Open Access is an initiative that aims to make scientific research freely available to all. To date our community has made over 100 million downloads. It’s based on principles of collaboration, unobstructed discovery, and, most importantly, scientific progression. As PhD students, we found it difficult to access the research we needed, so we decided to create a new Open Access publisher that levels the playing field for scientists across the world. How? By making research easy to access, and puts the academic needs of the researchers before the business interests of publishers.
We are a community of more than 103,000 authors and editors from 3,291 institutions spanning 160 countries, including Nobel Prize winners and some of the world’s most-cited researchers. Publishing on IntechOpen allows authors to earn citations and find new collaborators, meaning more people see your work not only from your own field of study, but from other related fields too.
To purchase hard copies of this book, please contact the representative in India:
CBS Publishers & Distributors Pvt. Ltd.
www.cbspd.com
|
customercare@cbspd.com
Zoonotic diseases are an important public health problem worldwide. Two large groups of zoonotic viruses include arboviruses and rodent-borne viruses. Avian influenza, SARS-CoV-2, hepatitis E, and recently re-emerged monkeypox are also medically important viral zoonoses. Tick-borne encephalitis is the most important tick-borne disease in Europe with a growing incidence. West Nile infections are continuously reported as small or large outbreaks. Although the number of Usutu virus infections showed an increasing trend, this arbovirus is still neglected as well as Toscana, Tahyna, and Bhanja viruses. The number of Crimean-Congo hemorrhagic fever cases is increasing in the recent years. Hantaviruses are the most important rodent-borne viruses. Orthohantavirus Puumala is responsible for more than 90% of hemorrhagic fever with renal syndrome cases in Europe; however, Dobrava orthohantavirus is also recorded. Lymphocytic choriomeningitis is a neglected viral zoonosis with unknown prevalence. Avian influenza outbreaks in poultry are on the rise over the past two decades, with a consequent increase in human infections. The SARS-CoV-2 pandemic has highlighted the importance of coronaviruses in human diseases. Hepatitis E virus is an emerging virus with zoonotic genotype 3 the most frequently detected in Europe. The epidemiology of monkeypox has changed with considerable human-to-human transmission, predominantly among men who have sex with men.
Croatian Institute of Public Health, Zagreb, Croatia
School of Medicine University of Zagreb, Zagreb, Croatia
Vladimir Savić
Croatian Veterinary Institute, Zagreb, Croatia
Snježana Židovec-Lepej
University Hospital for Infectious Diseases “Dr Fran Mihaljević”, Zagreb, Croatia
Maja Bogdanić
Croatian Institute of Public Health, Zagreb, Croatia
Vladimir Stevanović
Faculty of Veterinary Medicine, University of Zagreb, Croatia
Ljubo Barbić
Faculty of Veterinary Medicine, University of Zagreb, Croatia
*Address all correspondence to: tatjana.vilibic-cavlek@hzjz.hr
1. Introduction
Zoonoses represent an important public health problem worldwide. It is estimated that 60% of known infectious diseases and up to 75% of newly emerging diseases are zoonotic in origin [1]. Some zoonotic diseases are still neglected, mainly due to a lack of commercially available diagnostic tests. The most important emerging and neglected viral zoonoses in Europe are presented in Table 1.
Tick-borne encephalitis virus (TBEV) is one of the most important human tick-borne viral zoonoses in Europe and Asia. From 2012 to 2020, a significant increase in TBEV cases was recorded in the European Union/European Economic Area (EU/EEA) countries with 19 countries reporting 29.974 cases of TBE. The Czech Republic, Germany, and Lithuania reported 52.9% of all cases. TBE cases showed a seasonal distribution with the majority detected from April to November. In many countries, a bimodal distribution was observed with the first peak occurring in early July, and a second, usually smaller peak, at the end of September. Cases were predominantly males (59.5%) [2].
West Nile virus (WNV) is the most widely distributed mosquito-borne viral zoonosis in southern, eastern, and western Europe. Since 2012, WNV cases were continuously reported in small or large outbreaks. The largest outbreak so far was recorded in 2018, when the number of WNV cases exceeded the total number of infections reported between 2010 and 2017 [3]. Since 2008, the WNV lineage 2 has spread over central Europe and the eastern Mediterranean region and has become endemic causing significant outbreaks in humans and animals. WNV lineage 1 re-emerged in Italy in 2021 with a trend of rapid expansion. Comparative analysis of WNV lineage 1 and 2 suggested that WNV-1-infected patients might have an increased risk to develop severe neuroinvasive disease [4].
Although the number of human Usutu virus (USUV) infections is growing, this virus is still neglected in many European countries. To date, over 100 cases of acute human USUV infections have been described in Europe, including 30 patients with neuroinvasive disease. Most human clinical cases were reported in Italy because of active USUV circulation in this country [5]; however, cases of neuroinvasive disease were also reported in Croatia (2013, 2018) [6, 7], France (2016) [8], Hungary (2018) [9], and Austria (2019) [10].
Although Toscana virus (TOSV) is a frequent cause of aseptic meningitis in southwestern Europe, TOSV infection is not a notifiable disease in the EU/EEA. So far, more than 800 autochthonous and imported human cases were reported in residents of Mediterranean countries and in tourists and travelers returning from endemic areas [11]. In some European countries such as France and Italy, TOSV is among the three most common causes of meningitis in the summer months [12].
There are very limited data on the distribution and prevalence of Tahyna orthobunyavirus (TAHV) in the human population as well as the information on the public health significance of its natural foci in Europe. The TAHV disease is neglected and underreported [13]. Similarly, data on the human Bhanja bandavirus (BHAV) infections are very scarce.
Crimean-Congo hemorrhagic fever virus (CCHFV) is an emerging tick-borne arbovirus that causes severe disease with high fatality rates. In the EU/EEA and its neighboring countries, sporadic cases, as well as outbreaks of CCHF were reported in Albania, Bulgaria, Georgia, Greece, Kosovo, Russia, Spain, Ukraine, and Turkey. The number of cases is increasing in the recent years [14].
Puumala (PUUV) and Dobrava (DOBV) are the most frequent orthohantaviruses that cause hemorrhagic fever with renal syndrome (HFRS) in Europe. In the period 2016–2020, the overall HFRS notification rate varied between 0.4 and 1.0 cases/10.000 population, with no obvious long-term trend. Most cases were infected by PUUV (98.3%), and people aged 25 years and older accounted for 92% of cases [15]. Tula orthohantavirus has recently been molecularly confirmed as a human pathogen, resulting in a very mild form of HFRS [16].
Lymphocytic choriomeningitis virus (LCMV) is a neglected rodent-borne virus with very few reports of human infections. The disease has been underreported due to the restricted availability of serological testing, which makes it challenging to estimate the incidence. However, seroprevalence data suggest that the virus is present in Europe with seroprevalence rates of up to 15% in the general population [17]. However, in some highly endemic countries, seropositivity was high (37.5% in Slovakia and 36% in Croatian Vir Island) [18].
Avian influenza virus (AIV) is mainly an occupational (re-)emerging infection in humans in Europe. AIV of subtype H7N7 was detected in 86 humans who handled affected poultry and in three of their family members in the Netherlands in 2003 [19]. Although numerous human H5N1 infections occurred mainly in Asia and Africa, few human cases of H5N1 infection were recently reported in a poultry keeper and poultry workers in the United Kingdom [20].
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus that caused over 6.9 million deaths worldwide by May 2023. The epidemiological situation of coronavirus disease (COVID-19) is continually evolving [21, 22].
Hepatitis E virus (HEV) infection is a global health problem, yet a clinically underdiagnosed cause of acute and chronic hepatitis. The zoonotic HEV3 genotype is the most common cause of infections in Europe [23]. In the past decade, a 10-fold increase in reported cases was observed in EU/EEA countries. Males above 50 years of age represent the majority of acute HEV cases [24].
