Emerging and re-emerging viruses affecting the nervous system

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(2019) 1:20

REVIEW

Neurological Research and Practice

Open Access

Emerging and re-emerging viruses affecting the nervous system Uta Meyding-Lamadé1*, Eva Craemer1 and Paul Schnitzler2

Abstract Emerging and re-emerging viruses may cause meningitis, encephalitis, meningoencephalomyelitis, encephalitis, Guillian-Barré-like-syndromes as well as strokes. Most important viruses belong to the family of Adenoviridae, Arbovirus, Arenaviridae, Herpesviridae, Picornaviridae, Paramyxoviridae as well as Togaviridae. Clinical presentation usually consists of a biphasic presentation. Non-specific febrile illnesses may be accompanied by rash, headache, arthralgia and myalgia. Thereafter focal neurological signs may evolve. Diagnostic strategies for the detection of emerging and re-emerging viruses may be difficult due to the short viraemic period. Pitfalls in serology may be due to antibody crossreactivity. Arboviruses are transmitted by arthropods. Aedes mosquitos are one of the vectors for arboviruses like Chikungunya-virus, Dengue-virus, Japanese-Encephalitis-B-virus and West-Nile-virus. Since the last centuries Aedes mosquitos have spread from their naturally habitat in Africa to America as well as Europe. The arboviruses risk profile depend essentially on the occurrence, the activity of the respective vector, this may be the key to fight the disease and its spread. Due to global shifts in the ecological balance but also as a result of more or less successful control measures, some diseases have become rarer, others are more common. The viruses persist in the respective vector months to years; in ticks they may persist for years and in mosquitoes 1 to 4 months. In order to survive bad climatic conditions unscathed, the viruses partially overwinter in arthropods. Keywords: Emerging viruses, Dengue-virus, Japanese-encephalitis-B-virus, Meningoencephalitis, Neuroinfectious disease, Nipahvirusencephalitis, Vector-borne disease

Introduction The increased trade, travel habits, urbanization and climate change are some of the factors, which favour evolution and spread of new pathogens. Infectious diseases are emerging or re-emerging every year. Neuroinfectious diseases may occur as outbreaks in small localized regions or may spread rapidly over large geographical areas. An epidemic occurs when an infectious disease spreads rapidly to many people like the Zika Virus outbreak. A pandemic is a global disease outbreak as seen e.g. in HIV/AIDS. Recent outbreaks caused by Chikungunya-virus, West – Nile-virus, Enterovirus infection and Ebolavirus have caused severe neurological manifestations and spread rapidly across continents. Endemic diseases are constantly present, usually in low * Correspondence: [email protected] 1 Department of Neurology, Krankenhaus Nordwest GmbH, Steinbacher Hohl 2-26, 60488 Frankfurt/Main, Germany Full list of author information is available at the end of the article

numbers. Neuroinfectious diseases transmitted by viruses may cause a broad spectrum of neurological presentations such as meningitis,