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To prevent the emergence of zoonotic infectious diseases and reduce their epidemic potential, we need to understand their origins in nature. Bats in the order Chiroptera are widely distributed worldwide and are natural reservoirs of prominent zoonotic viruses, including Nipah virus, Marburg virus, and possibly SARS-CoV-2. In this study, we applied unbiased metagenomic and metatranscriptomic approaches to decipher the virosphere of frugivorous and insectivorous bat species captured in Guéckédou, Guinea, the epicenter of the West African Ebola virus disease epidemic in 2013–2016. Our study provides a snapshot of the viral diversity present in these bat species, with several novel viruses reported for the first time in bats, as well as some bat viruses closely related to known human or animal pathogens. In addition, analysis of Mops condylurus genomic DNA samples revealed the presence of an Ebola virus nucleoprotein (NP)-derived pseudogene inserted in its genome. These findings provide insight into the evolutionary traits of several virus families in bats and add evidence that nonretroviral integrated RNA viruses (NIRVs) derived from filoviruses may be common in bat genomes.

Dengue virus sequences used in this study were obtained from two Iranian patients who were both with a history of traveling to Malaysia. The maximum likelihood phylogenetic tree demonstrated that two sequences were grouped into dengue virus 1. Specifically, strains Iran-DF1 and Iran-DF2 clustered in genotype I and III, respectively.

Usutu virus (USUV) is an arbovirus within the genus flavivirus, which was first introduced to Southern Europe approximately twenty years ago causing epizootics among wild and captive birds. In Germany USUV was initially discovered in wild birds, mainly Common blackbirds (Turdus merula), in the Upper Rhine valley in southwest of the country in 2011 and has not spread much northwards since. Phylogenetic analyses revealed that the still ongoing USUV epidemic is caused by two different USUV strains, USUV-Germany belonging to the USUV Europe 3 lineage and USUV-Bonn belonging to the USUV Africa 3 lineage. The two strains were introduced independently. In August 2015 a new USUV strain, named USUV-Berlin, was isolated in Vero cells from two carcasses of juvenile Great grey owls (Strix nebulosa) kept in the Zoological Garden Berlin, which had suffered from a hyperacute fatal systemic infection. Both owls carried high USUV genome loads. Full-length USUV genomes sequences were determined and phylogenetic analysis demonstrated a close relationship with a Spanish mosquito-derived sequence from 2006. Immunohistochemical antigen detection in organ samples of the owls showed the typical USUV infection patterns. According to the phylogenetic analysis, USUV-Berlin belongs to the Africa 2 lineage, and can thus be distinguished from the other strains circulating in Germany. Repeated findings of different USUV strains suggest more frequent introductions into Central Europe and a higher mobility of this virus than assumed to date.

BACKGROUND: The replication-competent recombinant vesicular stomatitis virus (rVSV)-based vaccine expressing a Zaire ebolavirus (ZEBOV) glycoprotein was selected for rapid safety and immunogenicity testing before its use in West Africa. METHODS: We performed three open-label, dose-escalation phase 1 trials and one randomized, double-blind, controlled phase 1 trial to assess the safety, side-effect profile, and immunogenicity of rVSV-ZEBOV at various doses in 158 healthy adults in Europe and Africa. All participants were injected with doses of vaccine ranging from 300,000 to 50 million plaque-forming units (PFU) or placebo. RESULTS: No serious vaccine-related adverse events were reported. Mild-to-moderate early-onset reactogenicity was frequent but transient (median, 1 day). Fever was observed in up to 30% of vaccinees. Vaccine viremia was detected within 3 days in 123 of the 130 participants (95%) receiving 3 million PFU or more; rVSV was not detected in saliva or urine. In the second week after injection, arthritis affecting one to four joints developed in 11 of 51 participants (22%) in Geneva, with pain lasting a median of 8 days (interquartile range, 4 to 87); 2 self-limited cases occurred in 60 participants (3%) in Hamburg, Germany, and Kilifi, Kenya. The virus was identified in one synovial-fluid aspirate and in skin vesicles of 2 other vaccinees, showing peripheral viral replication in the second week after immunization. ZEBOV-glycoprotein-specific antibody responses were detected in all the participants, with similar glycoprotein-binding antibody titers but significantly higher neutralizing antibody titers at higher doses. Glycoprotein-binding antibody titers were sustained through 180 days in all participants. CONCLUSIONS: In these studies, rVSV-ZEBOV was reactogenic but immunogenic after a single dose and warrants further evaluation for safety and efficacy. (Funded by the Wellcome Trust and others; ClinicalTrials.gov numbers, NCT02283099, NCT02287480, and NCT02296983; Pan African Clinical Trials Registry number, PACTR201411000919191.).

a b s t r a c t Background: Since the re-emergence of Chikungunya virus (CHIKV) in Reunion in 2005 and the recent outbreak in the Caribbean islands with an expansion to the Americas the CHIK diagnostic became very important. Objectives: We evaluate the performance of laboratories regarding molecular and serological diagnostic of CHIK worldwide. Study design: A panel of 12 samples for molecular and 13 samples for serology were provided to 60 laboratories in 40 countries for evaluating the sensitivity and specificity of molecular and serology testing. Results: The panel for molecular diagnostic testing was analysed by 56 laboratories returning 60 data sets of results whereas the 56 and 60 data sets were returned for IgG and IgM diagnostic from the participating laboratories. Twenty-three from 60 data sets performed optimal, 7 acceptable and 30 sets of results require improvement. From 50 data sets only one laboratory shows an optimal performance for IgM detection, followed by 9 data sets with acceptable and the rest need for improvement. From 46 IgG serology data sets 20 provide an optimal, 2 an acceptable and 24 require improvement performance. The evaluation of some of the diagnostic performances allows linking the quality of results to the in-house methods or commercial assays used. Conclusion: The external quality assurance for CHIK diagnostics provides a good overview on the labora- tory performance regarding sensitivity and specificity for the molecular and serology diagnostic required for the quick and reliable analysis of suspected CHIK patients. Nearly half of the laboratories have to improve their diagnostic profile to achieve a better performance. © 2016 Z. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license

Objective The emergence of West Nile virus (WNV) in several European countries increases the risk of its introduction to Germany. This study evaluated a new method for WNV surveillance by testing for maternal antibodies in chicken eggs. Methods A total of 1,990 eggs were collected in 35 sampling sites in the south-west of Germany and tested for WNV-specific antibodies. Results The results did not indicate evidence for WNV circulation in the study area. Conclusion This work serves as a proof-of-concept that such a method is useful and a potential alternative to use of sentinel chicken for regular WNV surveillance.

Owing to their role as vectors of malaria parasites, species of the Anopheles maculipennis complex (Diptera: Culicidae) Meigen were intensively studied in the past, but with the disappearance of malaria in Germany in the middle of the last century, the interest in this field of research declined. A comprehensive ecological analysis of the current species distribution for Germany is lacking. Between 2010 and 2013, a total of 1445 mosquitoes of the An. maculipennis complex were collected at 72 different sites in Germany. The samples comprise 722 single individuals as well as 723 individuals in 90 pools of up to 25 mosquitoes. All samples were analysed with newly developed species-specific qPCR assays for the identification of the four German species using nucleotide differences within the internal transcribed spacer 2 (ITS2) ribosomal DNA. All gathered data were used for species distribution modelling. The overall prevalence of An. messeae s.l. was highest with 98.89% of all pools; An. daciae with 6.93% of all individuals and An. messeae s.s. with 69.53%. The prevalence of the other two species was relatively low: An. maculipennis s.s. with 13.30% of all individuals (6.67% of all pools) and An. atroparvus with 1.80% of all individuals (1.11% of all pools).

