Low capacity for molecular detection of Alphaviruses other than Chikungunya virus in 23 European laboratories, March 2022.
Authors: Pezzi Laura, Moegling Ramona, Baronti Cécile, Stanoeva Kamelia R, Presser Lance D, Jourdan Pauline, Ayhan Nazli, van den Akker Willem M R, Zientara Stephan, Gossner Céline M, Charrel Rémi N, Reusken Chantal B E M
Journal: PloS one
Summary
# Editorial Summary: Alphavirus Diagnostic Capacity in European Laboratories Anticipating increased alphavirus circulation across Europe due to vector expansion and climate change, researchers conducted an external quality assessment of molecular diagnostic capabilities across 23 expert laboratories in 16 European countries during March 2022, using a panel of nine alphaviruses (including chikungunya, Ross River, Eastern equine encephalitis and Mayaro viruses) alongside negative controls. Results revealed significant diagnostic gaps: whilst performance exceeded 90% for chikungunya virus, Ross River virus and Sindbis virus—the established European concerns—only 46% of laboratories correctly identified all test samples, with particular deficiencies in detecting Venezuelan equine encephalitis virus, Barmah Forest virus and Eastern equine encephalitis virus, and poor specificity for o'nyong-nyong and Mayaro viruses. Approximately half the participating laboratories relied on pan-alphavirus assays that demonstrated variable sensitivity and specificity, highlighting inconsistent technical approaches across Europe. For equine professionals, these findings underscore the diagnostic landscape's current vulnerability: given that these viruses cause disease in horses and their vectors are expanding geographically, delays or inaccuracy in alphavirus identification could impair outbreak response and client communication. The authors recommend implementing standardised, sensitive molecular assays and establishing routine external quality assessments to ensure European laboratories can reliably distinguish between alphavirus species as imported cases increase.
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Practical Takeaways
- •If you suspect equine encephalitis (EEE, WEE, VEE), be aware that many European diagnostic labs have poor detection capability for these viruses—consider international reference laboratories for confirmation
- •Pan-alphavirus PCR assays are common but unreliable for species differentiation; specificity is particularly poor for Mayaro and o'nyong-nyong viruses
- •With climate change and vector expansion, equine practitioners in Europe should expect increasing alphavirus cases but cannot rely on consistent lab performance for diagnosis
Key Findings
- •Only 46% of 23 European laboratories correctly identified all alphavirus samples in external quality assessment
- •Detection performance was >90% for CHIKV, RRV, and SINV but <50% for VEEV, BFV, and EEEV
- •Approximately half of laboratories (11/23) relied on pan-alphavirus assays with variable sensitivity and specificity
- •Significant diagnostic capability gaps exist for alphaviruses despite vector expansion risk in Europe