The pathology of co-infection with Usutu virus and Plasmodium spp. in naturally infected Eurasian blackbirds (Turdus merula)

Usutu virus (USUV) is a mosquito-borne zoonotic flavivirus causing mortality in Eurasian blackbirds ( Turdus merula) in Europe. In dead blackbirds, avian malaria co-infection due to mosquito-borne hemosporidians (e.g., Plasmodium spp.) has been reported. In humans, a similar co-infection of a flavivirus, Dengue virus, and Plasmodium spp. is causing increased severity of clinical disease. Currently, the effects of co-infection of arboviruses and hemosporidians in blackbirds remain unclear. This study investigates the rate of USUV and Plasmodium spp. co-infection in found-dead blackbirds ( n = 203) from 2016 to 2020 in the Netherlands. Presence of Plasmodium spp. was evaluated by cytology (43/203; 21,2%), histopathology (94/186; 50,5%) and qPCR (179/203; 88,1%). The severity of histological lesions in USUV and Plasmodium spp. co-infected dead blackbirds (121/203; 59,6%) were compared with those in Plasmodium spp. single-infected cases. Additionally, since no knowledge is present on the infection rate on live birds and mosquitoes in the Netherlands, a small group of live blackbirds ( n = 12) and selected in the field-collected mosquito pools ( n = 96) in 2020 were tested for the presence of Plasmodium spp. The latter was detected in the tested live blackbirds by qPCR (8/10; 80%), and cytology (3/11; 27,3%) and in the mosquito pools by qPCR (18/96; 18,7%). For this study, co-infection between USUV and Plasmodium spp. was observed only in the dead blackbirds. The high Plasmodium spp. presence, associated with lower lesions score, in single infected found dead birds suggest a predominantly smaller pathogenic role as single agent. On the other hand, the higher histological lesion scores observed in USUV and Plasmodium spp. co-infected birds suggests a major pathogenic role for the virus or an increased severity of the lesions due to a possible interplay of the two agents

SARS-CoV-2 Infection in Captive Hippos (Hippopotamus amphibius), Belgium.

Two adult female hippos in Zoo Antwerp who were naturally infected with SARS-CoV-2 showed nasal discharge for a few days. Virus was detected by immunocytochemistry and PCR in nasal swab samples and by PCR in faeces and pool water. Serology was also positive. No treatment was necessary

Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage 653 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage 653 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage 653 CKD (eGFR < 60 mL/min/1.73 m2) or eGFR reduction > 30% from baseline was evaluated. Results: The mean estimated GFR was 98 \ub1 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR < 90 ml/min/m2 were independent risk factors for stage 653 CKD and renal function worsening. When compared to patients with eGFR > 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage 653 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening

Pathological features of West Nile and Usutu virus natural infections in wild and domestic animals and in humans: A comparative review

Mosquito-borne flaviviruses are emerging pathogens with zoonotic potential. Due to the recent climate and environmental changes, they are spreading across Europe, becoming a major threat for public and veterinary health. West Nile virus (WNV) and Usutu virus (USUV) are arboviruses that are responsible for multiple disease outbreaks in different species of birds, reptiles, and mammals, including humans. This review reports and compares the clinical signs as well as the gross and microscopic pathological features during natural infection with WNV and USUV in wild and domestic animals, as well as in humans. The main objective of this comparative review is to delineate the common features and the specific differences that characterize WNV- and USUV-induced diseases in each group of species and to highlight the main gaps in knowledge that could provide insight for further investigation on the pathogenesis and neurovirulence of these viruses

Neuronal satellitosis is a common finding in the avian brain

Perineuronal or neuronal satellitosis is the term describing the presence of glial cells in the satellite space surrounding the neuronal perikaryon. Confusingly, this finding has been described both as a physiologic and pathologic condition in humans and animals. In animals, neuronal satellitosis has been described in mammals, as well as in avian species. For the latter, the authors wondered whether neuronal satellitosis is expressed in the normal telencephalon of different avian orders and families and whether this pattern in different species shows a specific brain-region association. For these aims, this study explored the presence of neuronal satellitosis in the major areas of the healthy telencephalon in wild and domestic avian species of different orders and families, evaluating its grade in different brain regions. Neuronal satellitosis was seen in the hyperpallium and mesopallium as areas with the highest grade. Passeriformes showed the highest grade of neuronal satellitosis compared to diurnal or nocturnal raptors, and Charadriiformes. To clarify the exact role of neuronal satellitosis in animals without neurological disease, further studies are needed. RESEARCH HIGHLIGHTS Neuronal satellitosis is a common finding in the healthy avian telencephalon. Neuronal satellitosis is a species- and brain-region-associated finding in birds. Passeriformes have the highest grade of neuronal satellitosis

Characterization of the Immunopathology of Usutu Virus-Associated Encephalitis: A Pilot Study in Naturally Infected Eurasian Blackbirds (Turdus Merula)

