Inactivation of West Nile virus, vaccinia virus and viral surrogates for relevant and emergent viral pathogens in plasma-derived products

BACKGROUND AND OBJECTIVES: Human plasma is the source of a wide variety of therapeutic proteins, yet it is also a potential source of viral contamination. Recent outbreaks of emergent viral pathogens, such as West Nile virus, and the use of live vaccinia virus as a vaccine have prompted a reassessment of the viral safety of plasma-derived products. The purpose of this study was to evaluate the efficacy of current viral inactivation methods for West Nile and vaccinia viruses and to reassess the use of model viruses to predict inactivation of similar viral pathogens. MATERIALS AND METHODS: Virus-spiked product intermediates were processed using a downscaled representation of various manufacturing procedures. Virus infectivity was measured before and after processing to determine virus inactivation. RESULTS: The results demonstrated effective inactivation of West Nile virus, vaccinia virus and a model virus, bovine viral diarrhoea virus, during pasteurization, solvent/detergent treatment and caprylate treatment. Caprylate provided rapid and effective inactivation of West Nile virus, vaccinia virus, duck hepatitis B virus and Sindbis virus. Inactivation of West Nile virus was similar to that of bovine viral diarrhoea virus. CONCLUSIONS: This study demonstrates that procedures used to inactivate enveloped viruses in manufacturing processes can achieve inactivation of West Nile virus and vaccinia virus. In addition, the data support the use of model viruses to predict the inactivation of similar emergent viral pathogens.     

西尼罗病毒感染免疫应答反应研究进展

西尼罗病毒病是由西尼罗病毒引起的一种人兽共患传染病,给人类和动物健康带来重大危害。虽现已有疫苗处在研究阶段,但仍没有人用疫苗获批上市。通过感染动物模型,有关西尼罗病毒免疫反应的研究已经开展。本文对固有免疫和获得性免疫在抵抗西尼罗病毒感染中的作用进行综述,为进一步研究西尼罗病毒激发免疫应答反应的机制和新型疫苗研制提供依据。     

Epidemiology of human West Nile virus infections in the European Union and European Union enlargement countries, 2010 to 2018

BackgroundWest Nile virus (WNV) circulates in an enzootic cycle involving mosquitoes and birds; humans are accidental hosts.AimWe analysed human WNV infections reported between 2010 and 2018 to the European Centre for Disease Prevention and Control to better understand WNV epidemiology.MethodsWe describe probable and confirmed autochthonous human cases of WNV infection reported by European Union (EU) and EU enlargement countries. Cases with unknown clinical manifestation or with unknown place of infection at NUTS 3 or GAUL 1 level were excluded from analysis.ResultsFrom southern, eastern and western Europe, 3,849 WNV human infections and 379 deaths were reported. Most cases occurred between June and October. Two large outbreaks occurred, in 2010 (n = 391) and in 2018 (n = 1,993). The outbreak in 2018 was larger than in all previous years and the first cases were reported unusually early. The number of newly affected areas (n = 45) was higher in 2018 than in previous years suggesting wider spread of WNV.ConclusionReal-time surveillance of WNV infections is key to ensuring that clinicians and public health authorities receive early warning about the occurrence of cases and potential unusual seasonal patterns. Human cases may appear shortly after first detection of animal cases. Therefore, public health authorities should develop preparedness plans before the occurrence of human or animal WNV infections.     

加强对西尼罗病毒的认识

西尼罗病毒感染可引起西尼罗热和西尼罗脑炎,是一种新发传染病,为近年来全球公共卫生的新威胁。本文对西尼罗病毒的生物学特性、致病机制、临床症状和疫苗等方面的研究进展进行综述,为我国防治西尼罗病毒感染提供参考。     

西尼罗病毒RT-PCR检测方法的建立及其初步应用

目的　建立西尼罗病毒 (WestNilevirus ,WNV)RT PCR检测方法 ,为WNV感染的诊断和流行病学调查奠定基础。方法　选择Vero E6细胞进行WNV培养 ,通过乳鼠脑内接种病毒培养液获得WNV感染脑组织。在病毒基因组E区和C区设计 3对引物 ,以WNV培养液 ,建立并优化病毒核酸RT PCR分析方法。然后 ,以此对感染蚊虫模拟标本和乳鼠脑组织进行检测。PCR产物测序后 ,用Blast进行同源性分析。结果　用RT PCR在WNV培养液中扩增出与预期大小一致的核苷酸片段 ,并通过改变循环数 ,模板稀释倍数等参数对该方法进行了优化 ;将建立的方法用于检测感染蚊虫模拟标本和感染乳鼠脑组织 ,均检测出WNV目的基因片段 ,且扩增效果与病毒培养液无明显差异 ;套式PCR能显著提高检测的敏感性 ( 10 8-10 9倍 )。结论　本研究建立的WNVRT PCR检测方法具有较高的敏感性 ,可用于WNV感染的流行病学调查研究     

