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Erschienen in: Archives of Virology 6/2015

Open Access 01.06.2015 | Original Article

Evolutionary trends of European bat lyssavirus type 2 including genetic characterization of Finnish strains of human and bat origin 24 years apart

verfasst von: Jakava-Viljanen Miia, Nokireki Tiina, Sironen Tarja, Vapalahti Olli, Sihvonen Liisa, Huovilainen Anita

Erschienen in: Archives of Virology | Ausgabe 6/2015

Abstract

Among other Lyssaviruses, Daubenton’s and pond-bat-related European bat lyssavirus type 2 (EBLV-2) can cause human rabies. To investigate the diversity and evolutionary trends of EBLV-2, complete genome sequences of two Finnish isolates were analysed. One originated from a human case in 1985, and the other originated from a bat in 2009. The overall nucleotide and deduced amino acid sequence identity of the two Finnish isolates were high, as well as the similarity to fully sequenced EBLV-2 strains originating from the UK and the Netherlands. In phylogenetic analysis, the EBLV-2 strains formed a monophyletic group that was separate from other bat-type lyssaviruses, with significant support. EBLV-2 shared the most recent common ancestry with Bokeloh bat lyssavirus (BBLV) and Khujan virus (KHUV). EBLV-2 showed limited diversity compared to RABV and appears to be well adapted to its host bat species. The slow tempo of viral evolution was evident in the estimations of divergence times for EBLV-2: the current diversity was estimated to have built up during the last 2000 years, and EBLV-2 diverged from KHUV about 8000 years ago. In a phylogenetic tree of partial N gene sequences, the Finnish EBLV-2 strains clustered with strains from Central Europe, supporting the hypothesis that EBLV-2 circulating in Finland might have a Central European origin. The Finnish EBLV-2 strains and a Swiss strain were estimated to have diverged from other EBLV-2 strains during the last 1000 years, and the two Finnish strains appear to have evolved from a common ancestor during the last 200 years.
Hinweise
An erratum to this article can be found at http://​dx.​doi.​org/​10.​1007/​s00705-015-2475-2.

Introduction

Rabies is a fatal and incurable zoonotic disease caused by RNA viruses belonging to the genus Lyssavirus within the family Rhabdoviridae. The negative-sense lyssavirus genome encodes five proteins: nucleoprotein (N), phosphoprotein (P), matrix protein (M), glycoprotein (G) and RNA polymerase (L) in the order 3′-N-P-M-G-L-5′. Phylogenetic analysis and the virus-host relationship suggest that all 15 currently known lyssaviruses probably originated in bats and can be divided into phylogroups. Phylogroup I comprises the classical rabies virus (RABV) and the majority of bat lyssaviruses, whereas Lagos bat virus (LBV) and Shimoni bat virus (SHIBV) form phylogroup II [1, 2]. West Caucasian bat virus (WCBV), Ikoma lyssavirus (IKOV) and Lleida bat lyssavirus (LLEBV) may be representatives of a possible new phylogroups [35].
The first record of a rabid bat in Europe occurred in Germany in 1954 [6], but only with the advent of antigenic typing and molecular tools could European bat lyssavirus (EBLV) be characterised and distinguished from classical RABV and other lyssaviruses [7, 8]. After the death of a Swiss bat biologist in Finland in 1985 and subsequent characterisation of the causative agent, it became evident that bat rabies in Europe at the time was caused by two different lyssaviruses, EBLV-1 and 2 [7, 9]. Both of these viruses are genetically and antigenically related to RABV but are significantly different from each other. Early genomic sequencing also indicated that two distinct genetic lineages (a and b) of EBLVs have evolved, which appeared to cluster geographically [10, 11].
During 1977–2013, 1064 rabies cases were reported in 11 of the 45 known indigenous bat species in 16 European countries [12]. Although numerous human contacts with European bats, primarily from handling sick or injured animals, have been reported [13], only a few EBLV-induced human casualties have been conclusively demonstrated: in Voroshilovgrad, Ukraine (1977), in Belgorod, Russia (1985), in Finland (1985) and in the UK in Scotland (2002) [9, 1417]. The Russian case was genetically typed as being EBLV-1a, while the Ukrainian case is only assumed to be EBLV-1 from antigenic profiling [15, 18]. The virus variants responsible for human rabies cases in the UK and Finland were typed as being EBLV-2a and b, respectively [17]. Subsequently, two other human rabies cases after a bat bite have been described in Ukraine [15]. However, these cases were diagnosed clinically and on the basis of anamnesis, and no virological or pathological results are available.
EBLV-2 is known to associate with two closely related Myotis bat species, Daubenton’s (Myotis daubentonii) and pond bats (M. dascyneme). The first isolation of EBLV-2 from a bat was carried out in 1987 from a pond bat in the Netherlands [19]. Elsewhere in Europe, EBLV-2 has been isolated sporadically from Daubenton’s bats in Switzerland [20], the UK [21, 22], Germany [23] and Finland [24]. In 1986, EBLV was detected in one Danish Daubenton’s bat and in one pond bat, but the causative strains were not analysed further. EBLV-2 was, however, demonstrated later in 2013 in mouth swabs from two Danish Daubenton’s bats using a molecular diagnostic strategy [25]. The strains from the UK and from the Netherlands appear to be closely related, as are the strains from Germany and those isolated from Switzerland [26]. The Finnish EBLV-2 strains and a strain from Switzerland have been suggested to form a lineage designated as EBLV-2b, with rest of the isolates forming the lineage EBLV-2a [10, 11]. EBLV-2 strains appear to form clusters according to the geographical area and year of isolation.
Evolutionary studies on lyssaviruses have tended to focus on the N protein, a conserved structural protein, and the G protein, which contains domains responsible for host-cell receptor recognition and membrane fusion, and which is the major target for the host neutralizing antibody response [1]. Previously, comprehensive evolutionary analysis has demonstrated that EBLV-1 and EBLV-2 have differing population structures and dispersal patterns. Molecular-clock estimates have suggested that the current linage of EBLV-1 arose some 500 to 750 years ago [27]. Little is known about the forces shaping the evolution of EBLV-2, and only three strains of EBLV-2 have previously been fully sequenced (EU293114, EF157977 and KF155004).
Finland has been free of rabies in terrestrial mammals since 1991. Nevertheless, rabies can remain a residual risk to public health due to the natural circulation of EBLV-2 [24, 28]. Here, we describe the phylogenetic analysis of two Finnish EBLV-2 strains, the first isolated from a human in 1985 and the second from a diseased bat in 2009. Using these isolates as a calibrator, this study provides an estimate of the EBLV-2 molecular clock. Increased information on the genome sequences of lyssaviruses is fundamental to understanding their epidemiology and evolution, and to demonstrating the importance of continuous surveillance and molecular characterization of lyssaviruses circulating in animal populations.

