Background West Nile fever (WNF) is a mosquito-borne flavivirus infection endemic in Africa and Asia.
In 1996, the first major WNF epidemic in Europe occurred in Romania, with a high rate of neurological infections.
We investigated the epidemic to characterise transmission patterns in this novel setting and to determine its origin.
Methods Hospital-based surveillance identified patients admitted with acute aseptic meningitis and encephalitis in 40 Romanian districts, including Bucharest.
Infection was confirmed with IgM capture and indirect IgG ELISAs.
In October, 1996, we surveyed outpatients in Bucharest and seven other districts to estimate seroprevalence and to detect infected patients not admitted to hospital.
We also measured the rates of infection and seropositivity in mosquitoes and birds, respectively.
Results Between July 15 and Oct 12, we identified 393 patients with serologically confirmed or probable WNF infection, of whom 352 had acute central-nervous-system infections. 17 patients older than 50 years died.
Fatality/case ratio and disease incidence increased with age.
The outbreak was confined to 14 districts in the lower Danube valley and Bucharest (attack rate 124/100 000 people) with a seroprevalence of 41%. The number of mild cases could not be estimated.
WN virus was recovered from Culex pipiens mosquitoes, the most likely vector, and antibodies to WN virus were found in 41% of domestic fowl. (...)
Mots-clés Pascal : Encéphalite West Nile, Arbovirose, Virose, Infection, Epidémiologie, Exploration clinique, Technique ELISA, Séropositivité, Facteur risque, Flavivirus, Flaviviridae, Virus, Transmission animal homme, Homme, Roumanie, Europe, Sud est, Système nerveux pathologie, Système nerveux central pathologie, Encéphale pathologie
Mots-clés Pascal anglais : West Nile encephalitis, Arbovirus disease, Viral disease, Infection, Epidemiology, Clinical investigation, ELISA assay, Seropositivity, Risk factor, Flavivirus, Flaviviridae, Virus, Transmission from animal to man, Human, Romania, Europe, Southeast, Nervous system diseases, Central nervous system disease, Cerebral disorder
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0418067
Code Inist : 002B05C02I1D. Création : 25/01/1999.