Severe Encephalitis Caused by Toscana Virus, Greece

Papa, Anna; Paraforou, Theoniki; Papakonstantinou, Ioannis; Pagdatoglou, Kiriaki; Kontana, Anastasia; Koukoubani, Triantafilia

doi:10.3201/eid2008.140248

Cited by 35 publications

(26 citation statements)

References 10 publications

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“…Epidemiological studies in Greece showed that the seroprevalence of phleboviruses in Greece is high, especially in the islands and the coastal areas of the mainland . Novel phleboviruses, such as Toscana virus lineage C and Adria virus, have been identified in human cases in Greece . In the present study the diagnosis was performed only by serology, because the PCR was negative, thus, the phlebovirus strain could not be identified.…”

Section: Discussionmentioning

confidence: 99%

Acute viral infections of the central nervous system, 2014‐2016, Greece

Papa

Papadopoulou

2017

Journal of Medical Virology

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In order to investigate the viral etiology of acute infections of central nervous system (CNS), multiplex and single PCRs combined with serology for arboviruses were applied on samples from 132 hospitalized patients in Greece during May 2014-December 2016. A viral pathogen was detected in 52 of 132 (39.4%) cases with acute CNS infection. Enteroviruses predominated (15/52, 28.8%), followed by West Nile virus (9/52, 17.3%). Phleboviruses, varicella-zoster virus, and Epstein-Barr virus accounted for 15.4%, 13.5%, and 11.5% of the cases, respectively. The study gives an insight into the etiology of viral CNS infections in a Mediterranean country, where arboviruses should be included in the differential diagnosis of acute CNS infections.

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Section: Discussionmentioning

confidence: 99%

Acute viral infections of the central nervous system, 2014‐2016, Greece

Papa

Papadopoulou

2017

Journal of Medical Virology

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“…At the outset of our study, the following data were available for Greece: (i) there was no serological data in domestic animals (cattle, goats, sheep, dogs or cats) for any phlebovirus transmitted by sand flies, (ii) in the 1970's, 13.1% of 38 adults living in Crete had NT-Abs against Naples virus, and 24.7% and 8.5% of 632 human sera from Athens inhabitants had NT-Abs against Naples virus and Sicilian virus, respectively [29]; (iii) more recent studies reported various rates of TOSV IgG using ELISA and/or IIF tests in continental Greece as well as in the Ionian and Aegean islands [8–10]; (iv) TOSV RNA (belonging to the lineage C) was detected in the CSF of a patient with meningitis [11], and (v) viral RNA corresponding to Adria virus, a novel virus belonging to the Salehabad species, was also identified in the CSF of a patient with meningitis [12, 13]. To date, SFSV or another SFS-like virus have been neither isolated nor detected by molecular techniques in Greece.…”

Section: Discussionmentioning

confidence: 99%

“…In Greece, in recent sporadic cases of meningitis, (i) TOSV RNA was detected in the CSF of a patient [11], and (ii) viral RNA corresponding to Adria virus, a novel virus belonging to the Salehabad species, was also identified in the CSF [12, 13]. To date, SFSV or another SFS-like virus have been neither isolated nor detected by molecular techniques in Greece.…”

Section: Introductionmentioning

confidence: 99%

Seroprevalence of Sandfly‐Borne Phleboviruses Belonging to Three Serocomplexes (Sandfly fever Naples, Sandfly fever Sicilian and Salehabad) in Dogs from Greece and Cyprus Using Neutralization Test

Alwassouf

Christodoulou²,

Bichaud

et al. 2016

PLoS Negl Trop Dis

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Phleboviruses transmitted by sandflies are endemic in the Mediterranean area. The last decade has witnessed the description of an accumulating number of novel viruses. Although, the risk of exposure of vertebrates is globally assessed, detailed geographic knowledge is poor even in Greece and Cyprus where sandfly fever has been recognized for a long time and repeatedly. A total of 1,250 dogs from mainland Greece and Greek archipelago on one hand and 422 dogs from Cyprus on the other hand have been sampled and tested for neutralising antibodies against Toscana virus (TOSV), Sandfly fever Sicilian virus (SFSV), Arbia virus, and Adana virus i.e. four viruses belonging to the 3 sandfly-borne serocomplexes known to circulate actively in the Mediterranean area. Our results showed that (i) SFSV is highly prevalent with 71.9% (50.7–84.9% depending on the region) in Greece and 60.2% (40.0–72.6%) in Cyprus; (ii) TOSV ranked second with 4.4% (0–15.4%) in Greece and 8.4% (0–11.4%) in Cyprus; (iii) Salehabad viruses (Arbia and Adana) displayed also substantial prevalence rates in both countries with values ranging from 0–22.6% depending on the region and on the virus strain used in the test. These results demonstrate that circulation of viruses transmitted by sand flies can be estimated qualitatively using dog sera. As reported in other regions of the Mediterranean, these results indicate that it is time to shift these viruses from the "neglected" status to the "priority" status in order to stimulate studies aiming at defining and quantifying their medical and veterinary importance and possible public health impact. Specifically, viruses belonging to the Sandfly fever Sicilian complex should be given careful consideration. This calls for implementation of direct and indirect diagnosis in National reference centers and in hospital microbiology laboratories and systematic testing of unelucidated febrile illness and central and peripheral nervous system febrile manifestations.

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“…The knowledge about the molecular epidemiology of TOSV has largely increased during the last decade. Three TOSV genetic lineages are currently identified, A, B, and C. TOSV lineage A strains were identified in several Mediterranean countries, including Italy, France, and Turkey; TOSV lineage B strains were detected in the Iberian Peninsula and France, while a novel lineage, TOSV lineage C, has been identified in meningitis and severe encephalitis cases in Croatia and Greece, respectively …”

Section: Sandfly‐borne Viral Diseasesmentioning

confidence: 99%

Emerging arboviral human diseases in Southern Europe

Papa

2017

Journal of Medical Virology

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Southern Europe is characterized by unique landscape and climate which attract tourists, but also arthropod vectors, some of them carrying pathogens. Among several arboviral diseases that emerged in the region during the last decade, West Nile fever accounted for high number of human cases and fatalities, while Crimean-Congo hemorrhagic fever expanded its geographic distribution, and is considered as a real threat for Europe. Viruses evolve rapidly and acquire mutations making themselves stronger and naive populations more vulnerable. In an effort to tackle efficiently the emerging arboviral diseases, preparedness and strategic surveillance are needed for the early detection of the pathogen and containment and mitigation of probable outbreaks. In this review, the main human arboviral diseases that emerged in Southern Europe are described.

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Severe Encephalitis Caused by Toscana Virus, Greece

Cited by 35 publications

References 10 publications

Acute viral infections of the central nervous system, 2014‐2016, Greece

Acute viral infections of the central nervous system, 2014‐2016, Greece

Seroprevalence of Sandfly‐Borne Phleboviruses Belonging to Three Serocomplexes (Sandfly fever Naples, Sandfly fever Sicilian and Salehabad) in Dogs from Greece and Cyprus Using Neutralization Test

Emerging arboviral human diseases in Southern Europe

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