The apicomplexan order Haemosporida is a clade of unicellular blood parasites that infect a variety of reptilian, avian and mammalian hosts. Among them are the agents of human malaria, parasites of the genus Plasmodium, which pose a major threat to human health. Illuminating the evolutionary history of Haemosporida may help us in understanding their enormous biological diversity, as well as tracing the multiple host switches and associated acquisitions of novel life-history traits. However, the deep-level phylogenetic relationships among major haemosporidian clades have remained enigmatic because the datasets employed in phylogenetic analyses were severely limited in either gene coverage or taxon sampling. Using a PCR-based approach that employs a novel set of primers, we sequenced fragments of 21 nuclear genes from seven haemosporidian parasites of the genera Leucocytozoon, Haemoproteus, Parahaemoproteus, Polychromophilus and Plasmodium. After addition of genomic data from 25 apicomplexan species, the unreduced alignment comprised 20,580 bp from 32 species. Phylogenetic analyses were performed based on nucleotide, codon and amino acid data employing Bayesian inference, maximum likelihood and maximum parsimony. All analyses resulted in highly congruent topologies. We found consistent support for a basal position of Leucocytozoon within Haemosporida. In contrast to all previous studies, we recovered a sister group relationship between the genera Polychromophilus and Plasmodium. Within Plasmodium, the sauropsid and mammal-infecting lineages were recovered as sister clades. Support for these relationships was high in nearly all trees, revealing a novel phylogeny of Haemosporida, which is robust to the choice of the outgroup and the method of tree inference.

To examine the diagnostic performance of real-time reverse transcription (RT)-polymerase chain reaction (PCR) assays for Zika virus detection. We compared seven published real-time RT-PCR assays and two new assays that we have developed. To determine the analytical sensitivity of each assay, we constructed a synthetic universal control ribonucleic acid (uncRNA) containing all of the assays' target regions on one RNA strand and spiked human blood or urine with known quantities of African or Asian Zika virus strains. Viral loads in 33 samples from Zika virus-infected patients were determined by using one of the new assays. Oligonucleotides of the published real-time RT-PCR assays, showed up to 10 potential mismatches with the Asian lineage causing the current outbreak, compared with 0 to 4 mismatches for the new assays. The 95% lower detection limit of the seven most sensitive assays ranged from 2.1 to 12.1 uncRNA copies/reaction. Two assays had lower sensitivities of 17.0 and 1373.3 uncRNA copies/reaction and showed a similar sensitivity when using spiked samples. The mean viral loads in samples from Zika virus-infected patients were 5 × 104 RNA copies/mL of blood and 2 × 104 RNA copies/mL of urine. We provide reagents and updated protocols for Zika virus detection suitable for the current outbreak strains. Some published assays might be unsuitable for Zika virus detection, due to the limited sensitivity and potential incompatibility with some strains. Viral concentrations in the clinical samples were close to the technical detection limit, suggesting that the use of insensitive assays will cause false-negative results. Étudier la performance diagnostique des tests basés sur l'amplification en chaîne par polymérase (PCR) en temps réel après transcription inverse (RT) pour détecter le virus Zika. Nous avons comparé sept tests publiés utilisant la RT-PCR en temps réel et deux nouveaux tests développés par nos soins. Afin de déterminer la sensibilité analytique de chaque test, nous avons conçu un acide ribonucléique synthétique de contrôle universel (ARNcun) contenant toutes les régions ciblées par les tests sur une hélice ARN et enrichi de l’urine ou du sang humain de quantités connues de souches africaines ou asiatiques du virus Zika. Les charges virales dans 33 échantillons provenant de patients infectés par le virus Zika ont été déterminées à l'aide de l'un des nouveaux tests. Les oligonucléotides des tests publiés utilisant la RT-PCR en temps réel ont présenté jusqu'à 10 mauvais appariements potentiels avec la lignée asiatique provoquant l'épidémie actuelle, alors qu'on a constaté de 0 à 4 mauvais appariements dans le cas des nouveaux tests. La limite de détection inférieure à 95% des sept tests les plus sensibles variait de 2,1 à 12,1 copies d'ARNcun/réaction. Deux tests présentaient des sensibilités plus basses de 17,0 et 1373,3 copies d'ARNcun/réaction et montraient une sensibilité similaire lorsque des échantillons enrichis étaient utilisés. Les charges virales moyennes dans les échantillons provenant de patients infectés par le virus Zika étaient de 5 × 104 copies d'ARN/mL de sang et de 2 × 104 copies d'ARN/mL d'urine. Nous proposons pour détecter le virus Zika des réactifs et des protocoles actualisés, adaptés aux souches responsables de la flambée actuelle. Tous les tests publiés ne permettent pas de détecter le virus Zika en raison d'une sensibilité limitée et d'une incompatibilité potentielle avec certaines souches. Les concentrations virales dans les échantillons cliniques étaient proches de la limite de détection technique, ce qui laisse penser que l'utilisation de tests insensibles donnera des résultats faussement négatifs. Examinar el rendimiento del diagnóstico de las pruebas de reacción en cadena de la polimerasa de transcriptasa inversa (RT-PCR) en tiempo real para la detección del virus de Zika. Se compararon siete pruebas de RT-PCR en tiempo real publicadas y dos pruebas nuevas que se han desarrollado. Con el fin de determinar la sensibilidad analítica de cada prueba, se construyó un ácido ribonucleico sintético de control universal (uncRNA) que contenía todas las regiones objetivo de las pruebas en una hebra de RNA y se añadió a sangre u orina humana con cantidades conocidas de cepas de virus de Zika de Asia o África. Se determinaron las cargas víricas en 33 muestras procedentes de pacientes infectados por el virus de Zika a través de una de las pruebas nuevas. Los oligonucleótidos de las pruebas de RT-PCR en tiempo real publicadas mostraron hasta 10 posibles discordancias con el linaje de Asia causante de los brotes actuales, en comparación con 0 de 4 discordancias en el caso de las pruebas nuevas. El límite de detección inferior del 95% de las siete pruebas más sensibles abarcó de 2,1 a 12,1 copias/reacción de uncRNA. Dos pruebas mostraron sensibilidades inferiores de 17,0 y 1373,3 copias/reacción de uncRNA y presentaron una sensibilidad similar al usar muestras infectadas. Las cargas víricas medias en las muestras procedentes de pacientes infectados por el virus de Zika fueron de 5 × 104 copias de RNA/mL de sangre y de 2 × 104 copias de RNA/ml de orina. Se proporcionan reactivos y protocolos actualizados para la detección adecuada del virus de Zika en el caso de las cepas de brotes actuales. Algunas pruebas publicadas pueden no ser adecuadas para la detección del virus de Zika, debido a la limitada sensibilidad y a la posible incompatibilidad con algunas cepas. Las concentraciones víricas en las muestras clínicas se acercaron al límite de detección técnico, lo que sugería que el uso de pruebas intensivas causaría resultados falsos negativos. دراسة الأداء التشخيصي لاختبارات تفاعل البوليميراز المتسلسل اللحظي (PCR) مع إنزيم النسخ العكسي (RT) لاكتشاف الإصابة بفيروس زيكا. قمنا بإجراء مقارنة بين سبعة اختبارات منشورة لتفاعل البوليميراز المتسلسل اللحظي مع إنزيم النسخ العكسي (RT‑PCR) واختبارين جديدين تم إعدادهما من جانبنا. ولتحديد الحساسية التحليلية لكل اختبار، قمنا بتكوين الحمض النووي الريبوزي الاصطناعي للمكافحة العامة (uncRNA) والذي يحتوي على جميع المناطق المستهدفة في الاختبار في شريط RNA واحد ويحتوي على مؤشرات للدم أو البول البشري الذي يحتوي على كميات معروفة من سلالات فيروس زيكا في منطقة أفريقيا أو آسيا. وتم تحديد الحمولات الفيروسية في 33 عينة صادرة من مرضى مصابين بفيروس زيكا باستخدام أحد الاختبارات الجديدة. أظهرت الأوليغونيكليوتيدات الخاصة باختبارات تفاعل البوليميراز المتسلسل اللحظي مع إنزيم النسخ العكسي ما يصل إلى 10 حالات محتملة من عدم التطابق مع السلالة الآسيوية المسببة للعدوى الحالية، بالمقارنة مع حالات عدم التطابق بالنسبة للاختبارات الجديدة بمعدل 0 إلى 4. تراوح حد الاكتشاف المنخفض بنسبة 95‏% في الاختبارات السبعة الأكثر حساسية من 2.1 إلى 12.1 من نسخ سلالات uncRNA لتفاعل كل حالة. وُجد لدى اثنين من الاختبارات درجات منخفضة من الحساسية بمقدار 17.0 و1373.3 لنسخ سلالات uncRNA لتفاعل كل حالة وأظهرت وجود درجة حساسية مماثلة عند استخدام عينات المؤشرات. بلغ متوسط الحمولات الفيروسية في العينات الصادرة عن المرضى المصابين بفيروس زيكا 5 × 10 4 نسخ من RNA لكل ملليلتر من الدم و 2 × 10 4 نسخ من RNA لكل ملليلتر من البول. نحن نوفر الكاشفات وأحدث البروتوكولات لاكتشاف فيروس زيكا والتي تناسب سلالات العدوى الحالية. وقد تكون بعض الاختبارات المنشورة غير مناسبة لاكتشاف فيروس زيكا نظرًا لوجود درجة محدودة من الحساسية واحتمالية عدم توافقها مع بعض السلالات. كانت نسب تركيز الفيروسات في العينات التحليلية قريبة من حد الاكتشاف التقني، مما يشير إلى أن استخدام الاختبارات التي تفتقد إلى الحساسية سيؤدي إلى إصدار نتائج خاطئة وسلبية. 旨在检查针对寨卡病毒检测的实时逆转录 (RT)-聚合酶链反应 (PCR) 试验的诊断性能。. 我们比较了 7 种公布的实时 RT-PCR 试验和我们开发的两种新试验。 为了确定各种试验的分析灵敏度，我们构建了在一个 RNA 链上包含所有试验目标区域的合成通用对照核糖核酸 (uncRNA) 以及带有已知数量的非洲或亚洲寨卡病毒株的加标人体血液或尿液。 通过使用一种新的试验测定 33 个寨卡病毒感染患者样本的病毒载量。. 已公布的实时 RT-PCR 试验的寡核苷酸，显示出与亚洲血统潜在的失配率高达 10，相比之下，新试验的失配率为 0 至 4。 七种最敏感试验的 95% 检测下限范围为 2.1 至 12.1 uncRNA 拷贝/反应。 两个试验中 17.0 和 1373.3 uncRNA 复制/反应的灵敏度较低，使用加标样本时表现出类似的灵敏度。 寨卡病毒感染患者的样本中，血液的平均病毒载量为 5 × 104 RNA 拷贝/毫升，尿液的平均病毒载量为 2 × 104 拷贝/毫升。. 我们为适合当前疫情的寨卡病毒检测提供试剂和更新方案。 由于有限的灵敏度以及与一些菌株潜在的不兼容性，因此一些公布的试验可能不适合寨卡病毒检测。 临床样本中的病毒含量接近于技术检测极限，这表明使用不敏感试验将会引起假阴性结果。. Изучить диагностические возможности выявления вируса Зика с помощью полимеразной цепной реакции (ПЦР) с обратной транскриптазой (ОТ) в режиме реального времени. Авторы сравнили семь методов ОТ-ПЦР, сведения о которых были опубликованы в литературе, и два новых метода, разработанные авторами. Для выявления аналитической чувствительности каждого метода были сконструированы синтетические универсальные контрольные рибонуклеиновые кислоты (ункРНК), содержащие все целевые участки на одной из цепей РНК. Эти РНК были добавлены к образцам крови или мочи пациентов, содержащих вирус Зика африканского или азиатского происхождения в известных количествах. Одним из новых методов определялась вирусная нагрузка для 33 образцов пациентов, зараженных вирусом Зика. Олигонуклеотиды для опубликованных методов ОТ-ПЦР показали до 10 потенциальных несовпадений при определении вируса азиатского происхождения, вызвавшего нынешнюю вспышку заболеваемости, тогда как новые методы показали от 0 до 4 несовпадений. Для семи наиболее чувствительных анализов 95%-й нижний порог определения составлял от 2,1 до 12,1 копии ункРНК на реакцию. Два метода продемонстрировали меньшую чувствительность (от 17,0 до 1373,3 копии ункРНК на анализ) и сходную чувствительность при использовании образцов с добавлением ункРНК. Средняя величина вирусной нагрузки в образцах пациентов, инфицированных вирусом Зика, составила 5 × 104 копий РНК/мл для крови и 2 × 104 копийРНК/мл для мочи. Авторы предлагают реактивы и обновленные протоколы для выявления вируса Зика, вызвавшего нынешнюю вспышку заболевания. Некоторые из методов, по которым имеются опубликованные литературные данные, могут быть неподходящими для текущей ситуации из-за ограниченной чувствительности и потенциальной несовместимости с некоторыми штаммами вируса. Концентрация вируса в клинических образах была близка к техническому пределу определения, что позволяет предположить, что использование нечувствительных методов может приводить к получению ложноотрицательных результатов