Materials and methods

Virus isolation in MNA cells and in suckling mice

Ethical approval and permission

The National Animal Experiment Board of the County Administrative Board of Southern Finland approved the diagnostic mouse inoculation test (permission number ESLH-2008-06899/Ym-23), which followed Finnish legislation, namely, the Finnish Act on the Use of Animals for Experimental Purposes (62/2006).
Human bat virus isolate FI-85 [9, 16] used in this study was the first archived newborn-mouse passage and had been kept at -70 °C since 1986. Virus isolation of the bat virus isolate FI-09 [24] was attempted in MNA cell culture (mouse neuroblast cells, Neuro-2a [ATCC® CCL-131™]), with three additional passages according to a procedure described in the OIE manual [29]. The bat brain suspension was subsequently inoculated into suckling mice. Eight newborn mice (ScaNmri) at 2 days old were intracerebrally infected with 20 µl of the suspension in a BSL-3 laboratory. When the mice started to develop signs of encephalitis, they were euthanized and the brains were collected and examined using a fluorescence antibody test (FAT) for the presence of lyssavirus as described earlier by Jakava-Viljanen et al. [24].

RNA extraction, primer design and RT-PCR

RNA was extracted from the brain suspensions of the mice using a QIAamp Viral RNA Mini Kit (QIAGEN, Germany, Hilden) according to the manufacturer’s instructions. Primers (Table 1) were designed with the program PCR Suite [30] and modified afterwards, if needed. A OneStep RT-PCR Kit (QIAGEN, Hilden, Germany) was used to amplify 34 overlapping fragments. The following thermal profile was used: a single cycle of reverse transcription for 30 min at 50 °C, 15 min at 94 °C for reverse transcriptase inactivation and DNA polymerase activation, followed by 30 amplification cycles of 1 min at 94 °C, 1 min at 50 °C and 1 min at 72 °C. After agarose gel electrophoresis, the bands were cut from the gel and DNA was extracted using a QIAquick Gel Extraction Kit (QIAGEN, Hilden, Germany).
Table 1
Primers used in the RT-PCR and sequencing. The position numbering is according to the EBLV-2 isolate RV1333 (EF157977)
Primer
Sequence (5’-3’)
Position
1f
acg ctt aac gac aaa acc ag
1 - 20
1r
tag ctc tcc caa tcg tca gg
326 - 345
2f
cgc tag gtt gga tcc tga tg
256 - 275
2r
ggc gca cat ctt gtg agt ag
636 - 655
3f
cca acg tag ctg aca gaa tgg
558 - 578
3r
aca tct cgt gag gtg cac ag
1066 - 1085
4f
cgg gag tta cat ggg tca ag
1015 - 1034
4r
gtc tgg cct gat gat tcg ag
1354 - 1373
5f
cag gat cat ggt caa tgg
1291 - 1308
5r
tcc caa cac cct caa ggt ag
1812 -1831
6f
aag aag aag gaa gcg atg agg
1745 - 1765
6r
tgc gct att tct gct tca ac
2116 - 2135
7f
acc tgc gct gga atg gtc
2070 - 2087
7r
ggg agc cat agg tca tca tc
2591 - 2610
8f
agt gag agg ttg cag gga tg
2530 - 2549
8r
act ctg ccc att gaa aca cc
2869 - 2888
9f
ttc cag agg gaa tga act gg
2826 - 2845
9r
ggt gtt cag tcg ggt gtt tc
3245 - 3264
10f
ctt tta tga gca ata gaa caa aac c
3186 - 3210
10r
atg tcg gat cac ctg cag tc
3688 - 3704
11f
aac tac cac gtt caa gag aaa gc
3619 - 3641
11r
ttt gcc tca tcg tga ttt tg
4115 - 4134
12f
tga aac tgt gtg gaa tct ctg g
4059 - 4080
12r
atg ctg ttg aag cat tgc ag
4518 - 4537
13f
tcc tca tca caa tgg agt ctt c
4441 - 4462
13r
ccc act ttg gga agt gac ag
4830 - 4849
14f
aaa gag agc caa acc caa cc
4787 - 4805
14r
att gca tcc tct ccc act tg
5154 - 5171
15f
acc ggt aca cag ggt ctt gc
5076 - 5095
15r
gca tct atc tcc ggt tcg ac
5458 - 5477
16f
aga tga ttg atc ccc tgg ag
5414 - 5433
16r
gag gca ctt tcg act tct gg
5747 - 5766
17f
cgc aca atc cat gat gtc tc
5697 - 5716
17r
gaa tca gga ggg agt tga acc
6173 - 6193
18f
tct cag agt gcc aac tgt ctg
6106 - 6126
18r
gtt cct tca agc tgg ctc ac
6415 - 6434
19f
tta gtg cag agg gct gaa gg
6340 - 6359
19r
tat ggg atc aaa ggg tgg tc
6709 - 6728
20f
ctg gct aaa cgg atc ctc ag
6634 - 6653
20r
aag aat tcc ctg ggg ttg ac
6964 - 6983
21f
ccg tcc cca gtg aga aag tc
6917 - 6936
21r
gac ctt gtc ccg tga ctc tg
7209 - 7228
22f
ttg gcg aac tac atc tta ccc
7129 - 7149
22r
tga gtc cct ctt ggg tca ac
7641 - 7660
23f
agc aca ggg aga caa cca ag
7590 - 7609
23r
gtg aaa tac cgc ctg gac tg
7979 - 7998
24f
gtc gca cag cat tca caa tc
7924 - 7943
24r
agc aga atg gtt gga ctt gc
8332 - 8351
25f
ccg gac ttg ggt gat aga ag
8254 - 8273
25r
aaa ttg ccg tcg aat tgt tc
8567 - 8586
26f
gct cat cct tcc tcg gaa tac
8513 - 8533
26r
gat ttg agt ccc tgg caa tg
9021 - 9040
27f
cca acg tcc atg ttg tca ag
8966 - 8985
27r
aga cat ccg gga aca tga ag
9417 - 9436
28f
caa gtg cat ccg acc gat ag
9369 - 9388
28r
cag atc gaa gtg agg gtt cc
9831 - 9850
29f
tgt tga ggc tag aca atc atc c
9788 - 9809
29r
taa ggt gtc ttc ccc gtg ac
10151 - 10167
30f
atc cga ctc agg cag ttg ag
10105 - 10124
30r
gag gcc atg agg tca ttc ac
10606 - 10625
31f
tgg aat ctc cag aac tgt gc
10539 - 10558
31r
tgg cct tgt agt ctg ggt tc
10923 - 10942
32f
ctc tcg atc aat ggt cca ctc
10867 - 10887
32r
tta gcc aag gtc cct ctt tg
11287 - 11306
33f
tga agt cga gtc att cct agt cc
11238 - 11260
33r
gct act acc ggc aag tcg ag
11672 - 11691
34f
aag caa gtc ata cga gga ag
11533 - 11552
34r
acg ctt aac aaa aaa aac ata g
11909 - 11930

