Phlebovirus infection in Greece: a case report

Sandfly-transmitted phleboviruses cause to humans an asymptomatic or mild infection to severe meningitis or encephalitis. Phleovirus infections are common in the Mediterranean countries during the summertime when sandflies are active. It is estimated that several cases remain undiagnosed.

In July 2013, a 45-year-old Greek male, was admitted to the General Hospital of Florina in northwestern Greece with two-day history of fever, myalgia, arthralgia, mild headache, and hemorrhagic exanthema. A serum sample obtained from the patient on the 6(th) day of illness was tested negative for West Nile virus infection. Instead, high titers of IgM and IgG antibodies against Toscana virus (TOSV) were detected, with low titers against sandfly fever Naples virus and no reactivity against sandfly fever Sicilian and Cyprus viruses, suggesting that the causative agent was TOSV or other phlebovirus with antigenic similarity to TOSV.

Phleboviruses have to be included in the differential diagnosis of acute summer febrile cases, accompanied or not by neurological symptoms. Effort has to be paid to test clinical samples during the first days of the disease when the virus is detectable by molecular or isolation methods, in order to elucidate the complex epidemiology of phleboviruses in the Mediterranean area. Hippokratia 2015; 19 (2):189-191.