{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T02:02:35Z","timestamp":1793757755732,"version":"4.6.1"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2022,4,8]],"date-time":"2022-04-08T00:00:00Z","timestamp":1649376000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>\n                    In Hungary,\n                    <jats:italic>West Nile virus<\/jats:italic>\n                    (WNV) has been responsible for 459 laboratory confirmed human cases between 2004 and 2019, while the first human\n                    <jats:italic>Usutu virus<\/jats:italic>\n                    (USUV) infection was confirmed only in 2018. A comprehensive serosurvey was conducted among blood donors to assess the WNV and USUV seroprevalence in 2019, one year after the largest European WNV epidemic. Altogether, 3005 plasma samples were collected and screened for WNV and USUV specific Immunoglobulin G (IgG) antibodies by Enzyme\u2013Linked Immunosorbent Assay (ELISA). All reactive samples were further tested for\n                    <jats:italic>tick-borne encephalitis virus<\/jats:italic>\n                    IgG antibodies by ELISA. Indirect immunofluorescence test and microneutralization assay were used as confirmatory methods. Overall, the WNV seroprevalence was 4.32%, and in five blood donors USUV seropositivity was confirmed. The highest seroprevalence was measured in Central, Eastern and Southern Hungary, while the Western part of the country proved to be less affected. There was a statistically strong association between the WNV seroprevalence of 2019 and the cumulative incidence in the period of 2004 and 2019 calculated for every NUTS 3 region. The last WNV serological screening was performed in 2016 and the prevalence of anti-WNV IgG proved to be 2.19%. One year after the 2018 WNV outbreak, a significant increase in seroprevalence was observed in the Hungarian population and evidence for USUV seropositivity was also obtained. The spatial pattern of seroprevalence can support the identification of high-risk areas raising awareness of the need for increased surveillance, such as screening vector, equine, and avian populations. The communication with general practitioners and other professionals in primary health care services can support the early identification of acute human cases. Education and awareness-raising on the importance of protection against mosquito vectors amongst residents are also important parts of preventive measures.\n                  <\/jats:p>","DOI":"10.1371\/journal.pone.0266840","type":"journal-article","created":{"date-parts":[[2022,4,8]],"date-time":"2022-04-08T13:26:20Z","timestamp":1649424380000},"page":"e0266840","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":19,"title":["West Nile and Usutu virus seroprevalence in Hungary: A nationwide serosurvey among blood donors in 2019"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4081-2308","authenticated-orcid":true,"given":"Anna","family":"Nagy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolett","family":"Csonka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e1ria","family":"Tak\u00e1cs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eszter","family":"Mezei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c9va","family":"Barab\u00e1s","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,4,8]]},"reference":[{"issue":"11","key":"pone.0266840.ref001","doi-asserted-by":"crossref","first-page":"6049","DOI":"10.3390\/ijerph10116049","article-title":"Flaviviruses in Europe: Complex circulation patterns and their consequences for the diagnosis and control of West Nile disease","volume":"10","author":"C Beck","year":"2013","journal-title":"Int J Environ Res Public Health"},{"issue":"1","key":"pone.0266840.ref002","doi-asserted-by":"crossref","first-page":"219","DOI":"10.3390\/v7010219","article-title":"Usutu virus: An emerging flavivirus in Europe","volume":"7","author":"U Ashraf","year":"2015","journal-title":"Viruses"},{"key":"pone.0266840.ref003","doi-asserted-by":"crossref","first-page":"2196","DOI":"10.1056\/NEJMoa022987","article-title":"Transmission of West Nile Virus from an Organ Donor to Four Transplant Recipients","author":"M Iwamoto","year":"2003","journal-title":"N Engl J Med"},{"key":"pone.0266840.ref004","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1056\/NEJMoa030969","article-title":"Transmission of West Nile Virus through Blood Transfusion in the United States in 2002","author":"LN Pealer","year":"2003","journal-title":"N Engl J Med"},{"issue":"5","key":"pone.0266840.ref005","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1542\/peds.113.5.1375","article-title":"West Nile Virus