Sequencing and sequence analysis

PCR products were sequenced using an ABI 3100 Avant Genetic Analyser (Applied Biosystems) with the primers used in the PCR and a Big Dye Terminator v3.1 Cycle Sequencing Kit (Applied Biosystems). Before sequencing, the reaction products were purified using a DyeEx 2.0 Spin Kit (QIAGEN, Hilden Germany). The sequences were analysed with Sequencing Analysis software version 6.0 (Applied Biosystems).

Phylogenetic analysis

The newly determined sequences (GenBank accession numbers JX129232 and JX129233) were aligned with other published full-length lyssavirus sequences from bat-type isolates obtained from GenBank to evaluate the genetic diversity of EBLV-2 strains and their relationship to other bat-associated genotypes. Amino acid sequences were deduced using the “translate” function of the program MEGA v.5.1 [31]. Phylogenetic trees of full-length genomes and partial N coding sequences were calculated using the maximum-likelihood approach in the program MEGA with 1000 bootstrap replicates. The pairwise sequence identities were calculated using CLUSTAL W2 (http://​www.​ebi.​ac.​uk/​Tools/​msa/​clustalw2/​), with default settings.

Rate of evolution and time of divergence

The program BEAST [32] was used to estimate the substitution rate of EBLV-2 and time of divergence from the phylogenetically closest lyssaviruses. The data set used for estimating the rate of evolution was based on the partial N coding sequences (400 bp) of EBLV-2 strains isolated from the years 1986 to 2012. The HKY model of nucleotide substitution was used [33] with both strict and relaxed lognormal clock models. Convergence of parameters was assessed using TRACER [32], and each run was continued until the effective sampling size of all parameters was greater than 200.

Results

Isolation of the EBLV-2 FI-09 strain in MNA cells and suckling mice

Inoculation of the bat sample into MNA cells revealed the presence of virus in only a limited number of cells after 3 days of incubation, and after the three subsequent passages, the tissue culture infection test was negative. When the cell culture isolation was unsuccessful, the brain suspension of the bat was inoculated into suckling mice. The mice began to develop signs of encephalitis on day 12 p.i. By day 17 p.i., all eight mice were euthanized. The presence of the virus in all of the brain samples was confirmed by FAT.

EBLV-2 genome, genomic distance and phylogenomic pattern

The complete lengths of the FI-85 and FI-09 genomes were 11,928 and 11,927 nucleotides, respectively (GenBank accession numbers JX129233-JX129232). Twenty nucleotides at the 5’ end and 22 nucleotides at the 3’ end of the genomes were primer-derived and were excluded from all phylogenetic analyses.
The general genome organization was typical for lyssaviruses, consisting of five structural genes, N, P, M, G and L, and non-coding regions between them and at both ends of the genome. The lengths of the genes and the number of deduced amino acids (in parentheses) were 1356 (451 aa), 894 (297 aa), 609 (202 aa), 1575 (524 aa) and 6384 (2127 aa), respectively. The long untranslated region between the G and L genes was the only area that varied in length between the two Finnish EBLV-2 strains, being 510 bp in FI-85 and 509 bp in FI-09. The corresponding lengths for other completely sequenced EBLV-2 strains were 511 bp for EU293114 and 512 bp for KF155004 and EF157977.
The nucleotide sequence identity between the FI-85 and FI-09 strains was 99.6 %. There were four amino acid differences between the two Finnish strains: N gene aa 106 (N><S), G gene aa 158 (V><A), L gene aa 154 (R><K) and aa 1656 (G><D). The N, P, M, G and L genes of the FI-85 and FI-09 strains shared 98–99 %, 98 %, 99–100 %, 97–99 % and 99 % amino acid sequence identity, respectively, with the previously published EBLV-2 strains. The similarity plot in Figure 1 displays the similarities along the genome. The non-coding regions are highly divergent, yet rather similar for all EBLV-2 strains.