Introduction: Usutu virus (USUV) is an emerging mosquito-borne flavivirus. USUV-related outbreaks of disease and mortality in wild birds, as well as neuroinvasive disease in humans have raised a health concern in Europe. Although a few pathologic studies describe the morphologic features of USUV-associated encephalitis in naturally infected wild birds, data regarding the immune response in situ are still lacking. This study aims to characterize the immune-cell populations in Usutu virus-associated encephalitis, comparing uninfected birds with birds infected with two circulating virus lineages. Materials and Methods: Immunohistochemistry was performed with specific antibodies for CD3 (T cells), PAX5 (early B cells) and MUM1 (late B cells and plasma cells) on brain tissue. Cell count was performed, and results were compared between uninfected birds (n = 4) and birds infected with Europe-3 (n = 4) and Africa-3 (n = 4) USUV-lineage. Results: The numbers of T cells and early and late B cells were higher in USUV-infected birds compared with uninfected birds, the majority being CD3+ cells. The PAX5+ cell count was higher, to a small degree, in Africa-3 compared with Europe-3-infected birds. Conclusions: This study reveals a major T cell and a minor B cell involvement in the immunopathology of Usutu virus-associated encephalitis. A slightly higher number of B cells in Africa-3-infected birds suggests a possible difference in the host response to these two lineages. Further and larger scale studies are needed to characterize the T cell population

Neuronal satellitosis is a common finding in the avian brain

Perineuronal or neuronal satellitosis is the term describing the presence of glial cells in the satellite space surrounding the neuronal perikaryon. Confusingly, this finding has been described both as a physiologic and pathologic condition in humans and animals. In animals, neuronal satellitosis has been described in mammals, as well as in avian species. For the latter, the authors wondered whether neuronal satellitosis is expressed in the normal telencephalon of different avian orders and families and whether this pattern in different species shows a specific brain-region association. For these aims, this study explored the presence of neuronal satellitosis in the major areas of the healthy telencephalon in wild and domestic avian species of different orders and families, evaluating its grade in different brain regions. Neuronal satellitosis was seen in the hyperpallium and mesopallium as areas with the highest grade. Passeriformes showed the highest grade of neuronal satellitosis compared to diurnal or nocturnal raptors, and Charadriiformes. To clarify the exact role of neuronal satellitosis in animals without neurological disease, further studies are needed. RESEARCH HIGHLIGHTS Neuronal satellitosis is a common finding in the healthy avian telencephalon. Neuronal satellitosis is a species- and brain-region-associated finding in birds. Passeriformes have the highest grade of neuronal satellitosis

Characterization of the Immunopathology of Usutu Virus-Associated Encephalitis: A Pilot Study in Naturally Infected Eurasian Blackbirds (Turdus Merula)

Introduction: Usutu virus (USUV) is an emerging mosquito-borne flavivirus. USUV-related outbreaks of disease and mortality in wild birds, as well as neuroinvasive disease in humans have raised a health concern in Europe. Although a few pathologic studies describe the morphologic features of USUV-associated encephalitis in naturally infected wild birds, data regarding the immune response in situ are still lacking. This study aims to characterize the immune-cell populations in Usutu virus-associated encephalitis, comparing uninfected birds with birds infected with two circulating virus lineages. Materials and Methods: Immunohistochemistry was performed with specific antibodies for CD3 (T cells), PAX5 (early B cells) and MUM1 (late B cells and plasma cells) on brain tissue. Cell count was performed, and results were compared between uninfected birds (n = 4) and birds infected with Europe-3 (n = 4) and Africa-3 (n = 4) USUV-lineage. Results: The numbers of T cells and early and late B cells were higher in USUV-infected birds compared with uninfected birds, the majority being CD3+ cells. The PAX5+ cell count was higher, to a small degree, in Africa-3 compared with Europe-3-infected birds. Conclusions: This study reveals a major T cell and a minor B cell involvement in the immunopathology of Usutu virus-associated encephalitis. A slightly higher number of B cells in Africa-3-infected birds suggests a possible difference in the host response to these two lineages. Further and larger scale studies are needed to characterize the T cell population

Pathology and Pathogenesis of Eurasian Blackbirds (Turdus merula) Naturally Infected with Usutu Virus

The Usutu virus (USUV) is a mosquito-borne zoonotic flavivirus. Despite its continuous circulation in Europe, knowledge on the pathology, cellular and tissue tropism and pathogenetic potential of different circulating viral lineages is still fragmentary. Here, macroscopic and microscopic evaluations are performed in association with the study of cell and tissue tropism and comparison of lesion severity of two circulating virus lineages (Europe 3; Africa 3) in 160 Eurasian blackbirds (Turdus merula) in the Netherlands. Results confirm hepatosplenomegaly, coagulative necrosis and lymphoplasmacytic inflammation as major patterns of lesions and, for the first time, vasculitis as a novel virus-associated lesion. A USUV and Plasmodium spp. co-infection was commonly identified. The virus was associated with lesions by immunohistochemistry and was reported most commonly in endothelial cells and blood circulating and tissue mononucleated cells, suggesting them as a major route of entry and spread. A tropism for mononuclear phagocytes cells was further supported by viral labeling in multinucleated giant cells. The involvement of ganglionic neurons and epithelial cells of the gastrointestinal tract suggests a possible role of oral transmission, while the involvement of feather follicle shafts and bulbs suggests their use as a diagnostic sample for live bird testing. Finally, results suggest similar pathogenicity for the two circulating lineages