Sandfly fever is carried by biting flies around the Mediterranean, through the Balkans, and into the Middle East & parts of China. It is called "3-day fever" because of brief debilitating course. Hospitalization is not necessary except for Toscana virus infection, which can cause aseptic meningitis.
CASES/YEAR
0 (US); 5,000 (Global)
OTHER NAMES
Phlebotomus fever; Papatasi fever; Toscana virus disease (Related Infection); Punta Toro virus disease (Related Infection);
INCUBATION
2-6 days; [Cecil, p. 2225]
INITIAL SYMPTOMS
Called "3-day fever" because of brief debilitating course; [Harrison ID, p. 965]
COMMENTS
Findings include fever, headache, myalgia, arthralgia, chest pain, fatigue, macular or urticarial rash, relative bradycardia, conjunctival injection, palatal vesicles, and leukopenia. Aseptic meningitis may occur. [Cecil, p. 2225] in military history, sandfly fever occurred as epidemics when non-immune troops entered endemic areas. Now, Mediterranean tourists are often affected. Sandfly fever viruses are maintained by transovarial transmission in the insect vectors. Most human cases are mild, and hospitalization is not necessary except for Toscana virus infection, which can cause aseptic meningitis. No true rash occurs, but the face may be flushed. [Guerrant, p. 481] Classic sandfly fever caused by Phlebotomus papatasi appeared to be eliminated after DDT campaigns against malaria killed most of these vectors in the Mediterranean basin. Plebotomus perniciosus is another sandfly that carries Toscana virus in the Tuscany area, where this virus is a common cause of aseptic meningitis. Toscana virus often infects travelers to Mediterranean Europe, Cyprus, and Portugal. [PPID, p. 2174] Classic sandfly fever is a self-limited infection with no rash and no CNS involvement. Toscana virus causes a febrile illness in rural residents and visitors to Italy, Spain, and Portugal. Toscana virus infection may be complicated by aseptic meningitis. Punta Toro virus disease causes sporadic infections in villages in tropical forests of the New World. [Harrison ID, p. 965]
DIAGNOSTIC
ELISA (detection of specific IgM antibody); RT-PCR; Isolate virus from mice after intracerebral inoculation; [Cecil, p. 2225]
SCOPE
Around the Mediterranean, through the Balkans, and into the Middle East and parts of China; [Harrison ID, p. 965] Also in western India, Pakistan, and Central America; [Cecil, p. 2225]
SIGNS & SYMPTOMS
-
>arthralgia
-
>fatigue, weakness
-
>fever
-
>myalgia
-
>relative bradycardia
-
E stomatitis
-
G nausea, vomiting
-
H leukopenia
-
N headache
-
N stiff neck
-
O conjunctivitis, acute
-
R chest pain
-
S rash (exanthem)
-
S urticaria
-
*encephalitis
-
*meningitis
REFERENCES FOR CASES/YEAR
1.
2. (Global) Epidemics have occurred during wars and natural disasters. [Harrison ID, p. 965] Guesstimate: 5000/year;