al. Viruses. .

Abstract

Toscana virus (TOSV), a member of the Phlebovirus genus transmitted by sandflies, is acknowledged for its capacity to cause neurological infections and is widely distributed across Mediterranean countries. The potential geographic distribution and risk to the human population remained obscure due to its neglected nature. We searched PubMed and Web of Science for articles published between 1 January 1971 and 30 June 2023 to extract data on TOSV detection in vectors, vertebrates and humans, clinical information of human patients, as well as the occurrence of two identified sandfly vectors for TOSV. We further predicted the global distribution of the two sandfly vectors, based on which the global risk of TOSV was projected, after incorporating the environmental, ecoclimatic, biological, and socioeconomic factors. A total of 1342 unique studies were retrieved, among which 389 met the selection criteria and were included for data extraction. TOSV infections were documented in 10 sandfly species and 14 species of vertebrates, as well as causing a total of 7571 human infections. The occurrence probabilities of two sandfly vectors have demonstrated the greatest contributions to the potential distribution of TOSV infection risk. This study provides a comprehensive overview of global TOSV distribution and potential risk zones. Future surveillance and intervention programs should prioritize high-risk areas based on updated quantitative analyses.

Keywords: Phlebovirus; Toscana virus; machine learning; sandfly.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of the literature review process.
Figure 2
Figure 2
Publications on TOSV detection in humans, vectors, and vertebrates collected up to June 2023. (a) Annual distribution of TOSV-related publications by host type. (b) Reported countries with confirmed TOSV infections in vertebrates, vectors, and human beings. (c) Distribution of local confirmed human infections. The year indicated beneath each country’s name represents the earliest documented instance of confirmed infections in humans, as derived from published sources. For human patients, only those with laboratory-confirmed infections were included. TOSV, Toscana virus.
Figure 3
Figure 3
Global distribution of TOSV infections: (a) in humans and (b) human-imported cases. The purple circles represent imported cases, with the size of each circle indicating the number of imported cases, as indicated on the right side. The orange-red arrows depict the path from the source countries to importing countries, with their opacity representing the number of imported cases. (c) In vectors and (d) in vertebrates. TOSV, Toscana virus.
Figure 4
Figure 4
Occurrence probability of TOSV infection and relative contributions (RCs) of the significant predictors (RC > 5%) based on the BRT models: (a) predicted risk distribution of TOSV infection (latitude 10° N–65° N, longitude 20° W–70° E); (b) RCs of predictors for TOSV infection; (c) response curve of predictors in BRT models for TOSV infection. Mean curves (red) and 95% percentiles (grey) show the contribution to predicting the probability of occurrence. The histograms show the frequency distributions of the predictors. TOSV, Toscana virus; RC, relative contribution; BRT, Boosted Regression Tree.
See this image and copyright information in PMC

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