Phylogenetic analysis and evolutionary trends

A phylogenetic tree was constructed based on the genome sequences of the two new EBLV-2 isolates and the full-length genome sequences of bat-related lyssavirus obtained from GenBank (Fig. 2). The analysis revealed that all five EBLV-2 strains are monophyletic. The phylogenetic tree also demonstrated that EBLV-2 strains share the most recent common ancestry with BBLV and KHUV, and more distant ancestry with ARAV, RABV and ABLV (albeit with low bootstrap support). A second major cluster of lyssaviruses consists of IRKV, DUVV and EBLV-1. The clearly most divergent group is formed by SHIV, LBV and WCBV.
In order to include more EBLV-2 strains, we constructed a second phylogenetic tree (Fig. 3) based on partial N gene sequences (400 nt), which are much more abundant in the GenBank database. EBLV-2 strains were also monophyletic in this region. Some discrepancies were observed between the two trees, especially in the composition of the major clusters, which were not reproduced in the phylogeny based on partial N gene sequences.
The substitution rate of European bat lyssavirus-2 was estimated using the two Finnish strains isolated 24 years apart as a calibrator. The overall rate was 7.67 × 10−5 substitutions per site per year. The current diversity of EBLV-2 was estimated to have appeared during the last 2000 years. However, EBLV-2 and other phylogroup I viruses were estimated to have already diverged from other lyssaviruses at about 8000 years ago (Fig. 4). The divergence of Finnish EBLV-2 strains and a strain from Switzerland from other EBLV-2 strains has occurred during the last 1000 years. The two Finnish strains have evolved from a common ancestor during the last 200 years.

Discussion

Sequencing, phylogenetic analysis and evolutionary analysis of Finnish EBLV-2 strains isolated from a human case in 1985 and from a bat in 2009 were described. It was shown that the EBLV-2 isolates share high nucleotide and amino acid sequence identity, regardless of the year and origin of isolation, but they also cluster according to the host species and the geographical place of isolation.
The closest relatives to EBLV-2 (Bokeloh and KHUV) are lyssavirus strains from Myotis bats from Germany and Tajikistan. An interesting case is ARAV (originating from Kyrgystan), which has an uncertain position in the phylogenetic analysis. The possibility of recombination of rabies viruses has been demonstrated in earlier studies [3436]. Lleida bat lyssavirus, detected in a bent-winged bat (M. schreibersii) in Spain in 2011 [5], is the most unique lyssavirus in Europe based on the N gene, although the whole genome sequence is not available. WCBLV has also been detected in M. schreibersii, and antibodies against WCBV have been detected in Africa in Miniopterus bats [37]. The tree topology was somewhat different in the phylogeny based on either the complete coding sequences or the commonly used partial N sequences, and it should be appreciated that for a detailed analysis of evolutionary history, complete genomes should be used. The limitation of this study, as in other studies, is the amount of data available for comparison.
The nucleotide sequence identity (deduced amino acid sequence identity) between FI-85 and FI-09 was 99.6 % (99.8 %). The N, M and L proteins were similar in structure and length between members of different lyssavirus species and strains, whereas the lengths of the P and cytoplasmic regions of the G protein were variable [3840]. No differences in structure were seen in the Finnish EBLV-2 isolates in comparison to other EBLV-2 complete genomes [4042]. The similarity plot in Figure 1 further demonstrates the similarities along the genomes of different lyssaviruses. Interestingly, the non-coding regions, which are highly divergent in other lyssaviruses, were rather similar for all EBLV-2 strains.
Based on this study, we estimate that the Finnish EBLV-2 strains and one Swiss strain from among the other EBLV-2 strains have evolved from a common ancestor during the last 1000 years. Earlier, the Finnish strains and the strain from Switzerland were suggested to form the lineage EBLV-2b, whereas the rest of the isolates form the lineage EBLV-2a [10, 11, 20, 27]. In our study, there was a division into subgroups EBLV-2a and EBLV-2b when full genomes were compared (Fig. 2), but when more strains were compared using shorter, 400-bp N gene sequences, we could not confirm the suggested division into subgroups (Fig. 3). In our comparison, the Finnish strains and the strain from Switzerland also clustered together based on N gene analysis. Interpretation of the molecular epidemiology of the strains is further complicated by the history of the Swiss bat biologist who died in Finland in 1985 of EBLV-2 infection (JX129233), who had been bitten 51 days before the onset of clinical signs by a Daubenton’s bat that was abnormal. The bat was freed before the patient developed symptoms and was not available for rabies analysis [16]. However, it is possible that the bat originated from Central Europe, possibly from Switzerland, even though the exposure took place in Finland.
The molecular clock estimates suggest that the current linage of EBLV-2 arose some 2000 years ago and that the most recent common ancestor (MRCA) occurred around 8000 years ago. In earlier molecular clock studies, Tao et al. [43] estimated based on G gene analysis that the time to the most common ancestor (TMRCA) of all lyssaviruses was approximately 5030 years. The West Caucasian bat virus divided first, and then phylogroup I and phylogroup II divided about 4000 years ago [43]. Davis et al. [27] estimated that the MRCA of EBLV-1 existed around 500 to 750 years ago based on G and N sequences, or 70 to 300 years ago, depending on the substitution rate [44]. The molecular clock estimates cannot be used to precisely describe events that occurred thousands, or even tens of thousands of years ago, since sequence data only exist from the last few decades. The overall rate of evolution appears somewhat slower for the bat-type lyssaviruses than for RABV. This is in line with bats being considered the true reservoir of lyssaviruses. The overall evolution rate for EBLV-2 in our study was 7.67 × 10−5 substitutions per site per year. For RABV, it has been suggested to be 1.56–1.78 × 10−4 [45], and 1 × 10−3 to 5.5 × 10−4 [7, 43, 46, 47], and for EBLV-1, 5–6 × 10−5 to 5–6 × 10−4 [27].
Behavioural and ecological traits of bats, such as hibernation, migration and coloniality, might influence viral evolution. Some rabies virus lineages evolve up to 22 times faster than others, depending on the reservoir host [48, 49]. Virus lineages in bat species in the temperate climate zone were found to have four times slower rates of evolution than lineages in bats from tropical or subtropical climates, and viral evolution was faster in bats that remain active year-round in comparison to bats that hibernate. This could be a major factor in a cold climate region such in Finland. Viral evolutionary rates were similarly unconstrained by host evolutionary relatedness such that lyssaviruses associated with closely related bat species or subspecies often had dissimilar evolutionary rates. Streicker et al. [48] demonstrated that the local host environment determines the evolutionary rates of lyssaviruses. Daubenton’s bats are facultatively seasonal migrants covering middle-range distances of 100–150 km [50], which supports the clustering of EBLV-2 according to the geographical place of isolation. In Finland, antibodies to EBLVs have only been detected in a restricted geographical area close to the location where the EBLV-2-positive bat was found in 2009 [28]. In a study of Daubenton’s bats from Finland, the UK, Switzerland and Spain, no population structuring was observed [51]. Daubenton’s bats migrate between the UK and the mainland, and the genetic structure of Daubenton’s bats is relatively homogeneous in western parts of Europe [52]. This could explain the relatedness within the proposed lineage 2a. As the migration pattern of Daubenton’s bats does not support the finding that the Finnish EBLV-2 Daubenton’s bat strain is closely related to the EBLV-2 strain from Switzerland, one can speculate whether there could have been contact between indigenous Finnish bats and the bats that were freed in Finland and whose origin is unknown [9, 16].
Increased information on the complete genome sequences of lyssaviruses is fundamental to understanding their epidemiology and evolution and demonstrates the importance of continuous monitoring and molecular characterization of lyssaviruses circulating in human and animal populations.

