Altogether, 19 confirmed WNV infections were identified from 2020–2021. From 2020 onwards, roughly 80% of all blood establishments in Germany tested their donations for WNV using nucleic acid amplification techniques in the transmission season. WNV transmissions via blood products often result in WNND due to the predisposing underlying medical conditions of transfusion recipients. WNV is a transfusion-transmissible-infection, and donor deferral or testing of donations after a stay in an affected area are effective means to ensure transfusion safety. So far, no clear expansion of the affected areas is discernible but may develop. Autochthonous mosquito-borne WNV infections in humans were reported in all following years, indicating a continuous circulation in the affected areas of Central-East Germany. The widespread domestic Culex mosquitoes are efficient vectors for WNV. This changed when in the exceptionally warm summer of 2018, conditions for viral replication in mosquitoes were ideal, and the first WNV cases among birds and horses were identified.
Human WNV cases have been identified in Southern and Eastern Europe for more than 20 years, but until 2018, Germany was considered to be a non-endemic country. In most individuals, WNV infection remains silent, while 20% develop mild symptoms of West Nile fever, and only 1% develop neuroinvasive disease (WNND).
It circulates in an enzootic cycle between ornithophilic mosquitoes as vectors and reservoirs and avian host species for amplification, but humans can be infected as accidental hosts. West Nile virus (WNV) is an arthropod-borne virus (arbovirus). For logistical reasons, in Halle, Poing and Kahla, no more than 10 EVS traps each could be operated by local attendants, while the Tierpark Berlin was sampled by 20 EVS traps per year, taken care of by the authors themselves. linked to WNF cases: After WNV infection had been diagnosed in zoo birds and a horse, EVS (encephalitis virus surveillance) traps (BioQuip, Products, Rancho Dominguez, CA, USA), equipped with dry ice as a CO 2 attractant, were operated continuously in Halle, federal state of Saxony-Anhalt (zoo, 31 August to 22 September 2018, starting three days after diagnosis of a WNV case in a great grey owl location 1 in Figure S1) in Poing, Bavaria (wildlife park, 17 to 30 September 2018, starting five days after diagnosis of a WNV case in a great grey owl location 2 in Figure S1) in Kahla, Brandenburg (horse pasture, 1 to 11 October 2018, starting 10 days after diagnosis of a WNV case in a foal location 3 in Figure S1) and in Berlin (wildlife park (Tierpark), 6 to 29 September 2018, starting two days after preliminary diagnosis of WNV infection in the first of two deceased snowy owls, and 12 September to 6 October 2019, three weeks after diagnosis of a WNV case in a snowy owl location 4 in Figure S1).
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