欧洲西尼罗病毒在人类和动物中的感染监测，月度报告-截至2025年8月6日提交的数据
摘要
流行病学总结2025年，截至2025年8月6日，欧洲6个国家报告了202例已知感染地点的当地获得性人感染西尼罗河病毒病例。最早和最晚发病日期分别为2025年6月2日和2025年8月2日。意大利（168例）、希腊（26例）、法国（3例，其中1例感染地点不明）、罗马尼亚（3例）、保加利亚（1例）和匈牙利（1例）报告了本地获得性病例。在欧洲，据报道有10人死亡。今年迄今报告的病例数略高于过去十年同期的平均水平（163例）。然而，这些数字仍低于2024年和2018年的数字，这两个年份的病毒传播尤为激烈，到今年此时分别报告了382例和385例。截至8月6日，在6个国家的40个地区报告了当地获得性人感染西尼罗病毒病例。相比之下，2024年同期为108个地区（11个国家），2018年为68个地区（7个国家）。所有六个国家以前都报告了西尼罗河病毒人间病例。意大利目前正在经历重大疫情，有168人确诊感染，其中10人死亡。在意大利，Latina省（ITI44）和Frosinone省（ITI45）首次报告了人间病例。同样，罗马尼亚也报告了其在sunilaj县的第一例病例（RO116）。正如前几年观察到的，大多数病例发生在65岁及以上的男性中。与往年相比，住院率很高，今年的住院率为100%，而过去十年的住院率为93%。大多数病例住院治疗很可能是由于西尼罗河病毒监测的性质，这种监测往往主要捕获最严重的病例。今年迄今的病死率为7%，与前十年观察到的11%相当。今年有56%的病例报告有神经系统症状，而前十年为66%。一般来说，预计神经系统病例占主导地位，因为症状更严重的病例更有可能被诊断出来。从兽医的角度来看，2025年欧洲报告了16起马科动物西尼罗河病毒疫情和20起鸟类西尼罗河病毒疫情。马科动物和鸟类之间爆发的最早开始日期是2025年1月15日在德国，2025年2月16日在意大利，而马科动物和鸟类之间爆发的最新开始日期分别是2025年7月29日在意大利和2025年7月29日在奥地利。意大利（11例）、希腊（2例）、德国（1例）、匈牙利（1例）和西班牙（1例）报告了马科动物的暴发。意大利（19例）和奥地利（1例）报告了禽类暴发。在动物疾病信息系统（ADIS）数据库中，没有提供关于报告的确切马科动物物种的信息，而鸟类的物种详细信息是可用的。以下鸟类与报告的暴发有关：普通喜鹊(4)，普通红隼(4)，腐食乌鸦(3)，鲱鱼鸥(3)，冠鸦(3)，普通红腹鸡(1)，岩鸽(1)，以及未识别的耧斗科(1)。2025年6月和7月，马科动物的月暴发数略高于6月和7月的10年平均值（2015-2024年），而2025年3月至7月鸟类的月暴发数低于历史月平均值，其中2025年7月下降明显。2024年，截至8月6日，分别在马科动物和鸟类中报告了38起和132起疫情，明显高于2025年同期报告的疫情数量。截至2025年8月6日，在6个国家的23个地区报告了禽类和/或马类暴发。相比之下，2024年同期有47个地区（8个国家），2018年有16个地区（3个国家）。所有六个国家在2024年和前几年都报告了鸟类和/或马科动物中发生西尼罗河病毒疫情，反映了这些领土上的地方性西尼罗河病毒活动。然而，截至8月6日，在意大利以下三个省(福贾省（ITF46）、拉奎拉省（ITF11）和莱科省（ITC43）首次报告了禽类和/或马类暴发。此外，希腊在aetoria - acarnania （EL631）和Kavala （EL515）以及西班牙在Almería （ES611）首次报告了马科动物暴发。在蚊子活动最少的冬季暴发西尼罗河病毒的报告应仔细评估，因为它们提出了关于感染时间的问题。两份这样的报告——德国1月份报告的一次在马科动物中爆发，意大利2月份报告的一次在鸟类中爆发——值得谨慎解读，因为它们可能反映的是残留检测（例如，前一年获得的感染遗留的抗体或病毒RNA），而不是2025年的活跃传播。 三个国家——意大利、希腊和匈牙利——报告了西尼罗河病毒人间病例以及在马科动物和鸟类中的暴发。截至2025年8月6日，意大利占所有报告的人间病例和所有报告的马科动物和鸟类暴发的83%，突出了该国西尼罗河病毒的重大活动。这可能是由于有利的气候条件和生态热点（例如湿地、农业区）通过影响蚊子媒介种群和宿主动态来支持西尼罗河病毒的传播。意大利的密集监测也可能有助于人类病例的高检出率以及鸟类和马科动物中的疫情。在以前未受影响的地区发现人类和动物感染西尼罗河病毒病例，这突出表明该病毒的地理范围正在扩大，这很可能是由于环境、气候和生态变化造成的。此外，加强监测或监测敏感性以及提高对这些领域的认识可能在发现病例方面发挥作用。由于诊断和报告的延误，以及大多数西尼罗河病毒感染为无症状或亚临床，本报告中提供的病例数可能低估了真实病例数。值得注意的是，对人类的季节性监测主要侧重于捕获实验室确诊病例，这导致诊断延迟。鉴于西尼罗河病毒在欧洲传播的有利天气条件，我们预计在未来几周内，人类病例和在马科动物和禽类中暴发的数量将继续增加。在前几年，传播高峰出现在8月至9月。ECDC和EFSA将密切关注欧洲的情况，特别是严重程度指标。
Epidemiological summary
In 2025, and as of 6 August 2025, 6 countries in Europe reported 202 locally acquired1 human cases of WNV infection with known place of infection. The earliest and latest date of onset were respectively on 2 June 2025 and 2 August 2025. Locally acquired cases were reported by Italy (168), Greece (26), France (3, of which 1 with unknown place of infection), Romania (3), Bulgaria (1) and Hungary (1). In Europe, 10 deaths were reported.
