Magyarországra behurcolt trópusi arbovírusfertőzések 2016 és 2020 között = Imported tropical arbovirus infections in Hungary between 2016 and 2020

Nagy, Orsolya and Nagy, Anna and Toth, Szilvia and Vargáné Koroknai, Anita and Takács, Mária (2021) Magyarországra behurcolt trópusi arbovírusfertőzések 2016 és 2020 között = Imported tropical arbovirus infections in Hungary between 2016 and 2020. ORVOSI HETILAP, 162 (50). pp. 2000-2009. ISSN 0030-6002

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Abstract

Introduction: Dengue-, Zika-and Chikungunya infections are among the most frequently imported tropical arbovirus infections. Due to their shared endemic regions, vectors and similar clinical symptoms, differential diagnosis is based on serological and molecular analysis. Objective: The aim of our study was to identify the imported arbovirus infections of travellers between 2016 and 2020. Furthermore, to improve the diagnostic sensitivity, anticoagulated whole blood and urine samples were involved in molecular diagnosis. Method: Virus-specific antibody kinetics was tested in paired sera of patients by ELISA method. In case of reactive results, further serological analysis was performed using immunofluorescence assays and/or ELISA tests to exclude serological cross-reactions caused by other members of the flavi-and alphaviruses. Detection of viral RNA was attempted from serum, anticoagulated whole blood and urine specimens using reverse transcription and real-time polymerase chain reaction. Results: Out of the tested 1037 travellers, reactive serological and/or molecular results were obtained in 133 cases. Anticoagulated whole blood proved to be the most suitable specimen for viral RNA detection of the three viruses. Discussion: Parallel testing of Dengue-, Zika-and Chikungunya infections is recommended, as symptom-based differential diagnosis is challenging. Due to the characteristic serological cross-reactivity of flavi-and alphaviruses, microbiological diagnosis relies on both serological and molecular tests. Conclusion: Involving anticoagulated whole blood and urine samples into molecular analysis and early sample collection improve the sensitivity of microbiological diagnostics. Identification of imported tropical arbovirus infections is of high importance as the presence of vector mosquitos in Europe raises the possibility of autochthon transmission.

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