Seroprevalence of West Nile virus infection in solid organ transplant recipients

A.G. Freifeld, J. Meza, B. Schweitzer, L. Shafer, A.C. Kalil. A.R. Sambol. Seroprevalence of West Nile virus infection in solid organ transplant recipients.
Transpl Infect Dis 2010: 12: 120–126. All rights reserved Background. Of people infected with mosquito‐borne West Nile virus (WNV), <1% develop neuroinvasive disease (NID). Population studies suggest that people older than 65 years may be at higher risk for neurologic symptoms. It has been suggested that solid organ transplant (SOT) recipients are also at higher risk for WNV NID, but definitive serologic and epidemiologic data are lacking. Methods. A serologic screening survey, using a US Food & Drug Administration‐approved enzyme‐linked immunosorbant assay to detect WNV immunoglobulin‐G (IgG) antibody responses in cohorts of SOT recipients and non‐immunocompromised controls, was undertaken at a large Midwestern university organ transplant center in the aftermath of the summer 2003 WNV regional outbreak. Hemagglutination‐inhibition testing was used to confirm WNV IgG‐positive results and differentiate them from positive results caused by Saint Louis encephalitis virus, another flavivirus that is endemic in the Midwestern US. Findings. The rate of WNV IgG‐seropositive responses did not differ between SOT recipients and non‐immunocompromised controls, and were 12% and 10%, respectively. Retrospective chart review showed no documented WNV NID in the seropositive SOT recipients, suggesting an incidence of WNV NID may be as low as 0.7% in this population. Interpretation. Asymptomatic WNV infection is common among immunocompromised SOT patients, occurring as often as it does in non‐immunocompromised controls. Our data indicated that severe WNV NID is less frequent in SOT patients, contrary to what has been suggested in other studies.     

No evidence of West Nile virus infection in Dutch blood donors

BACKGROUND AND OBJECTIVES: West Nile virus (WNV) can be transmitted by transfusion through infected blood components. This study aimed to determine the prevalence of WNV infection among Dutch blood donors to assess whether WNV is a possible threat for the Dutch blood supply. MATERIALS AND METHODS: Plasma samples from 61 992 blood donations were pooled in 7,749 test pools of eight donations using a Tecan robot. These samples were collected between April and October 2004. The pools were tested for the presence of WNV RNA by using the Procleix WNV assay. RESULTS: No WNV RNA-positive pools were detected. Based on Poisson distribution statistics, extrapolation of our data to all the Dutch donations in 2004 revealed that between 0 and 55 cases of WNV infection could be expected. CONCLUSIONS: No evidence of the presence of WNV RNA in Dutch blood donor samples from 2004 was found. However, surveillance of this emerging infection is of importance to safeguard the blood supply in the future because the transmission cycle of WNV is complex and hard to predict.     

West Nile virus: immunity and pathogenesis

West Nile virus (WNV) is a neurotropic, arthropod-borne flavivirus that is maintained in an enzootic cycle between mosquitoes and birds, but can also infect and cause disease in horses and humans. WNV is endemic in parts of Africa, Europe, the Middle East, and Asia, and since 1999 has spread to North America, Mexico, South America, and the Caribbean. WNV infects the central nervous system (CNS) and can cause severe disease in a small minority of infected humans, mostly immunocompromised or the elderly. This review discusses some of the mechanisms by which the immune system can limit dissemination of WNV infection and elaborates on the mechanisms involved in pathogenesis. Reasons for susceptibility to WNV-associated neuroinvasive disease in less than 1% of cases remain unexplained, but one favored hypothesis is that the involvement of the CNS is associated with a weak immune response allowing robust WNV replication in the periphery and spread of the virus to the CNS.     

