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Viruses 2013, 5(10), 2329-2348; doi:10.3390/v5102329
Review

Diagnosis of West Nile Virus Human Infections: Overview and Proposal of Diagnostic Protocols Considering the Results of External Quality Assessment Studies

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1 Operative Unit of Clinical Microbiology, Regional Reference Centre for Microbiological Emergencies, S. Orsola-Malpighi University Hospital, Bologna 40138, Italy 2 National Institute for Infectious Diseases (INMI) "L. Spallanzani", Rome 00149, Italy 3 UMR_D 190 "Emergence des Pathologies Virales", APHM Public Hospitals of Marseille, EHESP French School of Public Health & IHU Mediterranee Infection, IRD French Institute of Research for Development, Aix Marseille University, 13005, Marseille, France 4 Centre for Biological Security (ZBS-1), Robert Koch-Institut, Berlin 13353, Germany 5 National Microbiology Centre, Instituto de Salud Carlos III, Madrid 28220, Spain 6 NERC Centre for Ecology and Hydrology, Wallingford, Oxon OX10 8BB, UK 7 Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece 8 European Public Health Microbiology Training Programme (EUPHEM), European Centre for Disease Prevention and Control, Stockholm 171 83, Sweden 9 European Centre for Disease Prevention and Control, Stockholm 171 83, Sweden
* Author to whom correspondence should be addressed.
Received: 16 August 2013 / Revised: 28 August 2013 / Accepted: 9 September 2013 / Published: 25 September 2013
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Abstract

West Nile virus, genus Flavivirus, is transmitted between birds and occasionally other animals by ornithophilic mosquitoes. This virus also infects humans causing asymptomatic infections in about 85% of cases and <1% of clinical cases progress to severe neuroinvasive disease. The virus also presents a threat since most infections remain unapparent. However, the virus contained in blood and organs from asymptomatically infected donors can be transmitted to recipients of these infectious tissues. This paper reviews the presently available methods to achieve the laboratory diagnosis of West Nile virus infections in humans, discussing the most prominent advantages and disadvantages of each in light of the results obtained during four different External Quality Assessment studies carried out by the European Network for ‘Imported’ Viral Diseases (ENIVD).
Keywords: West Nile virus; state of the art laboratory diagnostic; external quality assurance West Nile virus; state of the art laboratory diagnostic; external quality assurance
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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Sambri, V.; Capobianchi, M.R.; Cavrini, F.; Charrel, R.; Donoso-Mantke, O.; Escadafal, C.; Franco, L.; Gaibani, P.; Gould, E.A.; Niedrig, M.; Papa, A.; Pierro, A.; Rossini, G.; Sanchini, A.; Tenorio, A.; Varani, S.; Vázquez, A.; Vocale, C.; Zeller, H. Diagnosis of West Nile Virus Human Infections: Overview and Proposal of Diagnostic Protocols Considering the Results of External Quality Assessment Studies. Viruses 2013, 5, 2329-2348.

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