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The Bernhard Nocht Institute for Tropical Medicine (BNITM) has reported four West Nile fever infections acquired in Germany and six more cases have been confirmed in Leipzig. Three of the affected people in Leipzig were seriously ill and hospitalized with meningitis, said virologist Jonas Schmidt-Chanasit of the Bernhard Nocht Institute in Hamburg. Three others showed milder symptoms, such as fever or a rash, and four had been tested as part of a blood or plasma donation. In addition, there are more than a dozen suspected cases that are currently being examined.
The first transmissions within Germany were reported last year. In June, the Robert Koch Institute (RKI) announced that it expected West Nile fever to spread further in Germany. So far, the cases have only occurred in the east (Saxony, Saxony-Anhalt and Berlin).
“The access points are definitely Leipzig and Berlin at the moment,” Schmidt-Chanasit told SPIEGEL. “But we can also observe a movement to the southwest, where there have already been some cases in animals.” Infected animals are often the first indicators that the virus is produced in a region and that humans could also be infected. In mid-July this year the first West Nile fever infections in birds were reported. In Berlin, the virus was detected in a dead blue tit. An alpine chough died of the infection in the Halle Mountain Zoo (Saxony-Anhalt), an eagle owl in Bernburg (Saxony-Anhalt) and a snowy owl in the Erfurt zoo (Thuringia).
“We fear that the virus could spread to southern Germany or the Ruhr area,” said Schmidt-Chanasit. There the population density is high and the temperatures are favorable for mosquitoes. At the moment, however, it cannot be said exactly.
The West Nile virus is transmitted by mosquitoes of the genus Culex, which are widespread in Germany and cause symptoms, mainly fever or rashes, in about 20 percent of infected people. Only about 1 percent of infections cause serious diseases that affect the nervous system. “Since only about 1 percent develop a serious illness, we have to take on a large number of unreported cases,” says Schmidt-Chanasit. “The truth is that there are probably hundreds of people infected.”
The Center for Travel Medicine (CRM) now advises careful protection against mosquitoes in affected regions. West Nile fever occurs predominantly in the tropics and subtropics. For a few years, it has also spread in North America and Southeast Europe. “In 2018, the first locally acquired infections in Germany were recorded in birds and horses, and in late summer last year, five people fell ill in eastern Germany for the first time,” says Tomas Jelinek, CRM scientific director, according to a Press release. More infections are to be expected next fall. However, Spain, Italy and, above all, Greece are currently much more affected ”.
Since there have been sporadic outbreaks in Europe since the 1960s, there is talk of migratory birds introducing West Nile virus from endemic tropical and subtropical areas in spring and then transmitting it to mosquitoes in Europe. Under certain weather conditions, these infected mosquitoes can also infect people with the virus.
So far there are no vaccines or a specific therapy for humans. Infections can only be prevented with mosquito repellent. Repellants that contain the active ingredient DEET (N, N-diethyl-m-toluamide) in a concentration of 30 to 50 percent are currently the most effective agent available, according to CRM.