Acknowledgments

Special thanks to Tiina Peltonen and other technicians at Evira for technical assistance. This study was funded by the Ministry of Agriculture and Forestry (grant MMM 2682/311/2009) and the Finnish Food Safety Authority Evira.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

The National Animal Experiment Board of the County Administrative Board of Southern Finland approved the diagnostic mouse inoculation test (permission number ESLH-2008-06899/Ym-23), which followed Finnish legislation, namely the Finnish Act on the Use of Animals for Experimental Purposes (62/2006).
Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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Literatur
1.
Zurück zum Zitat Badrane H, Bahloul C, Perrin P, Tordo N (2001) Evidence of two Lyssavirus phylogroups with distinct pathogenicity and immunogenicity. J Virol 75:3268–3276CrossRefPubMedCentralPubMed Badrane H, Bahloul C, Perrin P, Tordo N (2001) Evidence of two Lyssavirus phylogroups with distinct pathogenicity and immunogenicity. J Virol 75:3268–3276CrossRefPubMedCentralPubMed
2.
Zurück zum Zitat Kuzmin IV, Mayer AE, Niezgoda M, Markotter W, Agwanda B, Breiman RF, Rupprecht CE (2010) Shimoni bat virus, a new representative of the Lyssavirus genus. Virus Res 149:197–210CrossRefPubMed Kuzmin IV, Mayer AE, Niezgoda M, Markotter W, Agwanda B, Breiman RF, Rupprecht CE (2010) Shimoni bat virus, a new representative of the Lyssavirus genus. Virus Res 149:197–210CrossRefPubMed
3.
Zurück zum Zitat Kuzmin IV, Hughes GJ, Botvinkin AD, Orciari LA, Rupprecht CE (2005) Phylogenetic relationships of Irkut and West Caucasian bat viruses within the Lyssavirus genus and suggested quantitative criteria based on the N gene sequence for lyssavirus genotype definition. Virus Res 111:28–43CrossRefPubMed Kuzmin IV, Hughes GJ, Botvinkin AD, Orciari LA, Rupprecht CE (2005) Phylogenetic relationships of Irkut and West Caucasian bat viruses within the Lyssavirus genus and suggested quantitative criteria based on the N gene sequence for lyssavirus genotype definition. Virus Res 111:28–43CrossRefPubMed
4.
Zurück zum Zitat Marston DA, Horton DL, Ngeleja C, Hampson K, McElhinney LM, Banyard AC, Haydon D, Cleaveland S, Rupprecht CE, Bigambo M, Fooks AR, Lembo T (2012) Ikoma lyssavirus, highly divergent novel lyssavirus in an African civet. Emerg Infect Dis 18:664–667CrossRefPubMedCentralPubMed Marston DA, Horton DL, Ngeleja C, Hampson K, McElhinney LM, Banyard AC, Haydon D, Cleaveland S, Rupprecht CE, Bigambo M, Fooks AR, Lembo T (2012) Ikoma lyssavirus, highly divergent novel lyssavirus in an African civet. Emerg Infect Dis 18:664–667CrossRefPubMedCentralPubMed
5.
Zurück zum Zitat Ceballos NA, Morón SV, Berciano JM, Nicolás O, López CA, Juste J, Nevado CR, Setién AA, Echevarría JE (2013) Novel lyssavirus in bat, Spain. Emerg Infect Dis 19:793–795CrossRefPubMedCentral Ceballos NA, Morón SV, Berciano JM, Nicolás O, López CA, Juste J, Nevado CR, Setién AA, Echevarría JE (2013) Novel lyssavirus in bat, Spain. Emerg Infect Dis 19:793–795CrossRefPubMedCentral
6.
Zurück zum Zitat Mohr W (1957) Die Tollwut. Med Klinik 52:1057–1060 Mohr W (1957) Die Tollwut. Med Klinik 52:1057–1060
7.
Zurück zum Zitat Bourhy H, Kissi B, Lafon M, Sacramento D, Tordo N (1992) Antigenic and molecular characterization of bat rabies virus in Europe. J Clin Microbiol 30(9):2419–2426PubMedCentralPubMed Bourhy H, Kissi B, Lafon M, Sacramento D, Tordo N (1992) Antigenic and molecular characterization of bat rabies virus in Europe. J Clin Microbiol 30(9):2419–2426PubMedCentralPubMed
8.
Zurück zum Zitat Schneider LG, Cox JH (1994) Bat lyssaviruses in Europe. Curr Top Microbiol Immunol 187:207–218PubMed Schneider LG, Cox JH (1994) Bat lyssaviruses in Europe. Curr Top Microbiol Immunol 187:207–218PubMed
9.
Zurück zum Zitat Lumio J, Hillbom M, Roine R, Ketonen L, Haltia M, Valle M, Neuvonen E, Lähdevirta J (1986) Human rabies of bat origin in Europe. Lancet 15:378CrossRef Lumio J, Hillbom M, Roine R, Ketonen L, Haltia M, Valle M, Neuvonen E, Lähdevirta J (1986) Human rabies of bat origin in Europe. Lancet 15:378CrossRef
10.
Zurück zum Zitat Amengual B, Whitby JE, King A, Cobo JS, Bourhy H (1997) Evolution of European bat lyssaviruses. J Gen Virol 78:2319–2328PubMed Amengual B, Whitby JE, King A, Cobo JS, Bourhy H (1997) Evolution of European bat lyssaviruses. J Gen Virol 78:2319–2328PubMed
11.
Zurück zum Zitat McElhinney LM, Marston DA, Leech S, Freuling CM, van der Poel WH, Echevarria J, Vázquez-Moron S, Horton DL, Müller T, Fooks AR (2013) Molecular epidemiology of bat lyssaviruses in Europe. Zoonoses Public Health 60:35–45CrossRefPubMed McElhinney LM, Marston DA, Leech S, Freuling CM, van der Poel WH, Echevarria J, Vázquez-Moron S, Horton DL, Müller T, Fooks AR (2013) Molecular epidemiology of bat lyssaviruses in Europe. Zoonoses Public Health 60:35–45CrossRefPubMed
