Since 2018, autochthonous West Nile virus (WNV) infections have been regularly reported in eastern–central Germany. While clinically apparent infections in humans and horses are not frequent, seroprevalence studies in horses may allow the tracing of WNV and related flaviviruses transmission, such as tick-borne encephalitis virus (TBEV) and Usutu virus (USUV), and consequently help to estimate the risk of human infections. Hence, the aim of our study was to follow the seropositive ratio against these three viruses in horses in Saxony, Saxony Anhalt, and Brandenburg and to describe their geographic distribution for the year 2021. In early 2022, i.e., before the virus transmission season, sera from 1232 unvaccinated horses were tested using a competitive pan-flavivirus ELISA (cELISA). In order to estimate the true seropositive ratio of infection with WNV, TBEV, and USUV for 2021, positive and equivocal results were confirmed by a virus neutralization test (VNT). In addition, possible risk factors for seropositivity using questionnaires were analyzed using logistic regression based on questionnaires similar to our previous study from 2020. In total, 125 horse sera reacted positive in the cELISA. Based on the VNT, 40 sera showed neutralizing antibodies against WNV, 69 against TBEV, and 5 against USUV. Three sera showed antibodies against more than one virus, and eight were negative based on the VNT. The overall seropositive ratio was 3.3% (95% CI: 2.38–4.40) for WNV, 5.6% (95% CI: 4.44–7.04) for TBEV, and 0.4% (95% CI: 0.14–0.98) for USUV infections. While age and number of horses on the holding were factors predicting TBEV seropositivity, no risk factors were discovered for WNV seropositivity. We conclude that horses are useful sentinels to determine the flavivirus circulation in eastern–central Germany, as long as they are not vaccinated against WNV.

West Nile virus (WNV) infections were first detected in Germany in 2018, but information about WNV seroprevalence in horses is limited. The study’s overall goal was to gather information that would help veterinarians, horse owners, and veterinary-, and public health- authorities understand the spread of WNV in Germany and direct protective measures. For this purpose, WNV seroprevalence was determined in counties with and without previously registered WNV infections in horses, and risk factors for seropositivity were estimated. The cohort consisted of privately owned horses from nine counties in Eastern Germany. A total of 940 serum samples was tested by competitive panflavivirus ELISA (cELISA), and reactive samples were further tested by WNV IgM capture ELISA and confirmed by virus neutralization test (VNT). Information about potential risk factors was recorded by questionnaire and analyzed by logistic regression. A total of 106 serum samples showed antibodies against flaviviruses by cELISA, of which six tested positive for WNV IgM. The VNT verified a WNV infection for 54 samples (50.9%), while 35 sera neutralized tick-borne encephalitis virus (33.0%), and eight sera neutralized Usutu virus (7.5%). Hence, seroprevalence for WNV infection was 5.8% on average and was significantly higher in counties with previously registered infections (p = 0.005). The risk factor analysis showed breed type (pony), housing in counties with previously registered infections, housing type (24 h turn-out), and presence of outdoor shelter as the main significant risk factors for seropositivity. In conclusion, we estimated the extent of WNV infection in the resident horse population in Eastern Germany and showed that seroprevalence was higher in counties with previously registered equine WNV infections.

Gegenstand und Ziel Die Vorstellungsgründe, klinische Symptomatik, Diagnostik, Therapie und Ergebnis der Therapie von 12 Pferden mit klinisch apparenter West-Nil-Virus (WNV)-Infektion werden beschrieben. Material und Methoden Fallserie Ergebnisse Die adulten Pferde (Alter 6–18 Jahre, 7 Stuten, 5 Wallache) aus Sachsen oder Sachsen-Anhalt wurden zwischen September 2018 und September 2020 mit unterschiedlichen Vorberichten vorgestellt. Alle Pferde wurden im August oder September vorgestellt und keines der Pferde war gegen das WNV geimpft. Fieber war das häufigste Allgemeinsymptom und trat bei 8/12 Pferden auf. An neurologischen Symptomen traten Muskelfaszikulationen (11/12 Pferde), Ataxie (8/12 Pferde) sowie Hyperästhesie und Kopfschiefhaltung (je 6/12 Pferde) am häufigsten auf. Bei allen Pferden wurde die Infektion mittels Nachweises von IgM sowie neutralisierenden Antikörpern gegen das WNV diagnostiziert, zwei euthanasierte Pferde waren zudem PCR-positiv. Die symptomatische Therapie beinhaltete vor allem nicht-steroidale Antiphlogistika oder Dexamethason sowie Infusionstherapie. Die Dauer des Klinikaufenthaltes betrug im Durchschnitt 7,5 Tage. Sieben Pferde erholten sich laut Besitzerangaben vollständig, für 2 Pferde war keine Information erhältlich. Schlussfolgerungen und klinische Relevanz Die WNV-Enzephalomyelitis muss in Mitteldeutschland seit 2018 als Differentialdiagnose von im Sommer und Spätsommer auftretenden akuten neurologischen Erkrankungen ungeimpfter Pferdes in Betracht gezogen werden. Die beschriebenen Symptome sowie das Ergebnis der Therapie sind weitgehend deckungsgleich mit Berichten aus Nordamerika und anderen europäischen Ländern. Purpose and aim The presenting complaints, clinical signs, diagnostic evaluation, therapy, and outcome of 12 horses with clinically apparent West-Nile-Virus (WNV) infection are described. Material and methods Case series Results The adult horses (age 6–18 years, 7 mares, 5 geldings) from Saxony and Saxony-Anhalt were presented with various clinical histories between September 2018 and September 2020. All horses were presented in August or September and no horse was vaccinated against WNV. Fever as the most common general clinical sign was present in 8/12 horses. The most common neurological signs were muscle fasciculations (11/12 horses), ataxia (8/12 horses), hyperesthesia and head tilt (6/12 horses each). Diagnosis of WNV infection was confirmed by demonstrating IgM antibody and neutralizing antibody production in all horses; 2 euthanized horses also tested positive by PCR. Therapy was symptomatic and primarily included non-steroidal anti-inflammatories or dexamethasone as well as fluid therapy. Duration of hospitalization was 7.5 days on average. According to their owners, seven horses recovered completely, while information was missing for 2 horses. Conclusions and clinical relevance In eastern-central Germany, WNV-encephalomyelitis must be considered a differential diagnosis for unvaccinated horses with acute neurologic disease occurring in summer and late summer. The reported clinical signs and the outcome of therapy are mostly congruent with reports from North America and other European countries. Received: 15 May 2022 Accepted: 10 October 2022 Article published online: 14 December 2022 © 2022. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany