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Int. J. Environ. Res. Public Health 2013, 10(11), 6049-6083; doi:10.3390/ijerph10116049
Review

Flaviviruses in Europe: Complex Circulation Patterns and Their Consequences for the Diagnosis and Control of West Nile Disease

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1 UMR1161 Virologie INRA, ANSES, ENVA, EU-RL on equine West Nile disease, Animal Health Laboratory, ANSES, Maisons-Alfort 94704, France 2 CISA-INIA, Valdeolmos (Madrid) 28130, Spain 3 Département Hippique, VetAgroSup, Marcy l'Etoile 69280, France 4 UR346, INRA, Saint Genès Champanelle 63122, France 5 Epidemiology Unit, Animal Health Laboratory, ANSES, Maisons-Alfort 94704, France 6 Viral Zoonoses, Emerging and Vector-Borne Infections Group, Institute of Virology, University of Veterinary Medicine Vienna, Vienna 1210, Austria 7 Department of Microbiology and Immunology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat 123, Sultanate of Oman 8 IRBA, Marseille 13384, France
* Author to whom correspondence should be addressed.
Received: 19 August 2013 / Revised: 24 October 2013 / Accepted: 29 October 2013 / Published: 12 November 2013
(This article belongs to the Special Issue Epidemiology of West Nile Virus)
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Abstract

In Europe, many flaviviruses are endemic (West Nile, Usutu, tick-borne encephalitis viruses) or occasionally imported (dengue, yellow fever viruses). Due to the temporal and geographical co-circulation of flaviviruses in Europe, flavivirus differentiation by diagnostic tests is crucial in the adaptation of surveillance and control efforts. Serological diagnosis of flavivirus infections is complicated by the antigenic similarities among the Flavivirus genus. Indeed, most flavivirus antibodies are directed against the highly immunogenic envelope protein, which contains both flavivirus cross-reactive and virus-specific epitopes. Serological assay results should thus be interpreted with care and confirmed by comparative neutralization tests using a panel of viruses known to circulate in Europe. However, antibody cross-reactivity could be advantageous in efforts to control emerging flaviviruses because it ensures partial cross-protection. In contrast, it might also facilitate subsequent diseases, through a phenomenon called antibody-dependent enhancement mainly described for dengue virus infections. Here, we review the serological methods commonly used in WNV diagnosis and surveillance in Europe. By examining past and current epidemiological situations in different European countries, we present the challenges involved in interpreting flavivirus serological tests and setting up appropriate surveillance programs; we also address the consequences of flavivirus circulation and vaccination for host immunity.
Keywords: flaviviruses; West Nile virus; antibodies; cross-reactivity; diagnosis; cross-protection; ADE; natural infection; vaccination; vector-borne diseases flaviviruses; West Nile virus; antibodies; cross-reactivity; diagnosis; cross-protection; ADE; natural infection; vaccination; vector-borne diseases
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Beck, C.; Jimenez-Clavero, M.A.; Leblond, A.; Durand, B.; Nowotny, N.; Leparc-Goffart, I.; Zientara, S.; Jourdain, E.; Lecollinet, S. Flaviviruses in Europe: Complex Circulation Patterns and Their Consequences for the Diagnosis and Control of West Nile Disease. Int. J. Environ. Res. Public Health 2013, 10, 6049-6083.

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