In order to detect serum antibodies against clinically important Old and New World hantaviruses simultaneously, multiparametric indirect immunofluorescence assays (IFAs) based on biochip mosaics were developed. Each of the mosaic substrates consisted of cells infected with one of the virus types Hantaan (HTNV), Puumala (PUUV), Seoul (SEOV), Saaremaa (SAAV), Dobrava (DOBV), Sin Nombre (SNV) or Andes (ANDV). For assay evaluation, serum IgG and IgM antibodies were analyzed using 184 laboratory-confirmed hantavirus-positive sera collected at six diagnostic centers from patients actively or previously infected with the following hantavirus serotypes: PUUV (Finland, n = 97); SEOV (China, n = 5); DOBV (Romania, n = 7); SNV (Canada, n = 23); ANDV (Argentina and Chile, n = 52). The control panel comprised 89 sera from healthy blood donors. According to the reference tests, all 184 patient samples were seropositive for hantavirus-specific IgG (n = 177; 96%) and/or IgM (n = 131; 72%), while all control samples were tested negative. In the multiparametric IFA applied in this study, 183 (99%) of the patient sera were IgG and 131 (71%) IgM positive (accordance with the reference tests: IgG, 96%; IgM, 93%). Overall IFA sensitivity for combined IgG and IgM analysis amounted to 100% for all serotypes, except for SNV (96%). Of the 89 control sera, 2 (2%) showed IgG reactivity against the HTNV substrate, but not against any other hantavirus. Due to the high cross-reactivity of hantaviral nucleocapsid proteins, endpoint titrations were conducted, allowing serotype determination in >90% of PUUV- and ANDV-infected patients. Thus, multiparametric IFA enables highly sensitive and specific serological diagnosis of hantavirus infections and can be used to differentiate PUUV and ANDV infection from infections with Murinae-borne hantaviruses (e.g. DOBV and SEOV)., Author Summary Hantaviruses are the causative agents of hemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS) — serious emerging diseases, with case-fatality rates of up to 15% and about 35%, respectively. So far, over 21 human pathogenic serotypes have been described, which are classified into New World (circulating in the Americas) and Old World (Asia and Europe) hantaviruses. The prodromal phase of hantavirus infections — fever, myalgia, headache and gastrointestinal symptoms — is indistinguishable from those of many other viral infections. The cardiopulmonary phase of HFRS and diuretic phase of HFRS mimic the acute respiratory distress syndrome and renal failure, respectively. In this context, clinical diagnosis has to be confirmed by laboratory testing, which is predominantly based on serology. Although there is an increasing awareness of hantaviruses, infections are still underdiagnosed, in part due to a lack of available standardized serological assays. This study evaluated a commercial multiparametric indirect immunofluorescence assay for the simultaneous detection of antibodies against clinically important Old World (Hantaan, Puumala, Seoul, Saaremaa and Dobrava) and New World (Sin Nombre and Andes) hantaviruses. Test performance was found to be comparable to established highly sensitive and specific in-house assays.

The outbreaks of Zika virus (ZIKV) infection in Brazil, 2015-2016, were associated with severe congenital malformations. Our translational study aimed to test the efficacy of the antiviral agent sofosbuvir (SOF) against vertical transmission of ZIKV and the associated congenital syndrome (CZS), using a rhesus monkey model. Eight pregnant macaques were successfully infected during the organogenesis phase with a Brazilian ZIKV strain; five of them received SOF from two to fifteen days post-infection. Both groups of dams showed ZIKV-associated clinical signals, detectable ZIKV RNA in several specimens, specific anti-ZIKV IgM and IgG antibodies, and maternal neutralizing antibodies. However, malformations occurred only among non-treated dam offspring. Compared to non-treated animals, all SOF-treated dams had a shorter ZIKV viremia and four of five neonates had undetectable ZIKV RNA in blood and tissue samples. These results support further clinical evaluations aiming for the prevention of CZS.

