Flaviviruses in europe: Complex circulation patterns and their consequences for the diagnosis and control of west nile disease

Cécile Beck, Miguel Angel Jimenez-Clavero, Agnès Leblond, Benoît Durand, Norbert Nowotny, Isabelle Leparc-Goffart, Stéphan Zientara, Elsa Jourdain, Sylvie Lecollinet*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

136 Citations (Scopus)


In Europe, many flaviviruses are endemic (West Nile, Usutu, tick-borne encephalitis viruses) or occasionally imported (dengue, yellow fever viruses). Due to the temporal and geographical co-circulation of flaviviruses in Europe, flavivirus differentiation by diagnostic tests is crucial in the adaptation of surveillance and control efforts. Serological diagnosis of flavivirus infections is complicated by the antigenic similarities among the Flavivirus genus. Indeed, most flavivirus antibodies are directed against the highly immunogenic envelope protein, which contains both flavivirus cross-reactive and virus-specific epitopes. Serological assay results should thus be interpreted with care and confirmed by comparative neutralization tests using a panel of viruses known to circulate in Europe. However, antibody cross-reactivity could be advantageous in efforts to control emerging flaviviruses because it ensures partial cross-protection. In contrast, it might also facilitate subsequent diseases, through a phenomenon called antibody-dependent enhancement mainly described for dengue virus infections. Here, we review the serological methods commonly used in WNV diagnosis and surveillance in Europe. By examining past and current epidemiological situations in different European countries, we present the challenges involved in interpreting flavivirus serological tests and setting up appropriate surveillance programs; we also address the consequences of flavivirus circulation and vaccination for host immunity.

Original languageEnglish
Pages (from-to)6049-6083
Number of pages35
JournalInternational Journal of Environmental Research and Public Health
Issue number11
Publication statusPublished - Nov 12 2013


  • ADE
  • Antibodies
  • Cross-protection
  • Cross-reactivity
  • Diagnosis
  • Flaviviruses
  • Natural infection
  • Vaccination
  • Vector-borne diseases
  • West nile virus

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


Dive into the research topics of 'Flaviviruses in europe: Complex circulation patterns and their consequences for the diagnosis and control of west nile disease'. Together they form a unique fingerprint.

Cite this