Monkeypox virus (MPXV) represents a new global health emergency. Although the majority of cases of monkeypox were previously only identified in Africa, the current outbreak is being reported in many regions, including Europe. The first non-endemic outbreak of human monkeypox occurred in the United States (USA) in 2003 with 47 documented cases, but no community transmission, that was traced to imported infected West African rodents. Thereafter, sporadic cases of travel-associated MPXV infections were reported in Israel, the United Kingdom (UK), and the USA with limited secondary spread [25, 26]. In 2022, many countries in previously non-endemic regions reported multiple cases of monkeypox associated with considerable human-to-human transmission, starting with a cluster of cases in the UK in May 2022 [27]. Men who have sex with men (MSM) and bisexual men were predominantly affected in the 2022 outbreak [28].
Arboviruses are a diverse group of more than 500 viruses transmitted by arthropods (ticks, mosquitoes, sandflies). In nature, arboviruses are maintained in a cycle involving vertebrate hosts and hematophagous arthropods. Humans represent incidental or dead-end hosts for the majority of arboviral infections (Figure 1). However, human-to-human transmission through contact with infectious blood or body fluids is documented for CCHFV (Figure 2).
Figure 1.
Transmission cycle of mosquito-borne (A) and tick-borne arboviruses (B-D).
Figure 2.
Transmission cycle of Crimean-Congo hemorrhagic fever virus.
2.1 Tick-borne encephalitis virus
TBEV is a tick-borne flavivirus of the family Flaviviridae, genus Flavivirus, tick-borne encephalitis serocomplex. There are three main subtypes of TBEV: European, Far-East, and Siberian, which are distributed in a wide area from Europe to Japan. Two novel subtypes, the Baikalian subtype (Irkutsk region, Buryat Republic, and Trans-Baikal Territory of Eastern Siberia) and the Himalayan subtype (Qinghai-Tibet Plateau, China), were discovered recently [29, 30, 31]. The virus is maintained in nature in a cycle involving ticks of the Ixodes spp. and small mammals such as rodents (genera Apodemus and Myodes). The larvae and nymphs mainly feed on small- and medium-sized mammals, and adults on large animals such as ungulates. Ticks could also be TBEV reservoirs since the virus can be transmitted transovarially and transstadially [32]. The most common mode of transmission to humans is by the bite of an infected tick; however, approximately 1% of infections are caused by food-borne transmission (mainly consumption of unpasteurized goat milk) [33]. Seroprevalence studies from endemic regions indicate that a significant proportion of TBEV infections (70–98%) remain asymptomatic. In general, children typically have a milder form of the disease than adults [29]. The European TBE is usually a biphasic disease. The first phase corresponds to viremia and manifests as fever, fatigue, malaise, headache, muscle, and joint pain. After an improvement of a few days, the second phase occurs characterized by central nervous system (CNS) involvement. The most common presentation of neuroinvasive disease in children is meningitis. In adults, meningitis, meningoencephalitis, and meningoencephalomyelitis occur in 50%, 40%, and 5–10% of patients, respectively [34]. The Siberian TBE also results in a generally mild disease associated with a non-paralytic form of encephalitis. The Far-East subtype of TBEV causes the most severe monophasic form of TBE. The case-fatality rate for the European subtype of TBEV is 0.5–2%, compared to 20% for the Far-East subtype [29]. Analysis of local and systemic cytokine responses in TBE patients revealed a complex network of early innate immune response cytokines, Th1, Th2, Th9, Th22, Th17, and anti-inflammatory cytokines characterized by significantly increased cerebrospinal fluid (CSF) concentrations of IL-6 and IFN-γ [35]. Since the virus has already been cleared from the blood and is very exceptionally present in the CSF at the time of neurological symptoms, isolation of TBEV from blood and detection of viral RNA by reverse transcriptase polymerase chain reaction (RT-PCR) in blood or CSF have a limited diagnostic value [36]. Diagnosis is usually confirmed by the detection of specific IgM and IgG antibodies in the serum and CSF. Determination of IgG avidity may be helpful in cases with atypical serological responses [37]. Vaccination is the most effective method of TBE prevention in endemic areas.
2.2 West Nile virus
WNV is a mosquito-borne flavivirus of the family Flaviviridae, genus Flavivirus, Japanese encephalitis serocomplex. There are several genetic lineages of which lineages 1 and 2 are the most important [38]. WNV is transmitted in an enzootic cycle between birds and mosquitoes, mainly Culex spp. Most human infections occur after the bite of infected mosquitoes. Interhuman transmission may occur through blood transfusion and organ transplantation from an infected and viremic donor [39]. In addition, rare cases of transplacental transmission and transmission through breastfeeding were also described [40]. The majority of human WNV infections are asymptomatic. About 20% of patients present with a non-specific febrile disease (WNV fever) and < 1%, and mainly elderly and immunocompromised patients develop WNV neuroinvasive disease (meningitis, encephalitis, myelitis). Rare clinical presentations of WNV infection include retinitis [41], cerebellitis [42], cauda equina arachnoiditis [43], and opsoclonus-myoclonus syndrome [44]. WNV meningitis manifests as fever, headache, and nuchal rigidity and is clinically indistinguishable from viral meningitis caused by other etiologies. WNV encephalitis is characterized by altered mental status, seizures, focal neurologic deficits, or movement disorders. WNV myelitis is clinically identical to myelitis caused by poliovirus (acute flaccid paralysis) and can progress to respiratory paralysis needing mechanical ventilation. The mortality in neuroinvasive disease is 10% [45]. Cytokine immune responses to WNV in neuroinvasive disease are characterized by increased concentrations of innate and early acute phase responses (IL-6) and Th1 type immune responses (IFN-γ) cytokines in the CSF with Th2, Th17, and pro-inflammatory cytokines in the periphery [46]. Due to short-term and low-level viremia, diagnosis of WNV is usually confirmed by serology. Since IgM antibodies may persist in some patients even years after primary infections, IgG determination could differentiate current from previous infections in these cases. Due to possible cross-reactivity with other flaviviruses, the virus neutralization test (VNT) is still a “gold standard” confirmatory test for the diagnosis of WNV [47]. Prevention of WNV includes preventing mosquito bites using insect repellents, wearing long-sleeved shirts and pants, treating clothing and gear, and controlling mosquitoes indoors and outdoors. Vaccine against WNV is available only for horses [48].
2.3 Usutu virus
USUV is a mosquito-borne flavivirus of the family Flaviviridae, genus Flavivirus, Japanese encephalitis serocomplex. Birds are the natural reservoirs of USUV, while ornithophilic mosquitoes of the Culex spp. are the main vectors. Some bird species such as sparrows (Passer domesticus), gray owls (Strix nebulosi), and blackbirds (Turdus merula) are particularly vulnerable to USUV infection and have a high mortality rate [49]. The virus is transmitted to humans by the bite of infected female mosquitoes. There are eight genetic lineages, five European (Europe 1–5) and three African (Africa 1–3) [50]. The zoonotic potential of USUV has confirmed in a growing number of human cases. Like WNV, the majority of human infections are asymptomatic or present as a non-specific febrile disease (USUV fever). Immunocompromised and elderly patients may develop USUV neuroinvasive disease (meningitis, encephalitis) [51]. USUV Europe 2 lineage is the most prevalent genetic lineage detected in humans [52]. The serological diagnosis of USUV is challenging due to cross-reactivity with other flaviviruses, in particular between USUV and WNV highlighting the need for VNT. Using an RT-PCR, viral RNA can be detected in blood and CSF; however, the sensitivity is low [53]. Since there is no vaccine available, preventing mosquito bites is the best way for USUV prevention.