Background Rapid tests detecting both dengue virus (DENV) NS1 antigen and anti-DENV IgM and IgG antibodies facilitate diagnosis of dengue fever (DF) in resource-poor settings. Methodology/principal findings 92 acute phase serum samples from patients with a PCR-confirmed DENV infection collected in Lao People’s Democratic Republic (Lao PDR) in 2013 and 2015 were analyzed with the SD Bioline Dengue Duo test. A subset of 74 samples was additionally tested with the Platelia NS1 antigen test, the Panbio DENV μ-capture ELISA and the Panbio DENV IgG ELISA. IgM seroconversion was assayed using follow-up samples of 35 patients collected in the convalescent phase. 57.6%, 22.8% and 44.6% of acute phase serum samples tested positive in the SD Bioline Dengue Duo NS1, IgM, and IgG test, respectively. Diagnostic sensitivity of the SD Bioline Dengue Duo NS1 test strongly correlated with viral load, decreased rapidly over the acute phase of the disease, and was significantly reduced in presence of high anti-DENV IgG antibody titers resulting from secondary DENV infection. While a good concordance (Cohen’s kappa 0.78) was found between the SD Bioline Dengue Duo NS1 test and the Platelia NS1 antigen ELISA, both the SD Bioline Dengue Duo IgM and IgG test displayed a significantly lower sensitivity than the corresponding ELISA tests. Conclusions/significance The SD Bioline Dengue Duo test is a valuable tool for diagnosis of DENV infections especially when analyzing early acute phase samples with high viral load. Nevertheless, in endemic areas, where secondary flavivirus infections are common, diagnostic sensitivity of the NS1 and IgM test components may be compromised.

The discovery and characterization of novel arthropod-borne viruses provide valuable information on their genetic diversity, ecology, evolution and potential to threaten animal or public health. Arbovirus surveillance is not conducted regularly in Romania, being particularly very scarce in the remote and diverse areas like the Danube Delta. Here we describe the detection and genetic characterization of a novel orbivirus (Reoviridae: Orbivirus) designated as Letea virus, which was found in grass snakes (Natrix natrix) during a metagenomic and metatranscriptomic survey conducted between 2014 and 2017. This virus is the first orbivirus discovered in reptiles. Phylogenetic analyses placed Letea virus as a highly divergent species in the Culicoides-/sand fly-borne orbivirus clade. Gene reassortment and intragenic recombination were detected in the majority of the nine Letea virus strains obtained, implying that these mechanisms play important roles in the evolution and diversification of the virus. However, the screening of arthropods, including Culicoides biting midges collected within the same surveillance program, tested negative for Letea virus infection and could not confirm the arthropod vector of the virus. The study provided complete genome sequences for nine Letea virus strains and new information about orbivirus diversity, host range, ecology and evolution. The phylogenetic associations warrant further screening of arthropods, as well as sustained surveillance efforts for elucidation of Letea virus natural cycle and possible implications for animal and human health.

The invasive mosquito species Aedes japonicus japonicus (Ae. japonicus) is widely distributed in Central Europe and is a known vector of various arboviruses in the laboratory, including flaviviruses such as Japanese Encephalitis virus or West Nile virus. However, the vector competence of Ae. japonicus for the recently emerging Zika virus (ZIKV) has not been determined. Therefore, field-caught Ae. japonicus from Germany were orally infected with ZIKV and incubated at 21, 24, or 27 degrees C to evaluate the vector competence under climate conditions representative of the temperate regions (21 degrees C) in the species' main distribution area in Europe and of Mediterranean regions (27 degrees C). Aedes japonicus was susceptible to ZIKV at all temperatures, showing infection rates between 10.0% (21 degrees C) and 66.7% (27 degrees C). However, virus transmission was detected exclusively at 27 degrees C with a transmission rate of 14.3% and a transmission efficiency of 9.5%. Taking into account the present distribution of Ae. japonicus in the temperate regions of Central Europe, the risk of ZIKV transmission by the studied Ae. japonicus population in Central Europe has to be considered as low. Nevertheless, due to the species' vector competence for ZIKV and other mosquito-borne viruses, in combination with the possibility of further spread to Mediterranean regions, Ae. japonicus must be kept in mind as a potential vector of pathogens inside and outside of Europe.

The summer of 2018 in Germany was the second hottest and driest on record. These generally extremely favorable climatic conditions most likely triggered the further expansion and the efficient propagation of the zoonotic arthropod-borne West Nile virus in many Southern/Southeastern and even Central European countries. WNV infections were detected for the first time in resident wild and aviary birds, such as common blackbirds, northern goshawks and great grey owls in Eastern and Southeastern Germany. The causative WNV strain belonged to the central European subclade II. Phylogeographic analysis indicated a single introduction event of WNV into Germany, most likely in 2016 from Czech Republic, and also a unique non-synonymous mutation in the NS3 gene. Extraordinary high temperatures in 2018 presumably led to decreased averaged extrinsic incubation period values for WNV in mosquitoes, leading to rapid virus amplification and greater transmission risk for vertebrates in Germany. Blood transfusion services and clinicians in Germany should be aware of these possible WNV infection risks in humans especially during late summer.

The cellular surface moleculeHis-taggedAssay validation was performed using paired serum samples from 15 Kosovar patients with a PCR-confirmed CCHFV infection and 28 Brazilian patients with a PCR-confirmed ZIKV infection, along with a panel of a priori CCHFV/ZIKV-IgM-negative serum samples. Both ELISAs were highly reproducible. Sensitivity and specificity were comparable with or even exceeded in-house gold standard testing and commercial kits. Furthermore, latex beads coated withRecombinant

Vector competence is defined as the potential of a mosquito species to transmit a mosquito-borne virus (mobovirus) to a vertebrate host. Viable virus particles are transmitted during a blood meal via the saliva of an infected mosquito. Forced salivation assays allow determining the vector potential on the basis of single mosquitoes, avoiding the use of animal experiments. The method is suitable to analyze a large number of mosquitoes in one experiment within a short period of time. Forced salivation assays were used to analyze 856 individual mosquitoes trapped in Germany, including two different Culex pipiens pipiens biotypes, Culex torrentium as well as Aedes albopictus, which were experimentally infected with Zika virus (ZIKV) and incubated at 18 °C or 27 °C for two and three weeks. The results indicated the lack of vector competence of the different Culex taxa for ZIKV. In contrast, Aedes albopictus was susceptible to ZIKV, but only at 27 °C, with transmission rates similar to an Aedes aegypti laboratory colony tested in parallel.