Immunogenic potential and protective efficacy of formalin inactivated circulating Indian strain of West Nile virus

Objective:To assess the best suitable condition for virus inactivation.and to study the immunogenic potential and protective efficacy of a circulating West Nile virus(WNV) strain in Assam.Methods:Bulk preparation of circulating WNV:WNIRGC07(GeneBank ID:HQ246154).was undertaken in a bioreaclor using eytodex-1.Virus Inactivation was done in three different conditions:22 ℃.4 ℃ and room temperature.The virus preparations were evaluated for antigenicity by ELISA and toxicity by cell proliferation kit.Virus efficacy was done in-viro on swiss albino mice against standard Indian WNV and Japanese encephalitis virus(JKV)strain.Humoral and cell mediated immune response was evaluated in mice sera by ELISA and neutralization assay.Results:Inactivation at 22 ℃ was found to be more suitable in terms of less toxicity and high antigenicity.The same was selected to study the immune response and efficacy in mice.It induced neutralizing antibody titre of 1:625 and high EgG response.In vivo experiment showed 100% protective efficacy against WNV and 20.8% cross protective efficacy against JEV.Further assessment of cellular immunity through immunized mice revealed augmentation of high levels of pro-inflammatory cytokines and moderate levels of anti—cytokines indicating a mixed balance of Th1 and Th2 response.Conclusions:Findings suggest that formalin inactivated Indian WNV strain has a good immunogenic potential.This is the first study on assessment of immunogenic potential of a lineage 5 strain of WNV.Our study reveals that it would be a promising and effective candidate for vaccine studies which warrants further evaluation.     

West Nile virus meningitis in a chronic immunosuppressed patient with rheumatoid arthritis

The clinical presentation of West Nile virus (WNV) can be severe in immunosuppressed patients. A 65-year-old with steroid-dependent rheumatoid arthritis on infliximab and methotrexate presented with meningitis and profound muscular weakness. Serum WNV IgM and IgG antibody were positive. WNV should be included in the differential diagnosis of neurological symptoms in peak months.     

A brief report of West Nile Virus neuroinvasive disease in the summer of 2012 in Hamilton,Ontario

West Nile neuroinvasive disease is a severe infectious disease that is associated with a high mortality rate, especially in immunocompromised hosts. Physicians who are aware of its clinical presentations may be able to order diagnostic tests more appropriately and avoid inappropriate treatment. In the present series, the cases of seven patients admitted to Hamilton Health Sciences (Hamilton, Ontario) in the summer of 2012 with a diagnosis of West Nile neuroinvasive disease were retrospectively reviewed based on available medical records. According to the clinical and laboratory criteria published by the Centers for Disease Control and Prevention, five cases were diagnosed as encephalitis, one case as meningitis and one case as meningomyelitis. Patients were managed supportively. Forty-three percent (three of seven) presented with rash, 71% (five of seven) did not report headache despite exhibiting neurological symptoms, 43% (three of seven) did not have fever on presentation and 37.5% of cerebrospinal fluid samples exhibited a neutrophil predominance. The mortality rate in the present series was 14.3% (one of seven), and 57.1% (four of seven) of the patients had residual symptoms on discharge and at follow-up.     

Vaccines in Development against West Nile Virus

West Nile encephalitis emerged in 1999 in the United States, then rapidly spread through the North American continent causing severe disease in human and horses. Since then, outbreaks appeared in Europe, and in 2012, the United States experienced a new severe outbreak reporting a total of 5,387 cases of West Nile virus (WNV) disease in humans, including 243 deaths. So far, no human vaccine is available to control new WNV outbreaks and to avoid worldwide spreading. In this review, we discuss the state-of-the-art of West Nile vaccine development and the potential of a novel safe and effective approach based on recombinant live attenuated measles virus (MV) vaccine. MV vaccine is a live attenuated negative-stranded RNA virus proven as one of the safest, most stable and effective human vaccines. We previously described a vector derived from the Schwarz MV vaccine strain that stably expresses antigens from emerging arboviruses, such as dengue, West Nile or chikungunya viruses, and is strongly immunogenic in animal models, even in the presence of MV pre-existing immunity. A single administration of a recombinant MV vaccine expressing the secreted form of WNV envelope glycoprotein elicited protective immunity in mice and non-human primates as early as two weeks after immunization, indicating its potential as a human vaccine.     