2.4 Toscana virus
TOSV is a sandfly-borne phlebovirus of the family Phenuiviridae, genus Phlebovirus. So far, there is no evidence of a vertebrate species acting as a reservoir in the TOSV natural cycle. The virus is transmitted to humans through the bite of an infected female sandfly of the genus Phlebotomus (P. perniciosus and P. perfiliewi) [54]. To date, three genetic lineages A, B, and C of TOSV have been identified. Lineage A included strains initially discovered in Italy, whereas lineage B consisted of strains isolated first in Portugal and in Spain [55]. TOSV lineage C strains were reported in Croatia and Greece [56, 57]. TOSV infections have been recorded in residents of or travelers to Mediterranean countries. Furthermore, human seroprevalence studies conducted in Italy, Turkey, and Greece indicated continuing TOSV circulation. In northern Africa, the TOSV-neutralizing antibody seroprevalence rates are much higher (22–33%) than that observed in southwestern Europe (up to 10% in highly endemic areas) [54]. The majority of TOSV infection are asymptomatic or presented as mild febrile disease, which causes the number of cases to be underestimated and underreported. However, some patients develop neuroinvasive disease, mainly meningitis but in rare cases, fatal encephalitis has been reported [58]. Literature data on immune responses during TOSV infection are limited with one study reporting increased concentrations of IL-6, IFN-γ, and IL-10 in the CSF compared with serum in a limited case series [59]. Indirect immunofluorescence (IFA) and enzyme-immunoassay (EIA) are commonly used serological tests for the diagnosis of TOSV. Cross-reactions can occur between viruses antigenically close to TOSV such as Naples phlebovirus. VNT is recommended for confirmation because it is the most specific serological assay. Although the virus can be isolated in the acute phase from blood or CSF, TOSV RNA detection using real-time RT-PCR is the test of reference for direct diagnostic purposes [11].
2.5 Tahyna orthobunyavirus
TAHV is a mosquito-borne bunyavirus of the family Peribunyaviridae, genus Orthobunyavirus, California encephalitis serogroup. The vertebrate hosts for TAHV are hares, rabbits, hedgehogs, and rodents, while culicine mosquitoes, Aedes vexans, are the main vectors [60]. The disease caused by TAHV (“Valtice fever“) was described in the 1960s after the virus was isolated from humans with acute flu-like illness in the Czech Republic [61]. Natural foci of TAHV occur in flooded lowland habitats, sometimes including suburban areas [62]. TAHV infections were reported in continental Europe, Asia, and Africa; however, the incidence of the disease is underestimated and underreported. The majority of TAHV infections are asymptomatic. Human disease caused by TAHV usually presents as a flu-like illness occurring in late summer and early autumn, mainly in children. Despite its association with neurovirulence (meningitis), TAHV infection remains a neglected disease, with rare reports of human clinical infections in the recent decades [61, 63]. However, up to 60–80% of seroprevalence rates have been documented in humans from endemic countries such as the Czech Republic [64]. Diagnosis is confirmed by the detection of TAHV RNA or specific antibodies.
2.6 Bhanja bandavirus
BHAV is a tick-borne bunyavirus of the family Phenuiviridae, genus Bandavirus. The vertebrate hosts for BHAV are sheep, goats, cattle, African hedgehogs (Atelerix albiventris), and African ground squirrels (Xerus erythropus), while metastriate ixodid ticks of the Haemaphysalis spp. are the main vectors. Human infections occur after a bite of an infected tick. Although BHAV is widely distributed in sub-Saharan Africa, central Europe, the Mediterranean basin, countries of the Middle East, and India, the virus is still neglected with only a few human clinical cases reported [65]. Laboratory BHAV infections were characterized by a low-grade fever, headache, muscle and joint pain, and photophobia that lasted 48 hours [66, 67]. Neuroinvasive infections presented with meningoencephalitis and pareses were also recorded [68]. Diagnosis of BHAV can be confirmed by the detection of viral RNA and/or specific antibodies [69].
2.7 Crimean-Congo hemorrhagic fever virus
CCHFV is a tick-borne bunyavirus of the family Nairoviridae, genus Orthonairovirus. Phylogenetic analysis of the S-segment CCHFV genome suggests seven major clades: clade I (Africa 2), clade II (Africa 1), clade III (Europe 2), clade IV (Africa 3), clade V (Europe 1), clade VI (Asia 1), and clade VII (Asia 2) [70]. The endemicity of CCHFV is closely associated with the geographical distribution of the reservoirs and vectors, ixodid ticks of the Hyalomma spp. Among ticks, the virus is transmitted transstadially and transovarially. CCHFV is transmitted to humans by bites of infected ticks or by direct contact with blood or tissues of viremic patients or viremic livestock [14]. The disease is endemic in all of Africa, the Middle East, Asia, and South-Eastern Europe. Abattoir workers, butchers, and farmers represent high-risk professions for CCHFV [70]. Seroprevalence studies indicate that the majority of CCHF infections (>80%) are asymptomatic or mild. The disease is usually milder in children. Hemorrhagic manifestations are present in severe cases, ranging from petechiae, epistaxis, and ecchymoses around the venipuncture sites to severe hemorrhages from different organs. The mortality rate may reach 40% [14]. In the acute phase of the disease, virus isolation (BSL-4), detection of viral RNA using RT-PCR, and antigen detection confirm the diagnosis of CCHF. IgM and IgG antibodies are detectable after the fifth day of the disease using EIA or IFA [71]. An inactivated vaccine propagated in the mouse brain is used in Bulgaria [72].
Orthohantaviruses and arenaviruses are important rodent-borne zoonotic viruses. Small rodents such as voles, rats, and mice are the natural reservoir. The chronically infected rodents shed the virus in urine, droppings, and saliva. Humans are mainly infected by inhalation of contaminated aerosols. Andes virus is the only rodent virus known to spread between humans (Figure 3) [73].
Figure 3.
Transmission cycle of rodent-borne viruses.
3.1 Orthohantaviruses
Orthohantaviruses are rodent-borne viruses of the family Hantaviridae, genus Orthohantavirus. Old World orthohantaviruses Hantaan (HTNV), DOBV, and Seoul (SEOV) cause HFRS in Europe and Asia, while New World orthohantaviruses cause hantavirus pulmonary syndrome (HPS) in the Americas. Nephropathia epidemica (NE) is a mild form of HFRS, caused by PUUV in Europe [74]. HTNV was known to be hosted by striped field mice (Apodemus agrarius), PUUV by bank voles (Clethrionomys glareolus), DOBV by yellow neck mice (Apodemus flavicollis), and SEOV by rats (Rattus rattus, Rattus norvegicus) [75]. SEOV is the only hantavirus with a global distribution, but also the most underestimated and often missed pathogenic orthohantavirus [16]. Infected rodents excrete the virus in urine, feces, and saliva, and humans are mostly infected by inhaling the aerosolized contaminated rodent excreta [15]. In addition, studies suggest that human-to-human transmission of the Andes virus may be possible [76]. In Europe, human outbreaks are associated with the occurrence of mast years, i.e., years with abundant oak and beech seed resulting in an abundance of rodents [15]. Human hantavirus infections usually occur in rural areas such as forests, fields, and farms, but transmission occurs in urban areas as well. The main clinical symptoms of HFRS include acute kidney failure, acute shock and vascular leakage. The mortality in NE is less than 0.5% compared to 15% in HFRS caused by HTNV/DOBV and 40% in HPS [77]. The diagnosis of hantavirus infections in endemic areas is often based on clinical symptoms and the presence of specific IgM and IgG antibodies [78].
3.2 Lymphocytic choriomeningitis virus
LCMV is a zoonotic rodent-borne virus of the family Arenaviridae, genus Mammarenavirus. The common house mouse (Mus musculus, Mus domesticus) is the natural rodent host and reservoir for the LCMV. Humans become infected through mucosal exposure to aerosols contaminated with rodent excreta, direct contact with rodents, or rodent bites. Pregnant women infected with LCMV during pregnancy may transmit the virus transplacentally to the fetus [17]. LCMV probably circulates globally due to the cosmopolitan distribution of its reservoirs. However, the true prevalence of LCMV infections is unknown, as many of them are mild or asymptomatic. Phylogenetic analyses of LCMV showed this virus to be highly diverse. Four main lineages were identified with most of the strains clustered within lineage 1 [79]. In immunocompetent individuals, acquired LCMV infection may be asymptomatic in one-third of cases or present as a self-limited febrile illness. However, the disease can progress into meningitis or meningoencephalitis, with an overall mortality of less than 1% [80]. However, in organ transplant recipients, the infection can result in multisystem organ failure resembling the Lassa hemorrhagic fever with a very high fatality rate [81]. LCMV is also an important fetal teratogen. Hydrocephalus, periventricular calcifications, and chorioretinitis are the main characteristics of congenital infection. About 35% of congenitally infected children die, and 70% of them had long-term neurologic sequelae [82]. An RT-PCR has been developed for the detection of LCMV RNA in blood and CSF [83]. EIA and IFA can detect LCMV IgM and IgG antibodies; however, these tests are limited to several laboratories. The diagnosis is more complicated in congenitally infected children since the majority do not harbor the virus at the time of birth. Serology is most commonly used for the diagnosis of congenital LCMV infection; however, transplacentally transferred maternal IgG antibodies frequently complicate the diagnosis [17].
An increasing number of avian influenza outbreaks in domestic poultry during the past two decades caused particularly by the H5N1 subtype, and consequently led to at least 874 confirmed human cases and 458 deaths caused by this subtype in 23 countries across Asia, Africa, Europe, and Americas [84]. Several zoonotic coronaviruses have emerged in the past two decades. The SARS-CoV occurred in November 2002 in China and spread to over 30 countries by July 2003, resulting in more than 8.098 confirmed cases, including 774 deaths. Middle East respiratory syndrome coronavirus (MERS-CoV) emerged in 2012 in Saudi Arabia. In total, 27 countries have reported MERS-CoV cases since 2012, leading to more than 2.580 cases and 858 deaths. SARS-CoV-2 is the third coronavirus with a pandemic potential that emerged in late 2019 in China [85].
4.1 Avian influenza virus
AIVs, belonging to the type A influenza virus, contain a segmented RNA genome. They can be divided into subgroups according to differences in their surface glycoproteins. So far, 16 HA subtypes (H1-H16) and nine NA subtypes (N1-N9) are known and each AIV has one HA and one NA subtype that can occur in any of the 144 possible combinations (from H1N1 to H16N9). All HA and all NA subtypes can be found in wild aquatic birds, which are considered influenza A natural hosts in which AIVs generally do not cause disease [86]. On the other hand, very few HA and NA subtypes are established in other birds and mammals, including humans, causing disease in these hosts [87] such as seasonal influenza in humans contemporarily caused by H1N1 and H3N2 subtypes. Human infections with AIVs occur most often after unprotected contact with infected birds or surfaces contaminated with AIVs. People involved in culling AIV-infected poultry flocks are at particular risk of the infection [88]. Live bird markets in countries with enzootic avian influenza are also places where human infections commonly occur [89]. Although AIVs can be present in poultry commodities from infected birds, consumption of contaminated food has not been substantiated to cause human infections [90]. Symptoms largely vary from asymptomatic, mild upper respiratory symptoms, and conjunctivitis in the vast majority of reported infections with subtypes other than H5 or H7 [91] up to flu-like-illness with severe symptoms, including inflammation of the lower respiratory tract, respiratory distress, and multiple organ dysfunctions in case of infections with H5N1 and H7N9 subtypes [92, 93]. The fatality rates caused by these two subtypes are 53 and 39%, respectively. Diagnosis using real-time RT-PCR primarily targeting the M1 matrix gene is adopted in most laboratories followed by subsequent subtyping using subtype-specific PCR primers and probes. Serological tests have several limitations and should not be considered for initial detection [94]. There are no approved vaccines for preventing avian influenza in humans although candidate vaccine AIVs have been developed for pandemic preparedness purposes.
4.2 SARS-CoV-2
SARS-CoV-2 is a rapidly evolving RNA virus of the family Coronaviridae, genus Betacoronavirus. The ECDC differentiates variants of concern (VOC), variants of interest (VOI), or variants under monitoring [21]. Until late 2021, before the emergence of Omicron, VOC such as Alpha and Delta were mainly associated with increased transmissibility and modest degrees of immune escape. However, current evidence suggests that immune escape properties were the main driver for the displacement of Delta by Omicron [95]. The genome sequencing showed 96% concordance between human SARS-CoV-2 strains and SARS-CoV-like strains isolated from bats indicating that SARS-CoV-2 originates from bats. Similar coronaviruses were found in Malayan pangolins (Manis javanica) suggesting their possible role as intermediate hosts. Further studies confirmed that different animal species are susceptible to SARS-CoV-2 such as farmed minks, zoo animals, and companion animals [96, 97]. Human-to-human SARS-CoV-2 transmission occurs primarily through respiratory droplets and aerosols produced during coughing or sneezing. Patients aged ≥50 years are at a higher risk of severe COVID-19 [85]. The proportion of individuals with asymptomatic infection is unclear. Patients with mild illness may have a fever, cough, sore throat, headache, muscle pain, and loss of taste and smell. More severe cases present with pneumonia that can progress to acute respiratory distress syndrome. The case fatality rates are less than 2% [98]. RT-PCR is considered the gold standard for detecting COVID-19 infection. Serological tests enhance the capacity to diagnose SARS-CoV-2 and have broad clinical applications, including analyzing the immune response and identifying asymptomatic cases [99].
HEV is a zoonotic virus of the family Hepeviridae, genus Orthohepevirus. Among the eight HEV genotypes in the Orthohepevirus A species identified so far, HEV1, HEV2, HEV3, and HEV4 are the most common genotypes causing human infections. HEV1 and HEV2 are prevalent in developing countries and can cause large-scale outbreaks originating from contaminated water. In contrast, HEV3 and HEV4 are zoonotic, and transmission to humans occurs mainly through contaminated raw or undercooked meat from infected animals (pigs, wild boars). HEV3 and HEV4 are distributed mostly in the developed countries [100]. Clinical manifestations of HEV infections include acute hepatitis, acute-on-chronic liver disease, chronic hepatitis, cirrhosis, and liver failure. Although the majority of HEV infections are acute and self-limiting, chronic HEV infections may occur in immunocompromised patients such as solid-organ transplant recipients [101]. In addition, HEV can cause severe hepatitis in pregnant women, especially in the third trimester, with a fatality rate of up to 20% [102]. HEV RNA and anti-HEV IgM antibodies can be detected in serum at the time of diagnosis, followed by anti-HEV IgG antibodies [100]. HEV vaccine has been developed and is licensed in China, but is not yet available elsewhere [103].