Chikungunya virus (CHIKV) is a mosquito-borne alphavirus (Togaviridae family) [1]. The virus was first isolated from humans, as well as from mosquitoes, during an outbreak at the border region between Mozambique and Tanzania in 1952. Human cases of chikungunya fever can cause severe, debilitating and often chronic arthralgia [2]. Several species of the mosquito genus Aedes were found competent to transmit CHIKV. However, Ae. aegypti and Ae. albopictus are considered the most important vectors. In the past, occurrences of CHIKV were restricted to the African and Asian continents, causing local, sporadic epidemics; during the last decade, however, the virus has expanded over a substantial geographical range, invading India, Indian Ocean islands and the Americas, where it has caused millions of human infections [2]. Three phylogenetic CHIKV lineages with distinct antigenic characteristics are known worldwide [2,3]. Two major lineages circulate in Africa (East, Central and Southern Africa region (ECSA) and West Africa) and a third is present in Asia. In Africa, CHIKV is maintained in an enzootic cycle. The transmission cycle includes forest-dwelling mosquito species of the genus Aedes and non-human primates [2]. Anthropophilic mosquito species, Ae. aegypti and Ae. albopictus, play a crucial role in the urbanisation of CHIKV. This is in contrast to Asia, where the virus has historically been maintained in an urban cycle between Ae. aegypti/albopictus and humans. Ae. aegypti is the primary vector for CHIKV. However, Ae. albopictus is considered to have a high competence to transmit a specific variant of the ECSA lineage. The virus mutant has a single amino acid change from alanine to valine at the E1 envelope glycoprotein amino acid 226 (E1–A226V) [4]. This change leads to a better adaptation of the virus to the species Ae. albopictus, resulting in a 50-fold increase in vector competence in comparison to Ae. aegypti. The ECSA mutant is considered to be the most important factor for CHIKV outbreaks in regions where the primary vector, Ae. aegypti, is absent. This is potentially linked to the spread of the ECSA lineage to the Indian Ocean and the first autochthonous CHIKV transmission in Europe [5]. Thus far, all CHIKV strains isolated during outbreaks in Europe belonged to the ECSA lineage. However, some of the isolates contained the E1-A226V-mutation [6-8], whereas others did not [9,10]. Therefore, other yet undefined mutations in the envelope proteins may also affect the adaptation of CHIKV to Ae. albopictus [9-11]. Autochthonous transmission of CHIKV has been repeatedly observed in mainland Europe. The virus circulated in France in 2010 [9], 2014 [7] and 2017 [8], and two major outbreaks occurred in Italy in 2007 [6] and 2017 [10]. In total, at least 605 human CHIKV cases were reported, the majority in the two epidemics in Italy (n = 575) [8]. This was possible because of the establishment of Ae. albopictus in the region. One of the most invasive mosquito species in the world [12,13], its global spread is driven by transcontinental connectivity through shipping and flight routes. At present, Ae. albopictus has infested more than 25 European countries [12,14], with highest abundances reported from Italy. The species is repeatedly introduced to various locations in central Europe [15], even though regions north of the Alps were previously considered unsuitable for the establishment of Ae. albopictus. Still, overwintering was recently suggested in Germany [16-18]. This included local expansion of populations and detection of larvae already in spring. According to the European Centre for Disease Prevention and Control (ECDC), Solna, Sweden, Ae. albopictus is classified as ‘established’ along the Upper Rhine Valley in Germany and France [14]. There is currently no available vaccine or CHIKV-specific treatment [5]. The control of the disease primarily depends on reduction of the vector population. Further options are individual protection with repellents or behavioural avoidance. Therefore, the evaluation of the vector competence of local mosquito populations is crucial, as the assessment of CHIKV risk transmission allows for the adapting of surveillance and control systems. Vector competence is the ability of a mosquito to acquire a pathogen and subsequently transmit it to a new host [2]. This is commonly evaluated through experimental infection experiments. These studies aim to identify infectious virus particles secreted with the saliva to the vertebrate host. Transmission only becomes possible if the virus can overcome the midgut and salivary glands, which are the most important barriers for infection of the vector and final escape [19]. Vector competence depends on a complex interaction of vector population, virus strain and temperature [20]. Only a suitable combination allows the virus to replicate and disseminate. Invasion of the salivary glands may result in transmission through the next bite. Vector competence studies using temperatures below 20 °C have become increasingly important since the observation of established populations of the Ae. albopictus north of the Alps [14]. We therefore conducted a vector competence study at three different temperatures, with a CHIKV outbreak strain from France, using Ae. albopictus populations from Germany and Italy, to comprehensively assess the risk of CHIKV transmission in Europe.

Due to the emergence of non-endemic mosquito vectors and the recent outbreaks of mosquito-borne diseases, mosquito-borne pathogens are considered an increasing risk to public and animal health in Europe. To obtain a status quo regarding mosquito-borne viruses and their vectors in Germany, 97,648 mosquitoes collected from 2011 to 2016 throughout the country were screened for arboviruses. Mosquitoes were identified to species, pooled in groups of up to 50 individuals according to sampling location and date, and screened with different PCR assays for Flavi-, Alpha- and Orthobunyavirus RNA. Two pools tested positive for Usutu virus-RNA, two for Sindbis virus-RNA, and 24 for Batai virus-RNA. The pools consisted of Culex pipiens s.l., Culex modestus, Culex torrentium, Culiseta sp., Aedes vexans, Anopheles daciae, and Anopheles messeae mosquitoes and could be assigned to nine different collection sites, with seven of them located in northeastern Germany. Phylogenetic analyses of the viral RNA sequences showed relationships with strains of the viruses previously demonstrated in Germany. These findings confirm continuing mosquito-borne zoonotic arbovirus circulation even though only a rather small percentage of the screened samples tested positive. With respect to sampling sites and periods, virus circulation seems to be particularly intense in floodplains and after flooding events when mosquitoes develop in excessive numbers and where they have numerous avian hosts available to feed on.

During the last years, headlines about the advance of tropical infectious diseases, which are transmitted by mosquitos, become more frequent. Some of these mosquitos are classified as invasive species in Europe. The World Health Organization (WHO) and the European Center for Disease Prevention and Control (ECDC) are enhancing the observation of the geographical spread of these species. Especially the Asian tiger mosquito and the Yellow fever mosquito are in focus. In Germany the vector competency of domestic mosquito species is investigated.

Crimean-Congo hemorrhagic fever orthonairovirus (CCHFV) is a tick-borne virus which causes severe disease in humans with fatality cases up to 30%. We investigated the genetic and evolutionary characteristics of CCHFV in Kosovo, in particular in humans and found that different virus variants of genotype V circulate, with Turkey as a possible origin for the progenitor of southern European CCHF outbreaks. Phylogenetic analyses also revealed a single introduction event and in situ evolution of CCHFV in this country. The viral metagenomics revealed a more abundant virome in the fatal CCHF cases and the presence of a novel tick-borne segmented RNA virus belonging to the recently discovered Jingmenvirus group which raises questions about the potential pathogenic effect of this novel virus on human and animal health.

Ebola (EBOV) and Zika viruses (ZIKV) are responsible for recent global health threats. As no preventive vaccines or antiviral drugs against these two re-emerging pathogens are available, we evaluated whether the molecular tweezer CLR01 may inhibit EBOV and ZIKV infection. This small molecule has previously been shown to inactivate HIV-1 and herpes viruses through a selective interaction with lipid-raft-rich regions in the viral envelope, which results in membrane disruption and loss of infectivity. We found that CLR01 indeed blocked infection of EBOV and ZIKV in a dose-dependent manner. The tweezer inhibited infection of epidemic ZIKV strains in cells derived from the anogenital tract and the central nervous system, and remained antivirally active in the presence of semen, saliva, urine and cerebrospinal fluid. Our findings show that CLR01 is a broad-spectrum inhibitor of enveloped viruses with prospects as a preventative microbicide or antiviral agent., Highlights • The molecular tweezer CLR01 inhibits EBOV and ZIKV infection. • ZIKV infection of cells derived from the anogenital tract and the central nervous system is blocked. • Anti-ZIKV activity is retained in semen, urine, saliva, and CSF. • CLR01 represents a broad-spectrum inhibitor of enveloped viruses with prospects as a microbicide or antiviral agent.

Arthropod-borne disease outbreaks as a result of pathogen influx including arboviruses transmitted by strains of Aedes species occur periodically in varying spots in Kenya. However, there has been paucity of documented information on the Aedes species involved in transmission of different haplotypes of arboviruses. This study assessed for concomitant infection of arboviruses in different vectors. Aedes species were sampled by Bio gent sentinel trap. Mosquitoes were stunned at 4°C for 5 minutes; sorted according to site, species and sex. RNA was extracted using Trizole®. cDNA was generated using one step real time PCR. Proportions of vectors and arboviruses were analyzed by R-statistics. A total of 37, 220 mosquitoes of Aedes species were analyzed. Vectors were: Aedes aegypti formosus (23,265=62.5%), Aedes aegypti aegypti (4,931=13.2%), Aedes mcintoshi (3,557=9.56%), Aedes ochraceus (2,156=5.79%), Aedes pembaensis (2,049=5.51%), Aedes tricholabis (487=1.31%), Aedes albicosta (415=1.11%), Aedes fulgens (200=0.54%) and Aedes fryeri (160=0.43%). Dengue virus (DENV) had highest entomological infections at 79% (n=1910) while Chikungunya (CHIKV) at 21%. DENV-2 had the highest frequency at 54%, while DENV-4 with the least frequency at 6%. Only ECSA genotype of CHIKV was present. Concomitant infections of arboviral haplotypes in different clades of Aedes species occur along the coastal region. Aedes aegypti aegypti is incubates all serotypes of DENV and genotype of CHIK viruses thus the major vectors of arboviruses. This information is important as it gives knowledge on areas at high risk for arboviral disease outbreaks. Consecutively, up scaled survey and implementation of control and prevention measures taken appropriately.

