West Nile disease in Tunisia: an overview of 60 years.

West Nile virus (WNV) is an arthropod borne virus of public health importance. The virus is a member of the genus Flavivirus and belongs to the Japanese encephalitis virus (JEV) antigenic complex under the Flaviviridae family. The WNV is continuously spreading across Tunisia especially in the coastal and Southern area of the country. The first human West Nile disease (WND) epidemic in Tunisia occurred in 1997, since then, the quantity and the extension of spillover effects increased constantly. However, the existing knowledge of factors triggering such events continues to be rather poor. The last epidemic WNV human meningitis and meningoencephalitis recorded in 2012, with 86 cases and 6 deaths, confirmed the failure of the current system in predicting new cases. This review, based on analysis of scientific papers published between 1970 and 2015, summarises the state of knowledge on WNV in Tunisia and highlights the existing knowledge and research gaps that need to be addressed.