5.2 Monkeypox virus
MPXV is a zoonotic poxvirus of the family Poxviridae, genus Orthopoxvirus. Based on geography, disease severity, and sequence homology, MPXV strains were grouped into two genetic clades, the Central African/Congo Basin (CB) and West African (WA) clades. Some reports suggested that WA clade is associated with a milder disease [104]. The natural reservoirs of MPXV are small rodents. Transmission to humans occurs in direct contact with infected animals, through animal bites and scratches, as well as the handling and eating of infected animal meat. Human-to-human transmission may occur in prolonged direct contact with lesions and bodily fluids of patients, or indirect contact with objects such as bedding and clothing [105]. The clinical features of monkeypox include prodromal symptoms (fever, headache, malaise, chills, myalgia) lymphadenopathy, and a pleomorphic, often umbilicated skin rash [26]. However, in the most recent outbreak, several atypical presentations were observed. In MSM patients, genital lesions were present that subsequently spread to other parts of the body. Generally, monkeypox is a self-limited illness with a resolution over 2–4 weeks [106]. Detection of viral DNA in skin lesions using a PCR is a preferred test for diagnosis of MPXV. Oropharyngeal, anal, or rectal swabs are also suitable for testing in the absence of cutaneous lesions. Serology is not useful as it does not distinguish between different orthopoxviruses [105]. Since most cases of monkeypox are self-limiting, no specific antiviral therapy is indicated [107]. The vaccine protects against monkeypox and other orthopoxviruses, including smallpox and vaccinia [105].
Arthropod-borne and rodent-borne viral zoonoses are widely distributed in European countries and represent an important public health threat. While some (re-)emerging arboviruses such as TBEV and WNV are monitored continuously, USUV, TOSV, TAHV, and BHAV are still neglected and underreported. Orthohantaviruses are a significant cause of HFRS in Europe, while the incidence of LCMV is unknown. HEV is also a well-recognized emerging zoonotic virus in many European countries. Along with the above-mentioned zoonoses, the recent MPXV outbreak in non-endemic regions highlights the need for the “One Health approach” to prevent future zoonotic diseases.
This manuscript is supported by the project of the Croatian Science Foundation, IP-2016-06-7456: Prevalence and molecular epidemiology of emerging and re-emerging neuroinvasive arboviral infections in Croatia; CRONEUROARBO.
References
1.World Health Organization. Zoonotic Disease: Emerging Public Health Threats in the Region. Geneva, Switzerland: WHO; 2023. Available from: https://www.emro.who.int/fr/about-who/rc61/zoonotic-diseases.html
2.Van Heuverswyn J, Hallmaier-Wacker LK, Beauté J, Gomes Dias J, Haussig JM, Busch K, et al. Spatiotemporal spread of tick-borne encephalitis in the EU/EEA, 2012 to 2020. Euro Surveillance. 2023;28:2200543. DOI: 10.2807/1560-7917.ES.2023.28.11.2200543
3.Bakonyi T, Haussig JM. West Nile virus keeps on moving up in Europe. Euro Surveillance. 2020;25:2001938. DOI: 10.2807/1560-7917.ES.2020.25.46.2001938
4.Barzon L, Pacenti M, Montarsi F, Fornasiero D, Gobbo F, Quaranta E, et al. Rapid spread of a new West Nile virus lineage 1 associated with increased risk of neuroinvasive disease during a large outbreak in northern Italy, 2022: One health analysis. Journal of Travel Medicine. 2022:taac125. DOI: 10.1093/jtm/taac125
5.Pacenti M, Sinigaglia A, Martello T, De Rui ME, Franchin E, Pagni S, et al. Clinical and virological findings in patients with Usutu virus infection, Northern Italy, 2018. Euro Surveillance. 2019;24:1900180. DOI: 10.2807/1560-7917.ES.2019.24.47.1900180
6.Santini M, Vilibic-Cavlek T, Barsic B, Barbic L, Savic V, Stevanovic V, et al. First cases of human Usutu virus neuroinvasive infection in Croatia, August-September 2013: Clinical and laboratory features. Journal of Neurovirology. 2015;21:92-97. DOI: 10.1007/s13365-014-0300-4
7.Vilibic-Cavlek T, Savic V, Sabadi D, Peric L, Barbic L, Klobucar A, et al. Prevalence and molecular epidemiology of West Nile and Usutu virus infections in Croatia in the ‘One health’ context, 2018. Transboundary and Emerging Diseases. 2019;66:1946-1957. DOI: 10.1111/tbed.13225
8.Simonin Y, Sillam O, Carles MJ, Gutierrez S, Gil P, Constant O, et al. Human Usutu virus infection with atypical neurologic presentation, Montpellier, France, 2016. Emerging Infectious Diseases. 2018;24:875-878. DOI: 10.3201/eid2405.171122
9.Nagy A, Mezei E, Nagy O, Bakonyi T, Csonka N, Kaposi M, et al. Extraordinary increase in West Nile virus cases and first confirmed human Usutu virus infection in Hungary, 2018. Euro Surveillance. 2019;24:1900038. DOI: 10.2807/1560-7917.ES.2019.24.28.1900038
10.Graninger M, Hubmer S, Riederer F, Kettner S, Hauk M, Auf T, et al. The first case of Usutu virus neuroinvasive disease in Austria, 2021. Open Forum Infectious Diseases. 2022;9:ofac255. DOI: 10.1093/ofid/ofac255
11.Ayhan N, Charrel RN. An update on Toscana virus distribution, genetics, medical and diagnostic aspects. Clinical Microbiology and Infection. 2020;26:1017-1023. DOI: 10.1016/j.cmi.2019.12.015
12.European Centre for Disease Prevention and Control. Toscana Virus Infection. Stockholm, Sweden: European Centre for Disease Prevention and Control; 2023. Available from: https://www.ecdc.europa.eu/en/toscana-virus-infection
13.Vilibic-Cavlek T, Barbic L, Mrzljak A, Brnic D, Klobucar A, Ilic M, et al. Emerging and neglected viruses of zoonotic importance in Croatia. Pathogens. 2021;10(1):73. DOI: 10.3390/pathogens10010073
14.European Centre for Disease Prevention and Control. Factsheet about Crimean-Congo Haemorrhagic Fever. Stockholm, Sweden: European Centre for Disease Prevention and Control; 2023. Available from: https://www.ecdc.europa.eu/en/crimean-congo-haemorrhagic-fever/facts/factsheet
15.European Centre for Disease Prevention and Control. Hantavirus Infection. Annual Epidemiological Report for 2020. Stockholm, Sweden: European Centre for Disease Prevention and Control; 2020. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/Hantavirus-AER-2020.pdf
16.Clement J, Ahlm C, Avšič-Županc T, Botten J, Chandran K, Jonsson CB, et al. Meeting report: Eleventh international conference on hantaviruses. Antiviral Research. 2020;176:104733. DOI: 10.1016/j.antiviral.2020.104733
17.Vilibic-Cavlek T, Savic V, Ferenc T, Mrzljak A, Barbic L, Bogdanic M, et al. Lymphocytic choriomeningitis - emerging trends of a neglected virus: A narrative review. Tropical Medicine and Infectious Disease. 2021;6:88. DOI: 10.3390/tropicalmed6020088