Case numbers reported so far this year are slightly above the average for the past decade in the same period (163). However, these figures remain lower than those seen in 2024 and 2018—years when virus circulation was particularly intense, with 382 and 385 cases reported by this point in the year, respectively.
As of 6 August, locally acquired human cases of West Nile virus (WNV) infection have been reported in 40 regions across six countries. This compares with 108 regions (11 countries) during the same period in 2024 and 68 regions in 2018 (seven countries). All six countries have previously reported human cases of WNV. Italy is currently experiencing a significant outbreak, with 168 confirmed human infections, including 10 fatalities. For the first time in Italy, the provinces of Latina (ITI44) and Frosinone (ITI45) have reported human cases. Similarly, Romania has reported its first cases in Sălaj County (RO116).
As observed in previous years, most cases were among males aged 65 years and older. The hospitalisation rate was high compared with previous years, with 100% of cases hospitalised this year compared to 93% in the past decade. That most cases are hospitalised is most likely due to the nature of WNV surveillance, which tends to predominantly capture the most severe cases. The case fatality rate so far this year is 7%, which is comparable to the 11% observed in the previous decade. Neurological manifestations were reported in 56% of cases this year compared to 66% in the previous decade. In general, a dominance of neurological cases is expected, as cases with more severe symptoms are more likely to be diagnosed.
From the veterinary perspective, 16 WNV outbreaks among equids and 20 outbreaks among birds have been reported in Europe in 2025. The earliest start date of an outbreak among equids and birds was on 15 January 2025 in Germany and 16 February 2025 in Italy, while the latest onset of an outbreak among equids and birds was, respectively, on 29 July 2025 in Italy and 29 July 2025 in Austria. Outbreaks among equids were reported by Italy (11), Greece (2), Germany (1), Hungary (1) and Spain (1). Outbreaks among birds were reported by Italy (19) and Austria (1).
In the Animal Disease Information System (ADIS) database no information was provided on the exact equid species reported, whereas species details were available for birds. The following bird species were associated with the reported outbreaks: common magpie (4), common kestrel (4), carrion crow (3), herring gull (3), hooded crow (3), common moorhen (1), rock dove (1), and unidentified Columbidae (1).
In June and July 2025, the monthly number of outbreaks in equids slightly exceeded the 10-year mean (2015–2024) of June and July, while the monthly count for outbreaks in birds from March to July 2025 fell below the historical monthly mean, with a marked decline in July 2025. In 2024, up to 6 August, 38 and 132 outbreaks were reported in equids and birds, respectively, which is notably higher than the number of outbreaks reported during the same period in 2025.
As of 6 August 2025, outbreaks in birds and/or equids have been reported in 23 regions across six countries. This compares with 47 regions (eight countries) during the same period in 2024 and 16 regions (three countries) in 2018. All six countries reported WNV outbreaks in birds and/or equids in 2024 and in prior years, reflecting endemic WNV activity in these territories. However, as of 6 August, outbreaks in birds and/or equids were reported for the first time to ADIS in the following three Italian provinces: Foggia (ITF46), L'Aquila (ITF11), and Lecco (ITC43). Additionally, equid outbreaks were reported for the first time by Greece in Aetolia-Acarnania (EL631) and Kavala (EL515), and by Spain in Almería (ES611).
Reports of WNV outbreaks during the winter, when mosquito activity is minimal, should be carefully evaluated as they raise questions about the timing of infection. Two such reports - one outbreak in equids reported by Germany in January, and one in birds reported by Italy in February - warrant cautious interpretation, as they may reflect residual detection (e.g. lingering antibodies or viral RNA from infections acquired in the year before) rather than active transmission in 2025.
Three countries - Italy, Greece and Hungary - reported both WNV human cases and outbreaks in equids and birds. As of 6 August 2025, Italy accounted for 83% of all reported human cases and all reported outbreaks in equids and birds, underscoring the significant WNV activity in the country. This is likely due to favourable climate conditions and ecological hotspots (e.g. wetlands, agricultural areas) that support WNV transmission by influencing mosquito vector populations and host dynamics. Intensive surveillance in Italy may also contribute to high detection rates of human cases and outbreaks in birds and equids. The identification of WNV cases in humans and animals within previously unaffected areas underscores the ongoing geographic expansion of the virus, which is most likely due to environmental, climatic and ecological changes. In addition, increased surveillance or monitoring sensitivity and raised awareness in these areas might play a role in the detection of the cases.
Owing to delays in diagnosis and reporting, as well as the fact that most of the WNV infections are asymptomatic or subclinical, the case numbers provided in this report likely underestimate the true number of cases. Of note, the seasonal surveillance in humans primarily focuses on capturing laboratory-confirmed cases, which contributes to the diagnostic delay.
Given the favourable weather conditions for WNV transmission in Europe, we expect that the number of human cases and outbreaks in equids and birds will continue to raise in the coming weeks. In previous years, the peak of transmission was observed in August–September. Both ECDC and EFSA will follow-up closely on the situation in Europe, in particular regarding severity indicators.
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