13.
Zurück zum Zitat Brass DA (1994) Rabies in bats. Natural History and Public Health Implications. Ridgefield CN, Livia Press Brass DA (1994) Rabies in bats. Natural History and Public Health Implications. Ridgefield CN, Livia Press
14.
Zurück zum Zitat Anonymous (1986) Bat rabies in the Union of Soviet Socialist Republics. Rabies Bull Eur 4:12–14 Anonymous (1986) Bat rabies in the Union of Soviet Socialist Republics. Rabies Bull Eur 4:12–14
15.
Zurück zum Zitat Botvinkin AD, Poleschuk EM, Kuzmin IV, Borisova TI, Gazaryan SV, Yager P, Rupprecht CE (2003) Novel lyssaviruses isolated from bats in Russia. Emerg Infect Dis 9:1623–1625CrossRefPubMedCentralPubMed Botvinkin AD, Poleschuk EM, Kuzmin IV, Borisova TI, Gazaryan SV, Yager P, Rupprecht CE (2003) Novel lyssaviruses isolated from bats in Russia. Emerg Infect Dis 9:1623–1625CrossRefPubMedCentralPubMed
16.
Zurück zum Zitat Roine RO, Hillbom M, Valle M, Haltia M, Ketonen L, Neuvonen E, Lumio J, Lähdevirta J (1988) Fatal encephalitis caused by a bat-borne rabies-related virus. Clinical findings. Brain 111:1505–1516CrossRefPubMed Roine RO, Hillbom M, Valle M, Haltia M, Ketonen L, Neuvonen E, Lumio J, Lähdevirta J (1988) Fatal encephalitis caused by a bat-borne rabies-related virus. Clinical findings. Brain 111:1505–1516CrossRefPubMed
17.
Zurück zum Zitat Fooks AR, McElhinney LM, Pounder DJ, Finnegan CJ, Mansfield K, Johnson N, Brookes SM, Parsons G, White K, McIntyre PG, Nathwani D (2003) Case report: isolation of a European bat lyssavirus type 2a from a fatal human case of rabies encephalitis. J Med Virol 71:281–289CrossRefPubMed Fooks AR, McElhinney LM, Pounder DJ, Finnegan CJ, Mansfield K, Johnson N, Brookes SM, Parsons G, White K, McIntyre PG, Nathwani D (2003) Case report: isolation of a European bat lyssavirus type 2a from a fatal human case of rabies encephalitis. J Med Virol 71:281–289CrossRefPubMed
18.
Zurück zum Zitat Selimov MA, Tatarov AG, Botvinkin AD, Klueva EV, Kulikova LG, Khismatullina NA (1989) Rabies-related Yuli virus; identification with a panel of monoclonal antibodies. Acta Virol 33:542–546PubMed Selimov MA, Tatarov AG, Botvinkin AD, Klueva EV, Kulikova LG, Khismatullina NA (1989) Rabies-related Yuli virus; identification with a panel of monoclonal antibodies. Acta Virol 33:542–546PubMed
20.
Zurück zum Zitat Megali A, Yannic G, Zahno ML, Brügger D, Bertoni G, Christe P, Zanoni R (2010) Surveillance for European bat lyssavirus in Swiss bats. Arch Virol 155:1655–1662CrossRefPubMed Megali A, Yannic G, Zahno ML, Brügger D, Bertoni G, Christe P, Zanoni R (2010) Surveillance for European bat lyssavirus in Swiss bats. Arch Virol 155:1655–1662CrossRefPubMed
21.
Zurück zum Zitat Whitby JE, Heaton PR, Black EM, Wooldridge M, McElhinney LM, Johnstone P (2000) First isolation of a rabies-related virus from a Daubenton’s bat in the United Kingdom. Vet Rec 147:385–388CrossRefPubMed Whitby JE, Heaton PR, Black EM, Wooldridge M, McElhinney LM, Johnstone P (2000) First isolation of a rabies-related virus from a Daubenton’s bat in the United Kingdom. Vet Rec 147:385–388CrossRefPubMed
22.
Zurück zum Zitat Harris SL, Mansfield K, Marston DA, Johnson N, Pajamo K, O’Brien N, Black C, McElhinney LM, Fooks AR (2007) Isolation of European bat lyssavirus type 2 from a Daubenton’s bat (Myotis daubentonii) in Shropshire. Vet Rec 161:384–386CrossRefPubMed Harris SL, Mansfield K, Marston DA, Johnson N, Pajamo K, O’Brien N, Black C, McElhinney LM, Fooks AR (2007) Isolation of European bat lyssavirus type 2 from a Daubenton’s bat (Myotis daubentonii) in Shropshire. Vet Rec 161:384–386CrossRefPubMed
23.
Zurück zum Zitat Freuling C, Grossmann E, Conraths FJ, Schameitat A, Kliemt J, Auer E, Greiser-Wilke I, Müller T (2008) First isolation of EBLV-2 in Germany. Vet Microbiol 131:26–34CrossRefPubMed Freuling C, Grossmann E, Conraths FJ, Schameitat A, Kliemt J, Auer E, Greiser-Wilke I, Müller T (2008) First isolation of EBLV-2 in Germany. Vet Microbiol 131:26–34CrossRefPubMed
24.
Zurück zum Zitat Jakava-Viljanen M, Lilley T, Kyheröinen E-M, Huovilainen A (2010) First encounter of European bat lyssavirus type 2 (EBLV-2) in a bat in Finland. Epidemiol Infect 138:1581–1585CrossRefPubMed Jakava-Viljanen M, Lilley T, Kyheröinen E-M, Huovilainen A (2010) First encounter of European bat lyssavirus type 2 (EBLV-2) in a bat in Finland. Epidemiol Infect 138:1581–1585CrossRefPubMed
25.