18.Dobec M, Dzelalija B, Punda-Polic V, Zoric I. High prevalence of antibodies to lymphocytic choriomeningitis virus in a murine typhus endemic region in Croatia. Journal of Medical Virology. 2006;78:1643-1647. DOI: 10.1002/jmv.20749
19.Fouchier RA, Schneeberger PM, Rozendaal FW, Broekman JM, Kemink SA, Munster V, et al. Avian influenza a virus (H7N7) associated with human conjunctivitis and a fatal case of acute respiratory distress syndrome. PNAS. 2004;101:1356-1361
20.Oliver I, Roberts J, Brown CS, Byrne AM, Mellon D, Hansen R, et al. A case of avian influenza a(H5N1) in England, January 2022. Euro Surveillance. 2022;27:2200061. DOI: 10.2807/1560-7917.ES.2022.27.5.2200061
21.World Health Organization. Coronavirus (COVID-19) Dashboard. Geneva, Switzerland: WHO; 2023. Available from: https://covid19.who.int/
22.ECDC. COVID-19 situation updates. Stockholm, Sweden: ECDC; 2023. Available from: https://www.ecdc.europa.eu/en/covid-19/situation-updates
23.Willauer AN, Sherman KE. Hepatitis E virus: Has anything changed? Current Opinion in Gastroenterology. 2023;39:169-174. DOI: 10.1097/MOG.0000000000000918
24.European Centre for Disease Prevention and Control. Facts about Hepatitis E. Stockholm, Sweden: European Centre for Disease Prevention and Control; 2023. Available from: https://www.ecdc.europa.eu/en/hepatitis-e/facts
25.Reed KD, Melski JW, Graham MB, Regnery RL, Sotir MJ, Wegner MV, et al. The detection of monkeypox in humans in the Western hemisphere. The New England Journal of Medicine. 2004;350:342-350. DOI: 10.1056/NEJMoa032299
26.Rajsri KS, Rao M. A review of Monkeypox: The new global health emergency. Venereology. 2022;1:199-211. DOI: 10.3390/venereology1020014
27.Center for Disease Control and Prevention. 2022 Monkeypox Outbreak Global Map. Poxvirus. Atlanta, Georgia: Center for Disease Control and Prevention; 2023. Available from: https://www.cdc.gov/poxvirus/monkeypox/response/2022/world-map.html
28.Hatami H, Jamshidi P, Arbabi M, Safavi-Naini SAA, Farokh P, Izadi-Jorshari G, et al. Demographic, epidemiologic, and clinical characteristics of human monkeypox disease pre- and Post-2022 outbreaks: A systematic review and meta-analysis. Biomedicine. 2023;11:957. DOI: 10.3390/biomedicines11030957
29.Ruzek D, Avšič Županc T, Borde J, Chrdle A, Eyer L, Karganova G, et al. Tick-borne encephalitis in Europe and Russia: Review of pathogenesis, clinical features, therapy, and vaccines. Antiviral Research. 2019;164:23-51. DOI: 10.1016/j.antiviral.2019.01.014
30.Sukhorukov GA, Paramonov AI, Lisak OV, Kozlova IV, Bazykin GA, Neverov AD, et al. The Baikal subtype of tick-borne encephalitis virus is evident of recombination between Siberian and far-eastern subtypes. PLoS Neglected Tropical Diseases. 2023;17:e0011141. DOI: 10.1371/journal.pntd.0011141
31.Dai X, Shang G, Lu S, Yang J, Xu J. A new subtype of eastern tick-borne encephalitis virus discovered in Qinghai-Tibet plateau, China. Emerging Microbes & Infections. 2018;7:74. DOI: 10.1038/s41426-018-0081-6
32.Bournez L, Umhang G, Moinet M, Richomme C, Demerson JM, Caillot C, et al. Tick-borne encephalitis virus: Seasonal and annual variation of epidemiological parameters related to nymph-to-larva transmission and exposure of small mammals. Pathogens. 2020;9:518. DOI: 10.3390/pathogens9070518
33.Buczek AM, Buczek W, Buczek A, Wysokińska-Miszczuk J. Food-borne transmission of tick-borne encephalitis virus-spread, consequences, and prophylaxis. International Journal of Environmental Research and Public Health. 2022;19:1812. DOI: 10.3390/ijerph19031812
34.Bogovič P, Lotrič-Furlan S, Avšič-Županc T, Korva M, Kastrin A, Lusa L, et al. Comparison of clinical, laboratory and immune characteristics of the monophasic and biphasic course of tick-borne encephalitis. Microorganisms. 2021;9:796. DOI: 10.3390/microorganisms9040796
35.Zidovec-Lepej S, Vilibic-Cavlek T, Ilic M, Gorenec L, Grgic I, Bogdanic M, et al. Quantification of antiviral cytokines in serum, cerebrospinal fluid and urine of patients with tick-borne encephalitis in Croatia. Vaccine. 2022;10:1825. DOI: 10.3390/vaccines10111825
36.Bogovic P, Strle F. Tick-borne encephalitis: A review of epidemiology, clinical characteristics, and management. World Journal of Clinical Cases. 2015;3:430-441. DOI: 10.12998/wjcc.v3.i5.430
37.Vilibic-Cavlek T, Barbic L, Stevanovic V, Petrovic G, Mlinaric-Galinovic G. IgG avidity: An important serologic marker for the diagnosis of tick-borne encephalitis virus infection. Polish Journal of Microbiology. 2016;65:119-121. DOI: 10.5604/17331331.1197285
38.Rizzoli A, Jimenez-Clavero MA, Barzon L, Cordioli P, Figuerola J, Koraka P, et al. The challenge of West Nile virus in Europe: Knowledge gaps and research priorities. Euro Surveillance. 2015;20:21135. DOI: 10.2807/1560-7917.es2015.20.20.21135
39.Mrzljak A, Dinjar-Kujundzic P, Santini M, Barbic L, Kosuta I, Savic V, et al. West Nile virus: An emerging threat in transplant population. Vector Borne and Zoonotic Diseases. 2020;20:613-618. DOI: 10.1089/VBZ.2019.2608
40.Hinckley AF, O’Leary DR, Hayes EB. Transmission of West Nile virus through human breast milk seems to be rare. Pediatrics. 2007;119:e666-e671. DOI: 10.1542/peds.2006-2107
41.Konjevoda S, Dzelalija B, Canovic S, Pastar Z, Savic V, Tabain I, et al. West Nile virus retinitis in a patient with neuroinvasive disease. Revista da Sociedade Brasileira de Medicina Tropical. 2019;52:e20190065. DOI: 10.1590/0037-8682-0065-2019
42.Natarajan N, Varman M. West Nile virus cerebellitis in a healthy 10-year-old child. The Pediatric Infectious Disease Journal. 2007;26:767. DOI: 10.1097/INF.0b013e3180cc2c3f
43.Santini M, Zupetic I, Viskovic K, Krznaric J, Kutlesa M, Krajinovic V, et al. Cauda equina arachnoiditis - a rare manifestation of West Nile virus neuroinvasive disease: A case report. World Journal of Clinical Cases. 2020;8:3797-3803. DOI: 10.12998/wjcc.v8.i17.3797
44.Papageorgiou E, Xanthou F, Dardiotis E, Tsironi EE. Dancing eyes syndrome from West Nile virus encephalitis. Postgraduate Medical Journal. 2020;96:442. DOI: 10.1136/postgradmedj-2020-137827
45.Centers for Disease Control and Prevention. West Nile virus. Atlanta, Georgia: Centers for Disease Control and Prevention; 2023. Available from: https://www.cdc.gov/westnile/index.html
46.Zidovec-Lepej S, Vilibic-Cavlek T, Barbic L, Ilic M, Savic V, Tabain I, et al. Antiviral cytokine response in neuroinvasive and non-neuroinvasive West Nile virus infection. Viruses. 2021;13:342. DOI: 10.3390/v13020342