Infection: A Pediatric Perspective","volume":"113","author":"EB Hayes","year":"2004","journal-title":"Pediatrics"},{"issue":"3","key":"pone.0266840.ref006","doi-asserted-by":"crossref","first-page":"1666","DOI":"10.1542\/peds.2006-2107","article-title":"Transmission of West Nile Virus Through Human Breast Milk Seems to Be Rare","volume":"119","author":"AF Hinckley","year":"2007","journal-title":"Pediatrics"},{"issue":"1","key":"pone.0266840.ref007","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.femsle.2004.01.035","article-title":"New insights on the neuropathology of West Nile virus","volume":"233","author":"PE Ceccaldi","year":"2004","journal-title":"FEMS Microbiol Lett"},{"issue":"8","key":"pone.0266840.ref008","doi-asserted-by":"crossref","first-page":"1174","DOI":"10.3201\/eid1108.050289b","article-title":"Virology, pathology, and clinical manifestations of West Nile virus disease","volume":"11","author":"EB Hayes","year":"2005","journal-title":"Emerg Infect Dis"},{"issue":"2","key":"pone.0266840.ref009","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/s00401-015-1511-3","article-title":"Neurotropic virus infections as the cause of immediate and delayed neuropathology","volume":"131","author":"M Ludlow","year":"2016","journal-title":"Acta Neuropathol"},{"issue":"4","key":"pone.0266840.ref010","doi-asserted-by":"crossref","first-page":"654","DOI":"10.3201\/eid0704.017409","article-title":"Clinical findings of West Nile virus infection in hospitalized patients, New York and New Jersey, 2000","volume":"7","author":"D Weiss","year":"2001","journal-title":"Emerg Infect Dis"},{"issue":"14","key":"pone.0266840.ref011","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2807\/1560-7917.ES.2017.22.14.30501","article-title":"Blood donor screening for West Nile virus (WNV) revealed acute Usutu virus (USUV) infection, Germany, September 2016","volume":"22","author":"D Cadar","year":"2017","journal-title":"Euro Surveill"},{"key":"pone.0266840.ref012","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.meegid.2016.12.023","article-title":"Usutu virus, Belgium, 2016","volume":"48","author":"M Garigliany","year":"2017","journal-title":"Infect Genet Evol"},{"issue":"7","key":"pone.0266840.ref013","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3390\/v11070640","article-title":"Usutu virus: An arbovirus on the rise","volume":"11","author":"F Roesch","year":"2019","journal-title":"Viruses"},{"issue":"7","key":"pone.0266840.ref014","doi-asserted-by":"crossref","first-page":"652","DOI":"10.3201\/eid0807.020094","article-title":"Emergence of Usutu virus, an African mosquito-borne Flavivirus of the Japanese encephalitis virus group, Central Europe","volume":"8","author":"H Weissenb\u00f6ck","year":"2002","journal-title":"Emerg Infect Dis"},{"issue":"1","key":"pone.0266840.ref015","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.cmi.2016.09.019","article-title":"Usutu virus infections in humans: a retrospective analysis in the municipality of Modena, Italy","volume":"23","author":"A Grottola","year":"2017","journal-title":"Clin Microbiol Infect"},{"key":"pone.0266840.ref016","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1007\/s15010-014-0625-1","article-title":"First evidence of simultaneous occurrence of West Nile virus and Usutu virus neuroinvasive disease in humans in Croatia during the 2013 outbreak","volume":"42","author":"T Vilibic-Cavlek","year":"2014","journal-title":"Infection"},{"issue":"50","key":"pone.0266840.ref017","doi-asserted-by":"crossref","first-page":"9","DOI":"10.2807\/ese.14.50.19446-en","article-title":"First human case of Usutu virus neuroinvasive infection, Italy, August-September 2009","volume":"14","author":"M Pecorari","year":"2009","journal-title":"Euro Surveill"},{"issue":"1","key":"pone.0266840.ref018","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1007\/s13365-014-0300-4","article-title":"First cases of human Usutu virus neuroinvasive infection in Croatia, August\u2013September 2013: clinical and laboratory features","volume":"21","author":"M Santini","year":"2015","journal-title":"J Neurovirol"},{"issue":"5","key":"pone.0266840.ref019","doi-asserted-by":"crossref","first-page":"875","DOI":"10.3201\/eid2405.171122","article-title":"Human Usutu virus infection with atypical neurologic presentation, Montpellier, France, 2016","volume":"24","author":"Y Simonin","year":"2018","journal-title":"Emerg Infect Dis"},{"issue":"28","key":"pone.0266840.ref020","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2807\/1560-7917.ES.2019.24.28.1900038","article-title":"Extraordinary increase in west nile virus cases and first confirmed human usutu virus infection