Antiviral Cytokine Response in Neuroinvasive and Non-Neuroinvasive West Nile Virus Infection

Data on the immune response to West Nile virus (WNV) are limited. We analyzed the antiviral cytokine response in serum and cerebrospinal fluid (CSF) samples of patients with WNV fever and WNV neuroinvasive disease using a multiplex bead-based assay for the simultaneous quantification of 13 human cytokines. The panel included cytokines associated with innate and early pro-inflammatory immune responses (TNF-α/IL-6), Th1 (IL-2/IFN-γ), Th2 (IL-4/IL-5/IL-9/IL-13), Th17 immune response (IL-17A/IL-17F/IL-21/IL-22) and the key anti-inflammatory cytokine IL-10. Elevated levels of IFN-γ were detected in 71.7% of CSF and 22.7% of serum samples (p = 0.003). Expression of IL-2/IL-4/TNF-α and Th1 17 cytokines (IL-17A/IL-17F/IL-21) was detected in the serum but not in the CSF (except one positive CSF sample for IL-17F/IL-4). While IL-6 levels were markedly higher in the CSF compared to serum (CSF median 2036.71, IQR 213.82–6190.50; serum median 24.48, IQR 11.93–49.81; p < 0.001), no difference in the IL-13/IL-9/IL-10/IFN-γ/IL-22 levels in serum/CSF was found. In conclusion, increased concentrations of the key cytokines associated with innate and early acute phase responses (IL-6) and Th1 type immune responses (IFN-γ) were found in the CNS of patients with WNV infection. In contrast, expression of the key T-cell growth factor IL-2, Th17 cytokines, a Th2 cytokine IL-4 and the proinflammatory cytokine TNF-α appear to be concentrated mainly in the periphery.     

西尼罗病毒抗体酶联免疫吸附试验检测方法的评价

目的系统地评价血清西尼罗病毒(West Nile virus,WNV)抗体的酶联免疫吸附试验(ELISA)检测方法,为在人群和宿主动物中进行WNV感染血清流行病学调查提供技术支持。方法利用构建的包膜蛋白重组质粒(pQE-30)表达纯化西尼罗病毒包膜蛋白,以此为抗原进行ELISA检测。在对抗原包被量、酶标抗体浓度、血清稀释度进行优化的基础上,对本方法的灵敏度和特异度进行评价。结果确定最适抗原包被量为0.034μg,酶标抗体工作浓度和血清稀释度分别为1∶4 800和1∶80;批内变异和批间变异分别为6.7%和22.6%;对小鼠WNV抗体阳性血清53份、JEV抗体阳性血清48份和阴性对照血清94份进行检测,灵敏度为86.8%,特异度分别为93.8%和92.6%。结论本研究建立的ELISA方法灵敏、检测抗体特异,结果可重复,是一种有价值的血清学调查方法。     

西尼罗病毒的研究进展

西尼罗病毒（West Nile Virus,WNV）属黄病毒科,为正单链RNA病毒,主要由蚊虫叮咬传播。近几年,随着WNV感染的流行,除蚊虫叮咬以外的传播途径如输血等日益受到重视,WNV感染的实验室诊断不断取得进展,相关疫苗的研制也在进行之中。本文就WNV的分子生物学、流行病学、感染与免疫、实验室诊断及疫苗的研究进展作一综述。     

间接免疫荧光试验在西尼罗病毒抗体检测中的初步应用

目的了解人群血清西尼罗病毒(WNV)抗体存在的本底,探讨WNV与乙型脑炎病毒(JEV)的免疫交叉反应。方法以新兵入伍健康体检时收集的男性血清347份为检测标本,应用建立的间接免疫荧光试验(IFA)对WNV与JEV的IgG抗体进行检测。结果血清WNV和JEV的抗体阳性率分别为3.2%(11/347)和5.7%(14/244);在同时检测了两种病毒抗体的244份标本中,有3份两者均为阳性,分别占WNV和JEV抗体阳性数的60%(3/5)和21%(3/14)。结论人群对WNV缺乏免疫力,JEV抗体对WNV的交叉免疫作用有一定的局限性。     

Unprecedented increase of West Nile virus neuroinvasive disease,Spain, summer 2020

Cases of West Nile neuroinvasive disease (WNND) in Spain increased in summer 2020. Here we report on this increase and the local, regional and national public health measures taken in response. We analysed data from regional surveillance networks and the National Epidemiological Surveillance Network, both for human and animal West Nile virus (WNV) infection. During the 2020 season, a total of 77 human cases of WNV infection (median age 65 years; 60% males) were detected in the south-west of Spain; 72 (94%) of these cases developed WNND, presenting as meningoencephalitis, seven of which were fatal. In the previous two decades, only six human cases of WNND were detected in Spain. Reduced activities for vector control this season, together with other factors, might have contributed to the massive increase. Public health measures including vector control, campaigns to raise awareness among physicians and the general population, and interventions to ensure the safety of donations of blood products, organs, cells and tissues were effective to reduce transmission. Going forward, maintenance of vector control activities and an update of the vector-borne diseases response plan in Spain is needed.