Journal of Clinical Virology - Volume 82 - Supplement 1 - September 2016

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Abstracts / Journal of Clinical Virology 82S (2016) S1–S142 S55
particular to the area and this reveal it on the clinical featureswhich
increases its important in the studying.
Abstract no: 142
Presentation at ESCV 2016: Poster 68
Appropriate diagnosis of Zika virus infection:
Italy North-West experience
E. Burdino ∗, T. Allice , M.G. Milia , G. Gregori ,
T. Ruggiero , G. Calleri , F. Lipani , A. Lucchini ,
G. Venturi hisetti
1 Laboratory of Microbiology and Virology, Amedeo
di Savoia Hospital, Turin, Italy
2 Unit A of Infectious and Tropical Diseases, Amedeo
di Savoia Hospital, Turin, Italy
3 Department of Infectious Diseases, Amedeo di
Savoia Hospital, Turin, Italy
4 National Reference Laboratory for Arboviruses,
Department of Infectious, Parasitic and
Immune-Mediated Diseases, Istituto Superiore di
Sanità, Rome, Italy
Background: After large outbreaks occurred in Micronesia,
2007, and in the Pacific Area, 2013, Zika virus (ZIKV) was reported
in Brazil in early 2015 and subsequently in the Americas and
Caribbean. Autochthonous cases of ZIKV infections have been
worldwide reported fromat least 45 countries and increasing num-
ber of imported cases has been observed in Europe and United
States. The aim of the study was to evaluated ZIKV epidemiology in
travelers recently returning from endemic areas to Piemonte, Italy
North-West (4.2million inhabitants) from January to May 2016.
Methods: 68 samples (49 sera, 19 urine) were collected from
41 travelers returning from ZIKV endemic areas and referring
to the regional Centre for Infectious Diseases, Amedeo di Savoia
Hospital, Turin. Patients underwent laboratory examinations to
rule out a tropical fever. Specific IgG and IgM antibodies to ZIKV
were detected with ELISA IgM and IgG assay (Euroimmun, AG).
Confirmatory Plaque Reduction Neutralization Tests (PRNTs) were
performed at the Istituto Superiore di Sanità, Rome, Italy. Real Time
Polymerase Chain Reaction (RT-PCR) for ZIKV was performed on
serum/urinewith two commercial assays: RealStar Zika virus RT-PC
Kit (Altona Diagnostics) and Genesig Standard Kit (Primerdesign)
validatedwith a ZIKV PCR standard (MR766 Zika virus strain) kindly
provided by the Robert Koch Institute using 10-fold serial dilutions
from 106 to 1 copy/ l.
Results: Recent ZIKV infectionwas identified in3 out of 41 (7.3%)
travelers. Patient 1 (male, 29 years old) reported arthralgia, retro-
orbital pain, severe itching and mild burning maculopapular rash
5 days after returning from Venezuela. Leucopenia was present.
Serology for ZIKV was IgM positive and IgG negative. ZIKV RNA
was not detected in blood (urine not available). A second sero-
logic test performed 2 months later showed IgG seroconversion
(169 RU/mL) and undetectable IgM. Patient 2 (female, 31 years
old) 2 days after returning from Venezuela, reported chest and
limbs papular rash with arthralgia but no fever. ZIKV serologic
tests showed a low IgG titer (50 RU/mL) with undetectable IgM.
ZIKV RNA was negative in blood (urine not available). A second
serum sample was withdrawn 2 months later and showed increas-
ing IgG titer to 250 RU/mL. PRNTs for Patient 1 and 2 were positive
for ZIKV neutralizing antibodies (titer ≥ 1:10). Patient 3 (female,
40 years old) 3 days after returning from the Dominican Republic
presented with chest and limbs pruriginous rash and fever last-
ing from 8 days before, with leucopenia. ZIKV RNA was detected in
urine (5913 copies/ml); in serum a high IgG titer (106 RU/mL) with
undetectable IgMwas reported. Nine days later, ZIKV RNA was still
positive in urine (310 copies/ml); IgG titer increased to 265 RU/mL.
All patients tested negative for Dengue and Chikungunya viruses
and completely recovered after few days. ZIKV RT-PCR detection
limit was 46 copies/ L for the Altona assay and 23 for Gene-
sig [mean cycle threshold (Ct) values 37.3 and 37.5, respectively]
according to the ZIKV MR766 standard.
Conclusions: Returning travellers are sentinels of a rapidly
changing epidemiology and require a prompt diagnosis and a care-
ful surveillance for their implications in subsequent autochthonous
transmission of the disease. In this contest, standardized molecular
and serologic tests are mandatory for the appropriate diagnosis.
Abstract no: 164
Presentation at ESCV 2016: Poster 69
Screening of emerging viral infections among
risk groups
Judit Deak ∗, G. Kemenesi , F. Jakab
1 Department of Clinical Microbiology, University of
Szeged, Hungary
2 Virological Research Group, János Szentágothai
Research Center, University of Pécs, Institute of
Biology, Faculty of Sciences, University of Pécs, Pécs,
Hungary
Background: Among viral infections, Hantaviruses and West
Nile viruses (WNV) have been detected. Chikungunya virus, which
can cause outbreaks in the temperate region, has been found in
Italy. The members of Sandfly fever viruses (Genus: Phlebovirus):
Sicilian, Naples, Toscana and Cyprus types have been detected in
Italy, Portugal, Spain, France, Greece, Austria, Croatia and Turkey.
Crimean-Congo hemorrhagic fever has been detected in the Balkan
states, and dengue fever in Croatia, France and Norway. Aedes
albopictus, the vector of yellow fever, is widespread among the
European coastal regions and islands. The history of yellow fever
and dengue fever in temperate regions confirms that the transmis-
sion of both diseases could recur.
Patients and Methods: PCR and RT-PCR (TIB Molbiol, Berlin,
Germany and Roche, Mannheim, Germany) methods have been
introduced for the screening of the nucleic acids of Chikungunya,
Crimean-Congo hemorrhagic fever, Dengue, Hanta, Sandfly fever,
and West Nile viruses in healthy risk groups (hunters, fishers, gar-
deners and keepers in zoological garden) and blood donors in South
Hungary. Indirect immunofluorescence (IIF) methods were per-
formed with BIOCHIP slides (Euroimmun Med. Lab. AG., Lübeck,
Germany).
Results: PCR examinations proved negative both in risk groups
and controls. Hantavirus Seul, Dobrava, and Puumala IgGantibodies
proved positive in the cases of 5, 4 and 1 individuals, respectively.
Sandfly fever viruses: Sicilian, Naples, Toscana and Cypres IgMwere
positive in 6, 2, 5 and 1,and IgG antibodies in 21, 17, 16 and 11
individuals. WNV IgMwas positive in 3, and IgG in 22 cases. Chikun-
gunya and Crimean-Congo IgM and IgG were negative. Dengue
virus IgM was positive in 10 cases, while IgG was negative.
Conclusions: The intensification of migration, the growth in the
density of the population, the susceptibility to infectious diseases,
the decline of human immunity in consequence of insolation (UV
effect), and malnutrition all tend to make humanity sensitive to
infectious illnesses. Prevention, recognition, early diagnosis and
treatment are very important to counter local endemics and epi-
demics.