Congenital Zika virus (ZIKV) syndrome may cause fetal microcephaly in -1% of affected newborns. Here, we investigate whether the majority of clinically inapparent newborns might suffer from long-term health impairments not readily visible at birth. Infection of immunocompetent pregnant mice with high-dose ZIKV caused severe offspring phenotypes, such as fetal death, as expected. By contrast, low-dose (LD) maternal ZIKV infection resulted in reduced fetal birth weight but no other obvious phenotypes. Male offspring born to LD ZIKV-infected mothers had increased testosterone (TST) levels and were less likely to survive in utero infection compared to their female littermates. Males also presented an increased number of immature neurons in apical and basal hippocampal dendrites, while female offspring had immature neurons in basal dendrites only. Moreover, male offspring with high but not very high (storm) TST levels were more likely to suffer from learning and memory impairments compared to females. Future studies are required to understand the impact of TST on neuropathological and neurocognitive impairments in later life. In summary, increased sex-specific vigilance is required in countries with high ZIKV prevalence, where impaired neurodevelopment may be camouflaged by a healthy appearance at birth.

Zika virus (ZIKV) causes severe birth defects and can be transmitted via sexual intercourse. Semen from ZIKV-infected individuals contains high viral loads and may therefore serve as an important vector for virus transmission. Here we analyze the effect of semen on ZIKV infection of cells and tissues derived from the anogenital region. ZIKV replicates in all analyzed cell lines, primary cells, and endometrial or vaginal tissues. However, in the presence of semen, infection by ZIKV and other flaviviruses is potently inhibited. We show that semen prevents ZIKV attachment to target cells, and that an extracellular vesicle preparation from semen is responsible for this anti-ZIKV activity. Our findings suggest that ZIKV transmission is limited by semen. As such, semen appears to serve as a protector against sexual ZIKV transmission, despite the availability of highly susceptible cells in the anogenital tract and high viral loads in this bodily fluid., Semen from Zika virus infected individuals can contain high viral loads and can result in sexual transmission. Here, Müller et al. show that semen, and particularly seminal preparations containing extracellular vesicles, inhibit infection of Zika and other flaviviruses.

Yellow fever (YF) remains a public health issue in endemic areas despite the availability of a safe and effective vaccine. In 2015–2016, urban outbreaks of YF were declared in Angola and the Democratic Republic of Congo, and a sylvatic outbreak has been ongoing in Brazil since December 2016. Of great concern is the risk of urban transmission cycles taking hold in Brazil and the possible spread to countries with susceptible populations and competent vectors. Vaccination remains the cornerstone of an outbreak response, but a low vaccine stockpile has forced a sparing-dose strategy, which has thus far been implemented in affected African countries and now in Brazil. Accurate laboratory confirmation of cases is critical for efficient outbreak control. A dearth of validated commercial assays for YF, however, and the shortcomings of serological methods make it challenging to implement YF diagnostics outside of reference laboratories. We examine the advantages and drawbacks of existing assays to identify the barriers to timely and efficient laboratory diagnosis. We stress the need to develop new diagnostic tools to meet current challenges in the fight against YF.

Objective The studie describes the blood-feeding behaviour of mosquitoes in Mexico, to understand host–vector relationships and dynamics of disease transmission. Methods From September 2012 to November 2012 and in November 2013, 911 blood-fed Cx. quinquefasciatus mosquitoes were collected with aspirators inside houses in Chetumal and Cancun. Blood meals were analysed by PCR and subsequent Sanger sequencing of the cytochrome b gene. Results 93.3% of mosquitoes fed on mammals, 6.5% on birds and 0.2% on reptiles. The most frequent vertebrate hosts were humans (65.4%), dogs (23.2%), chicken (5.4%), cattle (2.2%) and cats (1.8%). Conclusions Cx. quinquefasciatus most frequently fed on humans and dogs in both studied cities, which is in contrast to a previous study that demonstrated lower prevalence of mammalian blood in engorged Cx. quinquefasciatus. Objectif Decrire le comportement alimentaire des moustiques hematophages au Mexique afin de comprendre les relations hote-vecteur et la dynamique de la transmission de la maladie. Methodes De septembre a novembre 2012 et en novembre 2013, 911 moustiques Cx. quinquefasciatus alimentes de sang ont ete collectes avec des aspirateurs a l'interieur des maisons a Chetumal et a Cancun. Les repas de sang ont ete analyses par PCR et ulterieurement par sequencage de Sanger du gene du cytochrome b. Resultats 93,3% des moustiques se sont alimentes sur des mammiferes, 6,5% sur des oiseaux et 0,2% sur des reptiles. Les hotes vertebres les plus frequents etaient les humains (65,4%), les chiens (23,2%), les poules (5,4%), les bovins (2,2%) et les chats (1,8%). Conclusions Cx. quinquefasciatus s'alimente plus frequemment sur les humains et les chiens dans les deux villes etudiees, ce qui est contraire au report d'une etude precedente qui a demontre une prevalence plus faible de sang de mammiferes chez Cx. Quinquefasciatus repus. Objetivo Describir la conducta alimentaria de mosquitos en Mejico, con el fin de entender la relacion hospedero-vector y la dinamica de transmision de la enfermedad. Metodos Entre Septiembre 2012 y Noviembre 2012 y en Noviembre 2013, 911 Cx. quinquefasciatus mosquitos alimentados con sangre fueron recolectados con aspiradoras dentro de casas en Chetumal y Cancun. La sangre de los estomagos de los mosquitos se analizo mediante PCR y posterior secuenciacion Sanger del gen del citocromo b. Resultados Un 93.3% de los mosquitos se alimentaban de mamiferos, 6.5% de pajaros y 0.2% de reptiles. Los hospederos vertebrados mas frecuentes eran humanos (65.4%), perros (23.2%), gallinas (5.4%), ganado (2.2%) y gatos (1.8%). Conclusiones Los Cx. quinquefasciatus se alimentaban mas frecuentemente de humanos y perros en ambas ciudades estudiadas, lo cual contrasta con un estudio previo que demostraba una menor prevalencia de sangre de mamifero en Cx. quinquefasciatus.

Between 2011 and 2013, three breeders of variegated squirrels (Sciurus variegatoides) had encephalitis with similar clinical signs and died 2 to 4 months after onset of the clinical symptoms. With the use of a metagenomic approach that incorporated next-generation sequencing and real-time reverse-transcriptase quantitative polymerase chain reaction (RT-qPCR), the presence of a previously unknown bornavirus was detected in a contact squirrel and in brain samples from the three patients. Phylogenetic analyses showed that this virus, tentatively named variegated squirrel 1 bornavirus (VSBV-1), forms a lineage separate from that of the known bornavirus species. (Funded by the Federal Ministry of Food and Agriculture [Germany] and others.).

Over recent decades, metagenomic studies have expanded the number of newly described, often unclassified, viruses within the family Circoviridae. Using broad-spectrum circovirus and cyclovirus PCRs, we characterized a novel circo-like virus in Aedes vexans mosquitoes from Germany whose main putative ORFs shared very low amino acid identity with those of previously characterized circoviruses and cycloviruses. Phylogenetic and genetic distance analysis revealed that this new virus species defined, together with previously described mosquito- and bat faeces-derived circo-like viruses, a different genus, tentatively called Krikovirus, within the family Circoviridae. We further demonstrated that viruses of the putative genus Krikovirus all shared a genomic organization that was unique among the family Circoviridae. Further investigations are needed to determine the host range, tissue tropism and transmission route(s). This report increases the current knowledge of the genetic diversity and evolution of the members of the family Circoviridae.

Ebola virus disease (EVD) developed in a patient who contracted the disease in Sierra Leone and was airlifted to an isolation facility in Hamburg, Germany, for treatment. During the course of the illness, he had numerous complications, including septicemia, respiratory failure, and encephalopathy. Intensive supportive treatment consisting of high-volume fluid resuscitation (approximately 10 liters per day in the first 72 hours), broad-spectrum antibiotic therapy, and ventilatory support resulted in full recovery without the use of experimental therapies. Discharge was delayed owing to the detection of viral RNA in urine (day 30) and sweat (at the last assessment on day 40) by means of polymerase-chain-reaction (PCR) assay, but the last positive culture was identified in plasma on day 14 and in urine on day 26. This case shows the challenges in the management of EVD and suggests that even severe EVD can be treated effectively with routine intensive care.