Zurück zum Zitat Rasmussen TB, Chrlél M, Baagøe, Fjederholt E, Kooi EA, Belsham GJ, Bøtner A (2014) Detection of European bat lyssavirus type 2 in Danish Daubenton’s bats using a molecular diagnostic strategy. In Proceedings of 8th annual EPIZONE meeting, Copenhagen Rasmussen TB, Chrlél M, Baagøe, Fjederholt E, Kooi EA, Belsham GJ, Bøtner A (2014) Detection of European bat lyssavirus type 2 in Danish Daubenton’s bats using a molecular diagnostic strategy. In Proceedings of 8th annual EPIZONE meeting, Copenhagen
26.
Zurück zum Zitat Schatz J, Ohlendorf B, Busse P, Pelz G, Dolch D, Teubner J, Encarnação JA, Mühle RU, Fischer M, Hoffmann B, Kwasnitschka L, Balkema-Buschmann A, Mettenleiter TC, Müller T, Freuling CM (2014) Twenty years of active bat rabies surveillance in Germany: a detailed analysis and future perspectives. Epidemiol Infect 142:1155–1166. doi:10.1017/S0950268813002185 CrossRefPubMed Schatz J, Ohlendorf B, Busse P, Pelz G, Dolch D, Teubner J, Encarnação JA, Mühle RU, Fischer M, Hoffmann B, Kwasnitschka L, Balkema-Buschmann A, Mettenleiter TC, Müller T, Freuling CM (2014) Twenty years of active bat rabies surveillance in Germany: a detailed analysis and future perspectives. Epidemiol Infect 142:1155–1166. doi:10.​1017/​S095026881300218​5 CrossRefPubMed
27.
Zurück zum Zitat Davis PL, Holmes EC, Larrous F, Van der Poel WH, Tjørnehøj K, Alonso WJ, Bourhy H (2005) Phylogeography, population dynamics and molecular evolution of European bat lyssaviruses. J Virol 79:10487–10497CrossRefPubMedCentralPubMed Davis PL, Holmes EC, Larrous F, Van der Poel WH, Tjørnehøj K, Alonso WJ, Bourhy H (2005) Phylogeography, population dynamics and molecular evolution of European bat lyssaviruses. J Virol 79:10487–10497CrossRefPubMedCentralPubMed
28.
Zurück zum Zitat Nokireki T, Huovilainen A, Lilley T, Kyheröinen EM, Ek-Kommonen C, Sihvonen L, Jakava-Viljanen M (2013) Bat rabies surveillance in Finland. BMC Vet Res 9:174CrossRefPubMedCentralPubMed Nokireki T, Huovilainen A, Lilley T, Kyheröinen EM, Ek-Kommonen C, Sihvonen L, Jakava-Viljanen M (2013) Bat rabies surveillance in Finland. BMC Vet Res 9:174CrossRefPubMedCentralPubMed
31.
Zurück zum Zitat Tamura K, Peterson D, Peterson N, Stecher G, Nei M, Kumar S (2011) MEGA5: molecular evolutionary genetics analysis using maximum likelihood, evolutionary distance, and maximum parsimony methods. Mol Biol Evol 28:2731–2739CrossRefPubMedCentralPubMed Tamura K, Peterson D, Peterson N, Stecher G, Nei M, Kumar S (2011) MEGA5: molecular evolutionary genetics analysis using maximum likelihood, evolutionary distance, and maximum parsimony methods. Mol Biol Evol 28:2731–2739CrossRefPubMedCentralPubMed
32.
Zurück zum Zitat Drummond AJ, Rambaut A (2007) BEAST: Bayesian evolutionary analysis by sampling trees. BMC Evol Biol 8(7):214CrossRef Drummond AJ, Rambaut A (2007) BEAST: Bayesian evolutionary analysis by sampling trees. BMC Evol Biol 8(7):214CrossRef
33.
Zurück zum Zitat Hasegawa M, Kishino H, Yano T (1985) Dating the human-ape splitting by a molecular clock of mitochondrial DNA. J Mol Evol 22:160–174CrossRefPubMed Hasegawa M, Kishino H, Yano T (1985) Dating the human-ape splitting by a molecular clock of mitochondrial DNA. J Mol Evol 22:160–174CrossRefPubMed
34.
Zurück zum Zitat Kuzmin I, Orciari L, Arai T, Smith J, Hanlon C, Kameoka Y, Rupprecht C (2003) Bat lyssaviruses (Aravan and Khujand) from Central Asia: phylogenetic relationship according to N, P and G gene sequences. Virus Res 97:65–79CrossRefPubMed Kuzmin I, Orciari L, Arai T, Smith J, Hanlon C, Kameoka Y, Rupprecht C (2003) Bat lyssaviruses (Aravan and Khujand) from Central Asia: phylogenetic relationship according to N, P and G gene sequences. Virus Res 97:65–79CrossRefPubMed
35.
Zurück zum Zitat Wei L, Yanfeng L, Jing L, Jianwei Z, Youhua X (2011) Evidence for inter- and intra-clade recombinations in rabies virus. Infect Genet Evol 11:1906–1912CrossRef Wei L, Yanfeng L, Jing L, Jianwei Z, Youhua X (2011) Evidence for inter- and intra-clade recombinations in rabies virus. Infect Genet Evol 11:1906–1912CrossRef
37.
Zurück zum Zitat Kuzmin IV, Niezgoda M, Franka R, Agwanda B, Markotter W, Beagley JC, Urazova OY, Breiman RF, Rupprecht CE (2008) Possible emergence of West Caucasian bat virus in Africa. Emerg Infect Dis 14:1887–1889CrossRefPubMedCentralPubMed Kuzmin IV, Niezgoda M, Franka R, Agwanda B, Markotter W, Beagley JC, Urazova OY, Breiman RF, Rupprecht CE (2008) Possible emergence of West Caucasian bat virus in Africa. Emerg Infect Dis 14:1887–1889CrossRefPubMedCentralPubMed
38.
Zurück zum Zitat Le Mercier P, Jacob Y, Tordo N (1997) The complete Mokola virus genome sequence: structure of the RNA-dependent RNA polymerase. J Gen Virol 78:1571–1576PubMed Le Mercier P, Jacob Y, Tordo N (1997) The complete Mokola virus genome sequence: structure of the RNA-dependent RNA polymerase. J Gen Virol 78:1571–1576PubMed