47.Vilibic-Cavlek T, Kristofic B, Savic V, Kolaric B, Barbic L, Tabain I, et al. Diagnostic significance of immunoglobulin G avidity in symptomatic and asymptomatic West Nile virus infection. Revista da Sociedade Brasileira de Medicina Tropical. 2018;51:591-595. DOI: 10.1590/0037-8682-0482-2017
48.Ng T, Hathaway D, Jennings N, Champ D, Chiang YW, Chu HJ. Equine vaccine for West Nile virus. Developmental Biology (Basel). 2003;114:221-227
49.Cadar D, Simonin Y. Human Usutu virus infections in Europe: A new risk on horizon? Viruses. 2022;15:77. DOI: 10.3390/v15010077
50.Cadar D, Lühken R, van der Jeugd H, Garigliany M, Ziegler U, Keller M, et al. Widespread activity of multiple lineages of Usutu virus, Western Europe, 2016. Euro Surveillance. 2017;22:30452. DOI: 10.2807/1560-7917.ES.2017.22.4.30452
51.Grottola A, Marcacci M, Tagliazucchi S, Gennari W, Di Gennaro A, Orsini M, et al. Usutu virus infections in humans: A retrospective analysis in the municipality of Modena, Italy. Clinical Microbiology and Infection. 2017;23:33-37. DOI: 10.1016/j.cmi.2016.09.019
52.Vilibic-Cavlek T, Petrovic T, Savic V, Lj B, Tabain I, Stevanovic V, et al. Epidemiology of Usutu virus: The European scenario. Pathogens. 2020;9:E699
53.Nikolay B, Weidmann M, Dupressoir A, Faye O, Boye CS, Diallo M, et al. Development of a Usutu virus specific real-time reverse transcription PCR assay based on sequenced strains from Africa and Europe. Journal of Virological Methods. 2014;197:51-54. DOI: 10.1016/j.jviromet.2013.08.039
54.Ayhan N, Prudhomme J, Laroche L, Bañuls AL, Charrel RN. Broader geographical distribution of Toscana virus in the Mediterranean region suggests the existence of larger varieties of sand fly vectors. Microorganisms. 2020;8:114. DOI: 10.3390/microorganisms8010114
55.Baggieri M, Marchi A, Bucci P, Nicoletti L, Magurano F. Genetic variability of the S segment of Toscana virus. Virus Research. 2015;200:35-44. DOI: 10.1016/j.virusres.2015.01.013
56.Ayhan N, Alten B, Ivovic V, Martinkovic F, Kasap OE, Ozbel Y, et al. Cocirculation of two lineages of Toscana virus in Croatia. Frontiers in Public Health. 2017;5:336. DOI: 10.3389/fpubh.2017.00336
57.Papa A, Paraforou T, Papakonstantinou I, Pagdatoglou K, Kontana A, Koukoubani T. Severe encephalitis caused by Toscana virus, Greece. Emerging Infectious Diseases. 2014;20:1417-1419. DOI: 10.3201/eid2008.140248
58.Bartels S, de Boni L, Kretzschmar HA, Heckmann JG. Lethal encephalitis caused by the Toscana virus in an elderly patient. Journal of Neurology. 2012;259:175-177. DOI: 10.1007/s00415-011-6121-y
59.Vilibic-Cavlek T, Zidovec-Lepej S, Ledina D, Knezevic S, Savic V, Tabain I, et al. Clinical, virological, and immunological findings in patients with Toscana neuroinvasive disease in Croatia: Report of three cases. Tropical Medicine and Infectious Disease. 2020;5:144. DOI: 10.3390/tropicalmed5030144
60.Camp JV, Kniha E, Obwaller AG, Walochnik J, Nowotny N. The transmission ecology of Tahyna orthobunyavirus in Austria as revealed by longitudinal mosquito sampling and blood meal analysis in floodplain habitats. Parasites & Vectors. 2021;14:561. DOI: 10.1186/s13071-021-05061-1
61.Mravcová K, Camp JV, Hubálek Z, Šikutová S, Vaux AGC, Medlock JM, et al. Ťahyňa virus-a widespread, but neglected mosquito-borne virus in Europe. Zoonoses and Public Health. 2023;70(5):371-382. DOI: 10.1111/zph.13042
62.Hubálek Z. Mosquito-borne viruses in Europe. Parasitology Research. 2008;103(Suppl. S1):S29-S43. DOI: 10.1007/s00436-008-1064-7
63.Vilibic-Cavlek T, Stevanovic V, Savic V, Markelic D, Sabadi D, Bogdanic M, et al. Detection of Tahyna Orthobunyavirus-neutralizing antibodies in patients with neuroinvasive disease in Croatia. Microorganisms. 2022;10:1443. DOI: 10.3390/microorganisms10071443
64.Hubálek Z. History of arbovirus research in the Czech Republic. Viruses. 2021;13:2334. DOI: 10.3390/v13112334
65.Hubálek Z. Biogeography of tick-borne Bhanja virus (bunyaviridae) in Europe. Interdisciplinary Perspectives on Infectious Diseases. 2009;2009:372691. DOI: 10.1155/2009/372691
66.Calisher CH, Goodpasture HC. Human infection with Bhanja virus. The American Journal of Tropical Medicine and Hygiene. 1975;24:1040-1042
67.Punda V, Beus I, Calisher CH, Vesenjak-Hirjan J. Laboratory infections with Bhanja virus. Zentralblatt fur Bakteriologie. 1980;(Suppl. 9):273-275
68.Vesenjak-Hirjan J, Calisher CH, Beus I, Marton E. First natural clinical human Bhanja virus infection. Zentralblatt fur Bakteriologie. 1980;(Suppl. 9):297-301
69.Matsuno K, Weisend C, Travassos da Rosa AP, Anzick SL, Dahlstrom E, Porcella SF, et al. Characterization of the Bhanja serogroup viruses (Bunyaviridae): A novel species of the genus phlebovirus and its relationship with other emerging tick-borne phleboviruses. Journal of Virology. 2013;87:3719-3728. DOI: 10.1128/JVI.02845-12
70.Shahhosseini N, Wong G, Babuadze G, Camp JV, Ergonul O, Kobinger GP, et al. Crimean-Congo hemorrhagic fever virus in Asia, Africa and Europe. Microorganisms. 2021;9:1907. DOI: 10.3390/microorganisms9091907
71.Centers for Disease Control and Prevention. Crimean-Congo Hemorrhagic Fever. Atlanta, Georgia: Centers for Disease Control and Prevention; 2023. Available from: https://www.cdc.gov/vhf/crimean-congo/index.html
72.Papa A, Papadimitriou E, Christova I. The Bulgarian vaccine Crimean-Congo haemorrhagic fever virus strain. Scandinavian Journal of Infectious Diseases. 2011;43:225-229. DOI: 10.3109/00365548.2010.540036
73.Martinez VP, Bellomo C, San Juan J, Pinna D, Forlenza R, Elder M, et al. Person-to-person transmission of Andes virus. Emerging Infectious Diseases. 2005;11:1848-1853. DOI: 10.3201/eid1112.050501
74.Vial PA, Ferrés M, Vial C, Klingström J, Ahlm C, López R, et al. Hantavirus in humans: A review of clinical aspects and management. The Lancet Infectious Diseases. 2023;S1473-3099(23):00128-00127. DOI: 10.1016/S1473-3099(23)00128-7
75.Kuhn JH, Schmaljohn CS. A brief history of Bunyaviral family Hantaviridae. Diseases. 2023;11:38. DOI: 10.3390/diseases11010038
76.Toledo J, Haby MM, Reveiz L, Sosa Leon L, Angerami R, Aldighieri S. Evidence for human-to-human transmission of hantavirus: A systematic review. The Journal of Infectious Diseases. 2022;226:1362-1371. DOI: 10.1093/infdis/jiab461
77.Romero MG, Anjum F. Hemorrhagic Fever Renal Syndrome. [Updated 2022 Jul 19]. Treasure Island (FL): StatPearls Publishing; 2023. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560660/
78.Sehgal A, Mehta S, Sahay K, Martynova E, Rizvanov A, Baranwal M, et al. Hemorrhagic fever with renal syndrome in Asia: History, pathogenesis, diagnosis, treatment, and prevention. Viruses. 2023;15:561. DOI: 10.3390/v15020561