To the Editor: Zika virus is an emerging virus that has spread to most countries in Latin America and the Caribbean (1,2). It is transmitted by mosquitoes and through sexual intercourse (3). Most persons infected with Zika virus are asymptomatic or experience mild symptoms (4). However, in a pregnant woman, infection may cause severe pregnancy and birth complications, most notably microcephaly in children infected in utero (5–7). Zika virus infection might also be associated with an increased incidence of Guillain-Barre syndrome (8). Thus, the virus represents a threat to healthcare workers who manage infected patients or diagnostic samples and researchers who work with infectious virus in laboratories.

To the Editor: Mayaro virus (MAYV), a mosquitoborne alphavirus endemic to South America, causes a self-limiting febrile arthralgia syndrome closely resembling Chikungunya fever (1). MAYV has been detected increasingly as imported infections in international travelers returning to Europe and North America (2–9). Joint pain, the most prominent symptom, is often long-lasting (several months), sometimes incapacitating (4,6,7,9), and may recur (8). Arthralgia develops during the acute phase and symmetrically affects the wrists, ankles, and small joints of hands and feet. Joint swelling may occur initially, but permanent joint damage has not been described (5). The clinical disease and diagnostic procedures have been described (1–9), but immunologic parameters and their possible role in the clinical follow-up of patients (i.e., during the postacute long-lasting arthralgia period) remain to be investigated. To further our knowledge of MAYV infection, we analyzed cytokine levels in serum samples from 6 travelers to South America who returned to Europe with Mayaro fever (MF). Two of the cases occurred during 2014; 4 occurred during 2011–2013 (2–5). The 6 travelers comprised 2 men and 4 women who were 20–54 (median 36) years of age (Technical Appendix Table). The 2 most recent cases occurred in spring 2014 in a 28-year-old female student and a 54-year-old male physician. Serologic testing was performed for both patients at the Bernhard Nocht Institute and confirmed by virus neutralization testing (4). The student had traveled for 3 weeks in Ecuador, visiting rainforest villages and hiking in the jungle. During her stay, she had experienced myalgia of the forearms, arthralgia of fingers and toes, subfebrile but elevated body temperatures, and maculopapular exanthema. On examination in Germany, the student had no clinical signs of disease, but she reported arthralgia of the ankles and hands. Laboratory test results showed a slightly increased C-reactive protein level (6.2 mg/L, reference value 12 months. In the examined patients, the prolonged arthralgia recovery phase was paralleled by significantly increased proinflammatory cytokine levels, indicating ongoing inflammation, probably related to arthritis. Elevated levels of RANTES and IP-10 suggest T-cell recruitment, possibly reflecting virus persistence and replication, as described for the related Chikungunya virus (10). Thus, cytokine measurements may be helpful for monitoring patient symptoms, especially when signs of arthritis (swellings and redness) and elevated standard serum inflammatory parameters are no longer present. In our study, the picture of MF cytokine elevations paralleled those described for Chikungunya virus infection (10); these elevated levels may help to elucidate the pathogenesis of MAYV-induced arthralgia. More immunology data are required to complete this evolving picture of viral arthralgia syndromes. Technical Appendix: International travelers who were recently diagnosed with Mayaro fever and were included in this study. Click here to view.(151K, pdf)

In a patient transferred from Togo to Cologne, Germany, Lassa fever was diagnosed 12 days post mortem. Sixty-two contacts in Cologne were categorised according to the level of exposure, and gradual infection control measures were applied. No clinical signs of Lassa virus infection or Lassa specific antibodies were observed in the 62 contacts. Thirty-three individuals had direct contact to blood, other body fluids or tissue of the patients. Notably, with standard precautions, no transmission occurred between the index patient and healthcare workers. However, one secondary infection occurred in an undertaker exposed to the corpse in Rhineland-Palatinate, who was treated on the isolation unit at the University Hospital of Frankfurt. After German authorities raised an alert regarding the imported Lassa fever case, an American healthcare worker who had cared for the index patient in Togo, and who presented with diarrhoea, vomiting and fever, was placed in isolation and medevacked to the United States. The event and the transmission of Lassa virus infection outside of Africa underlines the need for early diagnosis and use of adequate personal protection equipment (PPE), when highly contagious infections cannot be excluded. It also demonstrates that larger outbreaks can be prevented by infection control measures, including standard PPE.

Thanks to recent advances in random amplification technologies, metagenomic surveillance expanded the number of novel, often unclassified viruses within the family Rhabdoviridae. Using a vector-enabled metagenomic (VEM) tool, we identified a novel rhabdovirus in Aedes cantans mosquitoes collected from Germany provisionally named Ohlsdorf virus (OHSDV). The OHSDV genome encodes the canonical rhabdovirus structural proteins (N, P, M, G and L) with alternative ORF in the P gene. Sequence analysis indicated that OHSDV exhibits a similar genome organization and characteristics compared to other mosquito-associated rhabdoviruses (Riverside virus, Tongilchon virus and North Creek virus). Complete L protein based phylogeny revealed that all four viruses share a common ancestor and form a deeply rooted and divergent monophyletic group within the dimarhabdovirus supergroup and define a new genus, tentatively named Ohlsdorfvirus. Although the Ohlsdorfvirus clade is basal within the dimarhabdovirus supergroup phylogeny that includes genera of arthropod-borne rhabdoviruses, it remains unknown if viruses in the proposed new genus are vector-borne pathogens. The observed spatiotemporal distribution in mosquitoes suggests that members of the proposed genus Ohlsdorfvirus are geographically restricted/separated. These findings increase the current knowledge of the genetic diversity, classification and evolution of this virus family. Further studies are needed to determine the host range, transmission route and the evolutionary relationships of these mosquito-associated viruses with those infecting vertebrates.

Crimean-Congo hemorrhagic fever (CCHF) is a widely distributed, viral, tickborne disease. In Europe, cases have been reported only in the southeastern part of the continent. We report two autochthonous cases in Spain. The index patient acquired the disease through a tick bite in the province of Ávila - 300 km away from the province of Cáceres, where viral RNA from ticks was amplified in 2010. The second patient was a nurse who became infected while caring for the index patient. Both were infected with the African 3 lineage of this virus. (Funded by Red de Investigación Cooperativa en Enfermedades Tropicales [RICET] and Efficient Response to Highly Dangerous and Emerging Pathogens at EU [European Union] Level [EMERGE].). Supported by Red de Investigación Cooperativa en Enferme-dades Tropicales (RICET grant, RD12/0018/0023) and EMERGE (Efficient Response to Highly Dangerous and Emerging Patho-gens at EU [European Union] Level), a joint action funded under the third EU Health Program (677066),.Disclosure forms provided by the authors are available with the full text of this article at NEJM.org.We thank Julio Farias of the Pathology Department at Gregorio Marañón University General Hospital and Maria José Buitrago and the rest of the members of the Grupo de Respuesta Rápida of the Centro Nacional de Microbiología for their help. Sí

During 2014-2016, we conducted mosquito-based Zika virus surveillance in Rio de Janeiro, Brazil. Results suggest that Zika virus was probably introduced into the area during May-November 2013 via multiple in-country sources. Furthermore, our results strengthen the hypothesis that Zika virus in the Americas originated in Brazil during October 2012-May 2013.

Mosquitoes collected in Germany in 2016, including Culex pipiens pipiens biotype pipiens, Culex torrentium and Aedes albopictus, as well as Culex pipiens pipiens biotype molestus (in colony since 2011) were experimentally infected with Zika virus (ZIKV) at 18 °C or 27 °C. None of the Culex taxa showed vector competence for ZIKV. In contrast, Aedes albopictus were susceptible for ZIKV but only at 27 °C, with transmission rates similar to an Aedes aegypti laboratory colony tested in parallel.