in hungary, 2018","volume":"24","author":"A Nagy","year":"2019","journal-title":"Euro Surveill"},{"issue":"7","key":"pone.0266840.ref021","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3390\/microorganisms7070184","article-title":"West Nile virus and Usutu virus co-circulation in Europe: Epidemiology and implications","volume":"7","author":"S Zannoli","year":"2019","journal-title":"Microorganisms"},{"issue":"10","key":"pone.0266840.ref022","first-page":"2010","article-title":"Usutu virus, Austria and Hungary, 2010\u20132016","volume":"6","author":"T Bakonyi","year":"2017","journal-title":"Emerg Microbes Infect"},{"issue":"2","key":"pone.0266840.ref023","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.ttbdis.2012.01.002","article-title":"Seasonal activity and tick-borne pathogen infection rates of Ixodes ricinus ticks in Hungary","volume":"3","author":"L Egyed","year":"2012","journal-title":"Ticks Tick Borne Dis"},{"issue":"1","key":"pone.0266840.ref024","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1007\/s10393-014-0969-0","article-title":"A 4-Year Study of a Natural Tick-Borne Encephalitis Virus Focus in Hungary, 2010\u20132013","volume":"12","author":"V Z\u00f6ldi","year":"2015","journal-title":"Ecohealth"},{"issue":"4","key":"pone.0266840.ref025","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1089\/vbz.2011.0905","article-title":"Tick-borne encephalitis and Lyme disease in Hungary: The epidemiological situation between 1998 and 2008","volume":"13","author":"V Z\u00f6ldi","year":"2013","journal-title":"Vector-Borne Zoonotic Dis"},{"issue":"2","key":"pone.0266840.ref026","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1556\/amicr.58.2011.2.8","article-title":"Serologic evidence of West Nile virus infection in patients with exanthema in Hungary","volume":"58","author":"K Szomor","year":"2011","journal-title":"Acta Microbiol Immunol Hung"},{"issue":"11","key":"pone.0266840.ref027","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1089\/vbz.2018.2401","article-title":"West Nile Virus Seroprevalence Among Blood Donors in Hungary","volume":"19","author":"A Nagy","year":"2019","journal-title":"Vector-Borne Zoonotic Dis"},{"issue":"9","key":"pone.0266840.ref028","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1089\/vbz.2017.2126","article-title":"Usutu Virus Antibodies in Blood Donors and Healthy Forestry Workers in the Lombardy Region, Northern Italy","volume":"17","author":"E Percivalle","year":"2017","journal-title":"Vector-Borne Zoonotic Dis"},{"issue":"10","key":"pone.0266840.ref029","doi-asserted-by":"crossref","first-page":"E451","DOI":"10.1111\/1469-0691.12241","article-title":"Detection of specific antibodies against West Nile and Usutu viruses in healthy blood donors in northern Italy, 2010\u20132011","volume":"19","author":"A Pierro","year":"2013","journal-title":"Clin Microbiol Infect"},{"key":"pone.0266840.ref030","first-page":"1","article-title":"West Nile Virus Seroprevalence in the Greek Population in 2013: A Nationwide Cross-Sectional Survey","volume":"376","author":"C Hadjichristodoulou","year":"2015","journal-title":"PLoS One"},{"issue":"1","key":"pone.0266840.ref031","doi-asserted-by":"crossref","first-page":"84","DOI":"10.3906\/sag-1312-50","article-title":"Investigation of West Nile virus among healthy blood donors in the western part of Turkey","volume":"45","author":"SU B\u0130\u00e7ero\u011flu","year":"2015","journal-title":"Turk J Med Sci"},{"key":"pone.0266840.ref032","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1016\/j.ijid.2020.11.175","article-title":"Seroprevalence of West Nile Virus among Healthy Blood Donors from Different National Populations Residing in Qatar","volume":"103","author":"SR Dargham","year":"2021","journal-title":"Int J Infect Dis"},{"issue":"16","key":"pone.0266840.ref033","first-page":"pii = 1800349","article-title":"One Health approach for West Nile virus surveillance in the European Union: Relevance of equine data for blood safety","volume":"24","author":"European Union West Nile fever working group","year":"2019","journal-title":"Euro Surveill"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0266840","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,8]],"date-time":"2022-04-08T13:26:44Z","timestamp":1649424404000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0266840"}},"subtitle":[],"editor":[{"given":"Gheyath K.","family":"Nasrallah","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,4,8]]},"references-count":33,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4,8]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0266840","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4,8]]}}}