Current status of human arboviral diseases in Turkey

Infections caused by viruses transmitted via blood-feeding arthropods (arthropod-borne or arboviruses) have gained considerable attention and importance during the last decades due to their resurgence, impact on public health, and changing epidemiologic features. The complex transmission cycles affected by environmental, technological, and ecological changes place arboviral infections in the realm of emerging and reemerging infections that intermittantly reappear in epidemic form or display tendency to extend beyond endemic zones. A number of previously undetected arboviral diseases have emerged in Turkey during the last decade, although, in some cases, serologic evidence has been provided earlier. Since Crimean-Congo hemorrhagic fever first emerged in Turkey in 2002, there are now more than 4400 laboratory-confirmed cases of the disease. In addition, convincing evidence has accumulated to suggest that pathogenic flaviviruses, including West Nile virus, are in circulation. Recent studies have also revealed human exposure, central nervous system infections, and outbreaks of febrile diseases by sandfly fever viruses. In this study, reports published in local and international journals on surveillance and epidemiology of medically important arboviruses and associated diseases from Turkey have been reviewed, and current data on tick, mosquito, and sandfly vectors are incorporated.