39.
Zurück zum Zitat Warrilow D, Smith IL, Harrower B, Smith GA (2002) Sequence analysis of an isolate from a fatal human infection of Australian bat lyssavirus. Virology 297:109–119CrossRefPubMed Warrilow D, Smith IL, Harrower B, Smith GA (2002) Sequence analysis of an isolate from a fatal human infection of Australian bat lyssavirus. Virology 297:109–119CrossRefPubMed
40.
Zurück zum Zitat Marston DA, McElhinney LM, Johnson N, Müller T, Conzelmann KK, Tordo N, Fooks AR (2007) Comparative analysis of the full genome sequence of European bat lyssavirus type 1 and type 2 with other lyssaviruses and evidence for a conserved transcription termination and polyadenylation motif in the G-L 3′ non-translated region. J Gen Virol 88:1302–1314CrossRefPubMed Marston DA, McElhinney LM, Johnson N, Müller T, Conzelmann KK, Tordo N, Fooks AR (2007) Comparative analysis of the full genome sequence of European bat lyssavirus type 1 and type 2 with other lyssaviruses and evidence for a conserved transcription termination and polyadenylation motif in the G-L 3′ non-translated region. J Gen Virol 88:1302–1314CrossRefPubMed
42.
Zurück zum Zitat Marston DA, McElhinney LM, Ellis RJ, Horton DL, Wise EL, Leech SL, David D, de Lamballerie X, Fooks AR (2013) Next generation sequencing of viral RNA genomes. BMC Genomics 14:444CrossRefPubMedCentralPubMed Marston DA, McElhinney LM, Ellis RJ, Horton DL, Wise EL, Leech SL, David D, de Lamballerie X, Fooks AR (2013) Next generation sequencing of viral RNA genomes. BMC Genomics 14:444CrossRefPubMedCentralPubMed
43.
Zurück zum Zitat Tao X, Guo Z, Li H, Han N, Tang Q, Liang G (2013) Investigation of the evolutionary history of the lyssaviruses. Virol Sin 28:186–189CrossRefPubMed Tao X, Guo Z, Li H, Han N, Tang Q, Liang G (2013) Investigation of the evolutionary history of the lyssaviruses. Virol Sin 28:186–189CrossRefPubMed
45.
Zurück zum Zitat Kuzmina NA, Kuzmin I, Ellison JA, Taylor ST, Bergman DL, Dew B, Rupprecht CE (2013) A reassessment of the evolutionary timescale of bat rabies viruses based upon glycoprotein gene sequences. Virus Genes 47:305–310CrossRefPubMed Kuzmina NA, Kuzmin I, Ellison JA, Taylor ST, Bergman DL, Dew B, Rupprecht CE (2013) A reassessment of the evolutionary timescale of bat rabies viruses based upon glycoprotein gene sequences. Virus Genes 47:305–310CrossRefPubMed
47.
Zurück zum Zitat Hanada K, Suzuki Y, Gojobori T (2004) A large variation in the rates of synonymous substitution for RNA viruses and its relationship to a diversity of viral infection and transmission modes. Mol Biol Evol 21:1074–1080CrossRefPubMed Hanada K, Suzuki Y, Gojobori T (2004) A large variation in the rates of synonymous substitution for RNA viruses and its relationship to a diversity of viral infection and transmission modes. Mol Biol Evol 21:1074–1080CrossRefPubMed
50.
Zurück zum Zitat Hutterer R, Ivanova T, Meyer-Cords R, Rodrigues L (2005) Bat migrations in Europe. A review of banding data and literature. Federal Agency for Nature Conservation, Bonn, p 162 (Naturshcutz und Biologische Vielfalt Heft 28) Hutterer R, Ivanova T, Meyer-Cords R, Rodrigues L (2005) Bat migrations in Europe. A review of banding data and literature. Federal Agency for Nature Conservation, Bonn, p 162 (Naturshcutz und Biologische Vielfalt Heft 28)
51.
Zurück zum Zitat Laine VN, Lilley TM, Norrdahl K, Primmer CR (2013) Population genetics of Daubenton’s bat (Myotis daubentonii) in the Archipelago Sea, southwest Finland. Ann Zool Fenn 50:303–315CrossRef Laine VN, Lilley TM, Norrdahl K, Primmer CR (2013) Population genetics of Daubenton’s bat (Myotis daubentonii) in the Archipelago Sea, southwest Finland. Ann Zool Fenn 50:303–315CrossRef
52.
Zurück zum Zitat Smith GC, Aegerter JN, Allnutt TR, MacNicoll AD, Learmount J, Hutson AM, Atterby H (2011) Bat population genetics and Lyssavirus presence in Great Britain. Epidemiol Infect 10:1463–1469CrossRef Smith GC, Aegerter JN, Allnutt TR, MacNicoll AD, Learmount J, Hutson AM, Atterby H (2011) Bat population genetics and Lyssavirus presence in Great Britain. Epidemiol Infect 10:1463–1469CrossRef
Metadaten
Titel
Evolutionary trends of European bat lyssavirus type 2 including genetic characterization of Finnish strains of human and bat origin 24 years apart
verfasst von
Jakava-Viljanen Miia
Nokireki Tiina
Sironen Tarja
Vapalahti Olli
Sihvonen Liisa
Huovilainen Anita
Publikationsdatum
01.06.2015
Verlag
Springer Vienna
Erschienen in
Archives of Virology / Ausgabe 6/2015
Print ISSN: 0304-8608
Elektronische ISSN: 1432-8798
DOI
https://doi.org/10.1007/s00705-015-2424-0

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