First report of sandfly fever virus infection imported from Malta into Switzerland, October 2011

Abstract

We report the first documented cases of sandfly fever virus infection in travellers returning from Malta to Switzerland in autumn 2011. These cases illustrate the importance of considering sandfly-borne viral infection in the differential diagnosis of febrile patients from the Mediterranean island Malta. Raising awareness among physicians is relevant especially now at the beginning of the summer tourist season.

Broader Geographical Distribution of Toscana Virus in the Mediterranean Region Suggests the Existence of Larger Varieties of Sand Fly Vectors

“…Like other arboviruses, most TOSV infections in humans are asymptomatic [6]. So far, 864 symptomatic human cases (834 autochthonous and 30 imported) have been reported in residents of different Mediterranean countries and in tourists and travelers returning from endemic regions [7][8][9][10].…”

“…Seroprevalence studies demonstrate that human populations are exposed to TOSV in Italy, Spain, France, Portugal, Turkey, Malta, Cyprus, Greece, Croatia, Bosnia and Herzegovina, Kosovo, Bulgaria, Tunisia, and Algeria [7,[22][23][24][25][26][27][28][29][30][31][32][33][34][35][36]. Together, the results of serological surveillance studies and case reports showed that the TOSV geographic distribution is much wider than believed a decade ago; in particular, the presence of TOSV has been recently documented in North Africa and the Balkan countries [31,32,[34][35][36] (Figure 2).…”

Sandfly Fever: A Mini Review

“…Sandfly fever is also very important for travelers' health; imported cases are reported in the literature from non-endemic areas due to travelling [3][4][5]24]. In 1997, a case of travel associated SFSV infection presenting as meningitis in female patient, after a vacation to Turkey, was reported by Becker et al [5].…”

“…Other cases with febrile disease after returning to Switzerland from Malta found to have sandfly fever. One of the patients was lucky to present with insect bites and rash giving a clue about vector-borne travel-related disease and detected for phlebotomus fever which was found to be positive [3].…”

“…Sandfly fever, also known as Pappataci fever or phlebotomus fever is an interesting disease mimicking other conditions which causes fever, myalgia and malaise along with abnormalities in liver enzymes and hematological test results [1]. Without suspicion of the disease itself or a presence of an epidemic, it is very hard to diagnose this disease in a non-endemic area, particularly if it is travel associated and if the anamnesis is not clear [1][2][3][4][5]. The differential diagnosis consists of a very board spectrum list of diseases such as viral, parasitic and bacterial infections.…”