{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:13:18Z","timestamp":1787029998924,"version":"build-2736575974"},"reference-count":18,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T00:00:00Z","timestamp":1660608000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>West Nile virus (WNV) infection is a reemerging zoonosis recently provoking significant outbreaks throughout Europe. During the summer of 2018, the number of WNV infections rose with a peak of new diagnoses of West Nile neuro-invasive disease (WNND). Most of the Italian cases were clustered in the Po River Valley. We present a case series of nine patients with WNV infection admitted to the Cardinal Massaia Hospital from 30 August 2018 to 1 October 2018. Demographic, immunovirological, clinical and therapeutic data are shown, and a report on clinical sequelae from the subsequent follow-up in patients with WNV and WNND. We showed the clinical, radiological and biochemical characteristics of WNV-infected patients. The risk factors and the clinical presentation of WNV in most patients in our case series were typical of that described in the literature, although, despite the high morbidity and mortality of WNND, we showed survival of 100% and long-term sequelae in only three patients. Environmental conditions may be essential in WNV outbreaks, and WNND can be clinically neurological multiform. Our long-lasting follow-up with clinical or radiological monitoring confirmed the morbidity of long-term neurological sequelae after WNND. Further studies are needed to investigate the epidemiology and physiopathology of bacterial superinfections after WNV infection.<\/jats:p>","DOI":"10.3390\/tropicalmed7080185","type":"journal-article","created":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T03:40:32Z","timestamp":1660621232000},"page":"185","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Autochthonous West Nile Virus Infection Outbreak in Humans (Asti, Piedmont, Italy, August\u2013October 2018) and Long-Term Sequelae Follow-Up"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3865-9519","authenticated-orcid":false,"given":"Tommaso","family":"Lupia","sequence":"first","affiliation":[{"name":"Unit of Infectious Diseases, Cardinal Massaia Hospital, 14100 Asti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Libanore","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Cardinal Massaia Hospital, 14100 Asti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Corcione","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Infectious Diseases, University of Turin, 10124 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Fornari","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Infectious Diseases, University of Turin, 10124 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Rizzello","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Infectious Diseases, University of Turin, 10124 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Bosio","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Infectious Diseases, University of Turin, 10124 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Stroffolini","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Infectious Diseases, University of Turin, 10124 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Bigliano","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Cardinal Massaia Hospital, 14100 Asti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Fontana","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Cardinal Massaia Hospital, 14100 Asti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Patti","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Cardinal Massaia Hospital, 14100 Asti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Teresa","family":"Brusa","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Cardinal Massaia Hospital, 14100 Asti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Degioanni","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Cardinal Massaia Hospital, 14100 Asti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Concialdi","sequence":"additional","affiliation":[{"name":"Unit of Laboratory Medicine and Microbiology, Cardinal Massaia Hospital, 14100 Asti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Sara","family":"Navazio","sequence":"additional","affiliation":[{"name":"Unit of Laboratory Medicine and Microbiology, Cardinal Massaia Hospital, 14100 Asti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Penna","sequence":"additional","affiliation":[{"name":"Unit of Laboratory Medicine and Microbiology, Cardinal Massaia Hospital, 14100 Asti, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8338-0130","authenticated-orcid":false,"given":"Francesco Giuseppe","family":"De Rosa","sequence":"additional","affiliation":[{"name":"Unit of Infectious Diseases, Cardinal Massaia Hospital, 14100 Asti, Italy"},{"name":"Department of Medical Sciences, Infectious Diseases, University of Turin, 10124 Torino, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"376230","DOI":"10.1155\/2015\/376230","article-title":"The Global Ecology and Epidemiology of West Nile Virus","volume":"2015","author":"Chancey","year":"2015","journal-title":"BioMed. Res. Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1001\/jama.2013.8042","article-title":"West Nile Virus: Review of the Literature","volume":"310","author":"Petersen","year":"2013","journal-title":"JAMA"},{"key":"ref_3","unstructured":"(2019). West Nile Virus Infection. Annual Epidemiological Report for 2018, ECDC. Available online: https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/documents\/west-nile-fever-annual-epidemiological-report-2018.pdf."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1111\/zph.12654","article-title":"Recent rapid changes in the spatio-temporal distribution of West Nile Neuro-invasive Disease in Italy","volume":"67","author":"Moirano","year":"2019","journal-title":"Zoonoses Public Health"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2001095","DOI":"10.2807\/1560-7917.ES.2021.26.19.2001095","article-title":"Epidemiology of human West Nile virus infections in the European Union and European Union enlargement countries, 2010 to 2018","volume":"26","author":"Young","year":"2021","journal-title":"Eurosurveillance"},{"key":"ref_6","first-page":"563","article-title":"West Nile virus in the transfusion setting with a special focus on the Italian preventive measures adopted in 2008\u20132012 and their impact on blood safety","volume":"11","author":"Pupella","year":"2013","journal-title":"Blood Transfus."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Ricc\u00f2, M., Peruzzi, S., and Balzarini, F. (2021). Epidemiology of West Nile Virus Infections in Humans, Italy, 2012\u20132020: A Summary of Available Evidences. Trop. Med. Infect. Dis., 6.","DOI":"10.3390\/tropicalmed6020061"},{"key":"ref_8","unstructured":"(2022, June 27). Piano Nazionale Integrato di Prevenzione, Sorveglianza e Risposta ai Virus West Nile e Usutu\u20142019. Available online: https:\/\/www.seremi.it\/sites\/default\/files\/Circolare%20WN%20USUTU%202019%2005%2004%20%202019.pdf."},{"key":"ref_9","unstructured":"(2022, July 25). Epicentro Report West-Nile Virus. Available online: https:\/\/www.epicentro.iss.it\/westnile\/2018."},{"key":"ref_10","unstructured":"ECDC (2022, July 25). Epidemiological Update: West Nile Virus Transmission Season in Europe. Available online: https:\/\/www.ecdc.europa.eu\/en\/news-events\/epidemiological-update-west-nile-virus-transmission-season-europe-2018."},{"key":"ref_11","unstructured":"(2022, June 29). Malattie Emergenti Trasmesse da Vettori\u2013Dengue, Chikungunya, Zika, West Nile e Altre Arbovirosi. Available online: https:\/\/www.seremi.it\/sites\/default\/files\/Report%20Arbovirosi%20in%20Piemonte%202018_0.pdf."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1016\/j.envres.2018.08.016","article-title":"West Nile Virus infection in Northern Italy: Case-crossover study on the short-term effect of climatic parameters","volume":"167","author":"Moirano","year":"2018","journal-title":"Environ. Res."},{"key":"ref_13","unstructured":"(2022, June 27). Arpa Climate Report. Available online: https:\/\/www.arpa.piemonte.it\/rischinaturali\/tematismi\/clima\/rapporti-di-analisi\/annuale_pdf\/anno_2018.pdf."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Yeung, M.W., Shing, E., Nelder, M., and Sander, B. (2017). Epidemiologic and clinical parameters of West Nile virus infections in humans: A scoping review. BMC Infect. Dis., 17.","DOI":"10.1186\/s12879-017-2637-9"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"767","DOI":"10.1097\/INF.0b013e3180cc2c3f","article-title":"West Nile Virus Cerebellitis in a Healthy 10-Year-Old Child","volume":"26","author":"Natarajan","year":"2007","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Rousseau, A., Haigh, O., Ksiaa, I., Khairallah, M., and Labetoulle, M. (2020). Ocular Manifestations of West Nile Virus. Vaccines, 8.","DOI":"10.3390\/vaccines8040641"},{"key":"ref_17","first-page":"264","article-title":"West Nile virus meningoencephalitis. Nature clinical practice","volume":"2","author":"Debiasi","year":"2006","journal-title":"Neurology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1016\/S1473-3099(15)00134-6","article-title":"Long-term sequelae of West Nile virus-related illness: A systematic review","volume":"15","author":"Patel","year":"2015","journal-title":"Lancet Infect. Dis."}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/7\/8\/185\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:09:12Z","timestamp":1760141352000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/7\/8\/185"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,16]]},"references-count":18,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["tropicalmed7080185"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed7080185","relation":{},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,16]]}}}