Ongoing Activity of Toscana Virus Genotype A and West Nile Virus Lineage 1 Strains in T urkey: A Clinical and Field Survey

Toscana virus ( TOSV ), W est N ile virus ( WNV ) and tickborne encephalitis virus ( TBEV ) are among major viral pathogens causing febrile disease and meningitis/encephalitis. The impact of these viruses was investigated at a referral centre in A nkara Province, C entral A natolia in 2012, where previous reports suggested virus circulation but with scarce information on clinical cases and vector activity. Serum and/or cerebrospinal fluid samples from 94 individuals were evaluated, in addition to field‐collected arthropod specimens that included 767 sandflies and 239 mosquitoes. Viral nucleic acids in clinical samples and arthropods were sought via specific and generic nested/real‐time PCR s, and antibody responses in clinical samples were investigated via commercial indirect immunofluorescence tests ( IIFT s) and virus neutralization. A WNV antigen assay was also employed for mosquitoes. WNV neuroinvasive disease has been identified in a 63‐year‐old male via RNA detection, and the WNV strain was characterized as lineage 1. TOSV infections were diagnosed in six individuals (6.3%) via RNA or IgM detection. Partial sequences in a 23‐year‐old female, presented with fever and transient pancytopenia, were characterized as TOSV genotype A. Febrile disease with arthralgia and/or peripheral cranial nerve involvement was noted in cases with TOSV infections. Previous WNV and TOSV exposures have been observed in 5.3% and 2.1% of the subjects, respectively. No confirmed TBEV exposure could be identified. Morphological identification of the field‐collected mosquitoes revealed C ulex pipiens sensu lato (74.4%), A nopheles maculipennis (20.9%), An. claviger (2.1%) and others. Sandfly species were determined as P hlebotomus papatasi (36.2%), P . halepensis (27.3%), P . major s. l. (19.3%), P . sergenti (8.9%), P . perfiliewi (4.4%), P . simici (2.6%) and others. Viral infections in arthropods could not be demonstrated. TOSV genotype A and WNV lineage 1 activity have been demonstrated as well as serologically proven exposure in patients. Presence of sandfly and mosquito species capable of virus transmission has also been revealed.