Emergence of Toscana virus in Europe - PubMed (original) (raw)

Review

Emergence of Toscana virus in Europe

Rémi N Charrel et al. Emerg Infect Dis. 2005 Nov.

Abstract

Toscana virus (TOSV) is an arthropod-borne virus first identified in 1971 from the sandfly Phlebotomus perniciosus in central Italy. Many case reports in travelers and clinical research and epidemiologic studies conducted around the Mediterranean region have shown that TOSV has a tropism for the central nervous system (CNS) and is a major cause of meningitis and encephalitis in countries in which it circulates. In central Italy, TOSV is the most frequent cause of meningitis from May to October, far exceeding enteroviruses. In other northern Mediterranean countries, TOSV is among the 3 most prevalent viruses associated with meningitis during the warm seasons. Therefore, TOSV must be considered an emerging pathogen. Here, we review the epidemiology of TOSV in Europe and determine questions that should be addressed in future studies. Despite increasing evidence of its major role in medicine as an emerging cause of CNS infections, TOSV remains an unstudied pathogen, and few physicians are aware of its potential to cause CNS infections.

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Figures

Figure 1

Figure 1

Provinces of Italy and Spain in which clinical cases of Toscana virus (TOSV) infection have been documented, and seroprevalence studies were conducted. PCR, polymerase chain reaction; IgM, immunoglobulin M.

Figure 2

Figure 2

Phylogenetic trees reconstructed from nucleotide (A) and amino acid (B) sequences corresponding to a 236-nucleotide fragment of the N gene. Alignments were obtained with ClustalX 1.8 and p-distance matrices were obtained. Neighbor-joining by using 100 pseudoreplications for the bootstrap tests were carried out after excluding gaps from the alignments. Bootstrap values <75% are not shown. The numbers attached to branches are bootstrap values. A value of 0.05 substitutions per site is equivalent to 5% changes.

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