The recent spread of Zika virus (ZIKV) in the Americas and Asia necessitates an increased preparedness for improved maternal and perinatal health and blood safety. However, serological cross-reactions, especially to Dengue virus (DENV), complicate ZIKV antibody serodiagnosis. A novel “pan-Flavi” suspension multiplex immunoassay (PFSMIA) using 25 antigens, whole virus (WV), non-structural protein 1 (NS1), and envelope (E) proteins, from 7 zoonotic flaviviruses for specific detection of ZIKV and DENV IgM and IgG was developed. Patterns of antibody cross-reactivity, avidity, and kinetics were established in 104 sera from returning travelers with known ZIKV and DENV infections. PFSMIA gave IgM- and IgG-sensitivities for both viruses of 96–100%, compared to an immunofluorescence assay. Main IgM cross-reactions were to NS1, for IgG to the E and WV antigens. Infecting virus yielded reactivity to several antigens of the homologous virus, while cross-reactions tended to occur only to a single antigen from heterologous virus(es). A specificity-enhancing computer procedure took into account antibody isotype, number of antibody-reactive antigens per virus, avidity, average degree of cross-reactivity to heterologous flavivirus antigens, and reactivity changes in serial sera. It classified all 50 cases correctly. Applied to sera from 200 pregnant women and 173 blood donors from Sweden, one blood donor was found ZIKV NS1 IgM positive, and another as ZIKV NS1 IgG positive. These samples did not react with other ZIKV antigens and were thereby judged as false-positives. PFSMIA provided sensitive and specific ZIKV and DENV serology, warranting high-throughput serological surveillance and a minimized need for laborious and expensive virus neutralization assays. Electronic supplementary material The online version of this article (doi:10.1007/s00430-017-0517-y) contains supplementary material, which is available to authorized users.

Detection of antibodies is widely used for the diagnosis of infections with arthropod-borne flaviviruses including dengue (DENV) and Zika virus (ZIKV). Due to the emergence of ZIKV in areas endemic for DENV, massive co-circulation is observed and methods to specifically diagnose these infections and differentiate them from each other are mandatory. However, serological assays for flaviviruses in general, and for DENV and ZIKV in particular, are compromised by the high degree of similarities in their proteins which can lead to cross-reacting antibodies and false-positive test results. Cross- reacting flavivirus antibodies mainly target the highly conserved fusion loop (FL) domain in the viral envelope (E-) protein, and we and others have shown previously that recombinant E-proteins bearing FL-mutations strongly reduce cross-reactivity. Here we investigate whether such mutant E-proteins can be used to specifically detect antibodies against DENV and ZIKV in an ELISA- format. IgM antibodies against DENV and ZIKV virus were detected with 100% and 94.2% specificity and 90.7% and 87.5% sensitivity, respectively. For IgG the mutant E-proteins showed cross-reactivity, which was overcome by pre- incubation of the sera with the heterologous antigen. This resulted in specificities of 97.1% and 97.9% and in sensitivities of 100% and 100% for the DENV and ZIKV antigens, respectively. Our results suggest that E-proteins bearing mutations in the FL-domain have a high potential for the development of serological DENV and ZIKV tests with high specificity.

In March 2014, the World Health Organization was notified of an outbreak of a communicable disease characterized by fever, severe diarrhea, vomiting, and a high fatality rate in Guinea. Virologic investigation identified Zaire ebolavirus (EBOV) as the causative agent. Full-length genome sequencing and phylogenetic analysis showed that EBOV from Guinea forms a separate clade in relationship to the known EBOV strains from the Democratic Republic of Congo and Gabon. Epidemiologic investigation linked the laboratory-confirmed cases with the presumed first fatality of the outbreak in December 2013. This study demonstrates the emergence of a new EBOV strain in Guinea.

The interplay between arthropod-borne (arbo) viruses and their vectors is usually complex and often exert unique relationships. Aedes japonicus japonicus (Hulecoeteomyia japonica or Ochlerotatus japonicus japonicus), an invasive mosquito species with laboratory proven vector competence for a number of emerging viruses has been newly introduced to Germany and is currently expanding its range throughout the country. On the other hand, West Nile virus (WNV), an emerging arbovirus originating from Africa, is already circulating in several European countries and might soon be introduced to Germany. Because newly introduced and rapidly expanding vector species pose a potential risk for public health in Germany, we assessed the vectorial capacity of German Ae. j. japonicus populations for WNV and Japanese encephalitis virus (JEV). The results indicate that German Ae. j. japonicus are susceptible for JEV but are refractory to infection with WNV. Of 67 Ae. j. japonicus females challenged by feeding of WNV-containing blood, none had measurable amounts of WNV-RNA (0 % infection rate) on day 14 post-infection. In contrast, all females challenged with JEV were positive for JEV-RNA (100 % infection rate) on day 14 post-infection. The reason for WNV resistance remains to be determined but is independent from co-infection with other flaviviruses or the presence of endosymbiotic Wolbachia, since we found no evidence for other flavivirus infections within 1,033 tested A. j. japonicus females from the sampling region, nor detectable Wolbachia infection within 30 randomly selected individuals.

Hantavirus is a zoonosis transmitted from rodents to humans. Asymptomatic infected rodents can secrete hantaviruses in the urine, feces, and saliva. The main route of infection transmission to human is aerosols contaminated with the virus. This study was designed to evaluate the serological and molecular prevalence of hantavirus as an emerging zoonoses disease among street sweepers in Isfahan province, central Iran. Serum samples from 200 street sweepers in healthy condition and those with recent renal failure were tested by ELISA (IgM and IgG). Molecular analysis was subsequently applied for IgM positive cases. From these samples, 9 (4.5%) were positive, of which 2 (22.22%) were positive for both IgM and RT-PCR, while 7 (77.77%) were positive for IgG. The mean age and work experience of the positive cases were 39.7 and 11.5 respectively. According to our observations, all positive cases reported prevalence of rodents in their work place. The logistic regression test showed that the age and work experience were not risk factors for being positive, but prevalence of rodents in work place was a risk factor for being positive, when compared with negative cases. This is the first comprehensive study on the prevalence of hantavirus with positive results coming from Iranian population, which can raise the public awareness for the hantavirus infections as a public health threat.

A major concern caused by the discontinuation of disease modifying treatment for multiple sclerosis (MS) is a rebound of disease activity. Hypotheses about the underlying mechanism of fingolimod (FTY) induced exaggerated inflammatory responses are diverse. So far, vaccinations as a trigger for rebound activity following FTY suspension have not been described. However, several reports have highlighted the occurrence of neurological and autoimmune side effects after single or combined multi-vaccination procedures. Here, we describe the case of a highly active female MS patient demonstrating recurrent, severe MS relapses accompanied by extensive MRI activity, subsequent to yellow fever vaccination two months following FTY withdrawal. Blood and cerebrospinal fluid immunophenotyping indicated a B cell/plasma cell autoreactivity. Following a therapy with natalizumab the clinical, laboratory, MRI, and disease course improved significantly. This case hints towards a combined immunological mechanism characterized by molecular mimicry, bystander activation, and lymphocyte re-egress, resulting in extensive neurological impairment and shows that natalizumab represents a therapeutic option to counteract B cell mediated autoreactivity. Especially, the diagnostic and therapeutic management of this complex scenario might be instructive for clinical practice.

Little is known about the structure and function of the 250-kDa L protein of hantaviruses, although it plays a central role in virus genome transcription and replication. When attempting to study Andes virus (ANDV) L protein in mammalian cells, we encountered difficulties. Even in a strong overexpression system, ANDV L protein could not be detected by immunoblotting. Deletion analysis revealed that the 534 N-terminal amino acid residues determine the low-expression phenotype. Inhibition of translation due to RNA secondary structures around the start codon, rapid proteasomal degradation, and reduced half-life time were excluded. However, ANDV L protein expression could be rescued upon mutation of the catalytic PD-E-K motif and further conserved residues of the putative endonuclease at the N terminus of the protein. In addition, wild-type ANDV L rather than expressible L mutants suppressed the level of L mRNA, as well as reporter mRNAs. Wild-type L protein also reduced the synthesis of cellular proteins in the high-molecular-weight range. Using expressible ANDV L mutants as a tool for localization studies, we show that L protein colocalizes with ANDV N and NSs but not Gc protein. A fraction of L protein also colocalized with the cellular processing (P) body component DCP1a. Overall, these data suggest that ANDV L protein possesses a highly active endonuclease at the N terminus suppressing the level of its own as well as heterologous mRNAs upon recombinant expression in mammalian cells.

In spring 2016, a German traveller returning from Martinique cultivated imported plant offsets in her home, and accidentally bred Aedes aegypti. Thirteen adult mosquito specimens submitted for identification and the traveller were tested for Zika, dengue and chikungunya virus infections, with negative results. The detection of Ae. aegypti by the ‘Mueckenatlas’ project demonstrates the value of this passive surveillance scheme for potential public health threats posed by invasive mosquitoes in Germany.