79.Albariño CG, Palacios G, Khristova ML, Erickson BR, Carroll SA, Comer JA, et al. High diversity and ancient common ancestry of lymphocytic choriomeningitis virus. Emerging Infectious Diseases. 2010;16:1093-1100. DOI: 10.3201/eid1607.091902
80.Bonthius DJ. The arenaviruses. In: Reiss CS, editor. Neurotropic Viral Infections. Berlin/Heidelberg: Springer; 2016. pp. 149-174. DOI: 10.1007/978-3-319-33133-1_6
81.Schafer IJ, Miller R, Ströher U, Knust B, Nichol ST, Rollin PE, et al. Notes from the field: A cluster of lymphocytic choriomeningitis virus infections transmitted through organ transplantation - Iowa, 2013. MMWR. Morbidity and Mortality Weekly Report. 2014;63:249. DOI: 10.1111/ajt.12802
82.Ferenc T, Vujica M, Mrzljak A, Vilibic-Cavlek T. Lymphocytic choriomeningitis virus: An under-recognized congenital teratogen. World Journal of Clinical Cases. 2022;10:8922-8931. DOI: 10.12998/wjcc.v10.i25.8922
83.Cordey S, Sahli R, Moraz ML, Estrade C, Morandi L, Cherpillod P, et al. Analytical validation of a lymphocytic choriomeningitis virus real-time RT-PCR assay. Journal of Virological Methods. 2011;177:118-122. DOI: 10.1016/j.jviromet.2011.06.018
84.World Health Organization. Cumulative Number of Confirmed Human Cases of Avian Influenza a(H5N1) Reported to WHO. 2003-2023. Geneva, Switzerland: WHO; 2023. Available from: https://cdn.who.int/media/docs/default-source/global-influenza-programme/2023_march_tableh5n1.pdf?sfvrsn=ec46922b_1&download=true
85.Li Q , Guan X, Wu P, Wang X, Zhou L, Tong Y, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. The New England Journal of Medicine. 2020;382:1199-1207. DOI: 10.1056/NEJMoa2001316
86.Swayne DE, Suarez DL, Sims LD. Influenza. In: Swayne DE, Boulianne M, Logue C, McDougald LR, Nair V, Suarez DL, editors. Diseases of Poultry. 14th ed. Ames: Wiley Publishing; 2020. pp. 210-256
88.Farahat RA, Khan SH, Rabaan AA, Al-Tawfiq JA. The resurgence of avian influenza and human infection: A brief outlook. New Microbes New Infections. 2023;53:101122. DOI: 10.1016/j.nmni.2023.101122
89.Li YT, Linster M, Mendenhall IH, Su YCF, Smith GJD. Avian influenza viruses in humans: Lessons from past outbreaks. British Medical Bulletin. 2019;132:81-95. DOI: 10.1093/bmb/ldz036
90.Harder TC, Buda S, Hengel H, Beer M, Mettenleiter TC. Poultry food products-a source of avian influenza virus transmission to humans? Clinical Microbiology and Infection. 2016;22:141-146. DOI: 10.1016/j.cmi.2015.11.015
91.Freidl GS, Meijer A, de Bruin E, de Nardi M, Munoz O, Capua I, et al. Influenza at the animal-human interface: A review of the literature for virological evidence of human infection with swine or avian influenza viruses other than a(H5N1). Euro Surveillance. 2014;19:20793. DOI: 10.2807/1560-7917.es2014.19.18.20793
92.Beigel JH, Farrar J, Han AM, Hayden FG, Hyer R, de Jong MD, et al. Writing Committee of the World Health Organization (WHO) consultation on human influenza a/H5. Avian influenza a (H5N1) infection in humans. The New England Journal of Medicine. 2005;353:1374-1385. DOI: 10.1056/NEJMra052211
93.Gao R, Cao B, Hu Y, Feng Z, Wang D, Hu W, et al. Human infection with a novel avian-origin influenza a (H7N9) virus. The New England Journal of Medicine. 2013;368:1888-1897. DOI: 10.1056/NEJMoa1304459
94.European Centre for Disease Prevention and Control. Testing and Detection of Zoonotic Influenza Virus Infections in Humans in the EU/EEA, and Occupational Safety and Health Measures for those Exposed at Work. Stockholm, Sweden: European Centre for Disease Prevention and Control; 2022. Available from: https://www.ecdc.europa.eu/en/publications-data/zoonotic-influenza-virus-infections-humans-testing-and-detection
95.Markov PV, Ghafari M, Beer M, Lythgoe K, Simmonds P, Stilianakis NI, et al. The evolution of SARS-CoV-2. Nature Reviews. Microbiology. 2023;21:361-379. DOI: 10.1038/s41579-023-00878-2
96.Valencak TG, Csiszar A, Szalai G, Podlutsky A, Tarantini S, Fazekas-Pongor V, et al. Animal reservoirs of SARS-CoV-2: Calculable COVID-19 risk for older adults from animal to human transmission. Geroscience. 2021;43:2305-2320. DOI: 10.1007/s11357-021-00444-9
97.Stevanovic V, Vilibic-Cavlek T, Tabain I, Benvin I, Kovac S, Hruskar Z, et al. Seroprevalence of SARS-CoV-2 infection among pet animals in Croatia and potential public health impact. Transboundary and Emerging Diseases. 2021;68:1767-1773. DOI: 10.1111/tbed.13924
98.National Institutes of Health. Coronavirus Disease 2019 (COVID-19) Treatment Guidelines. Bethesda, Maryland: National Institutes of Health; 2023. Available from: https://www.covid19treatmentguidelines.nih.gov/
99.Vilibic-Cavlek T, Bogdanic M, Borko E, Hruskar Z, Zilic D, Ferenc T, et al. Detection of SARS-CoV-2 antibodies: Comparison of enzyme immunoassay, surrogate neutralization and virus neutralization test. Antibodies. 2023;12(2):35. DOI: 10.3390/antib1202003
100.Aslan AT, Balaban HY. Hepatitis E virus: Epidemiology, diagnosis, clinical manifestations, and treatment. World Journal of Gastroenterology. 2020;26:5543-5560. DOI: 10.3748/wjg.v26.i37.5543
101.Samala N, Wang RY, Auh S, Balla AK, Dakhoul L, Alter HJ, et al. Hepatitis E prevalence and infection in solid-organ transplant recipients in the United States. Journal of Viral Hepatitis. 2022;29:1134-1142. DOI: 10.1111/jvh.13739
102.Jha K, Tandukar A, Aryal R, Shrestha P, Bajracharya S, Bista KD. Severe hepatitis E infection in pregnancy: A case report. Annals of Medicine and Surgery (Lond). 2023;85:1213-1215. DOI: 10.1097/MS9.0000000000000449
103.World Health Organization. Hepatitis E. Geneva, Switzerland: World Health Organization; 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/hepatitis-e
104.Likos AM, Sammons SA, Olson VA, Frace AM, Li Y, Olsen-Rasmussen M, et al. A tale of two clades: Monkeypox viruses. The Journal of General Virology. 2005;86:2661-2672. DOI: 10.1099/vir.0.81215-0
105.European Centre for Disease Prevention and Control. Factsheet for Health Professionals on Mpox (Monkeypox). Stockholm, Sweden: European Centre for Disease Prevention and Control; 2023. Available from: https://www.ecdc.europa.eu/en/all-topics-z/monkeypox/factsheet-health-professionals
106.Lum FM, Torres-Ruesta A, Tay MZ, Lin RTP, Lye DC, Rénia L, et al. Monkeypox: Disease epidemiology, host immunity and clinical interventions. Nature Reviews. Immunology. 2022;22:597-613. DOI: 10.1038/s41577-022-00775-4
107.Singhal T, Kabra SK, Lodha R. Monkeypox: A review. Indian Journal of Pediatrics. 2022;89:955-960. DOI: 10.1007/s12098-022-04348-0
Written By
Tatjana Vilibić-Čavlek, Vladimir Savić, Snježana Židovec-Lepej, Maja Bogdanić, Vladimir Stevanović and Ljubo Barbić
Submitted: 29 May 2023Reviewed: 06 August 2023Published: 07 November 2023
Open access peer-reviewed chapter
