Phlebovirus infection in Greece: a case report

Area of Science:

• Arbovirology
• Infectious Diseases
• Neurovirology

Background:

• Sandfly-transmitted phleboviruses cause a spectrum of human illnesses, from mild febrile conditions to severe neurological diseases like meningitis and encephalitis.
• Phleovirus infections are endemic in Mediterranean regions, particularly during summer months when sandfly vectors are active.
• A significant number of phlebovirus infections may go undiagnosed, complicating epidemiological assessments.

Observation:

• A 45-year-old Greek male presented with acute febrile illness, myalgia, arthralgia, headache, and hemorrhagic rash.
• Initial testing ruled out West Nile virus infection.
• Serological analysis revealed high IgM and IgG antibody titers against Toscana virus (TOSV), with lower titers against sandfly fever Naples virus and no reactivity to other tested phleboviruses.

Findings:

• The patient's clinical presentation and serological profile strongly indicated Toscana virus (TOSV) as the causative agent.
• The findings suggest TOSV or antigenically similar phleboviruses are responsible for acute summer febrile illnesses in the region.
• The diagnostic window for viral detection, particularly via molecular or isolation methods, appears to be early in the disease course.

Implications:

• Phleboviruses, including TOSV, should be considered in the differential diagnosis of acute summer febrile illnesses, especially those with neurological manifestations.
• Timely diagnosis through early sample testing is essential for accurate etiological determination and understanding phlebovirus epidemiology in the Mediterranean.
• Enhanced surveillance and diagnostic capabilities are needed to effectively manage and study phlebovirus infections.