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West Nile virus in humans, Greece, 2018: the largest seasonal number of cases, 9 years after its emergence in the country
- Danai Pervanidou1 , Annita Vakali1 , Theano Georgakopoulou1 , Takis Panagiotopoulos2 , Eleni Patsoula2 , George Koliopoulos3 , Constantina Politis1 , Kostas Stamoulis4 , Elpida Gavana5 , Styliani Pappa5 , Maria Mavrouli6 , Maria Emmanouil7 , George Sourvinos8 , Andreas Mentis7 , Athanassios Tsakris6 , Christos Hadjichristodoulou9 , Sotirios Tsiodras1,10 , Anna Papa5
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View Affiliations Hide AffiliationsAffiliations: 1 Hellenic National Public Health Organization/former Hellenic Center for Disease Control & Prevention, Athens, Greece 2 School of Public Health, Faculty of Public Health Policy, University of West Attica, Athens, Greece 3 Benaki Phytopathological Institute, Athens, Greece 4 Hellenic National Blood Transfusion Center, Athens, Greece 5 National Reference Center for Arboviruses and Haemorrhagic Fever Viruses, Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece 6 Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece 7 Diagnostic Services Laboratory, Public Health Laboratories, Hellenic Pasteur Institute, Athens, Greece 8 Laboratory of Clinical Virology, Medical School, University of Crete, Heraklion, Crete, Greece 9 Laboratory of Hygiene and Epidemiology, Medical School, University of Thessaly, Larisa, Greece 10 National and Kapodistrian University of Athens, Athens, GreeceDanai Pervanidoud.pervanidou eody.gov.gr
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Citation style for this article: Pervanidou Danai, Vakali Annita, Georgakopoulou Theano, Panagiotopoulos Takis, Patsoula Eleni, Koliopoulos George, Politis Constantina, Stamoulis Kostas, Gavana Elpida, Pappa Styliani, Mavrouli Maria, Emmanouil Maria, Sourvinos George, Mentis Andreas, Tsakris Athanassios, Hadjichristodoulou Christos, Tsiodras Sotirios, Papa Anna. West Nile virus in humans, Greece, 2018: the largest seasonal number of cases, 9 years after its emergence in the country. Euro Surveill. 2020;25(32):pii=1900543. https://doi.org/10.2807/1560-7917.ES.2020.25.32.1900543 Received: 28 Aug 2019; Accepted: 15 Feb 2020
Abstract
Human cases of West Nile virus (WNV) infection are recorded since 2010 in Greece, with seasonal outbreaks occurring almost annually. Enhanced surveillance has been implemented since 2010, to promptly characterise cases’ temporal and geographical distribution and inform authorities for implementation of appropriate measures (mosquito control, health education, blood safety).
We describe the epidemiology of WNV human infections in Greece focusing on the 2018 season.
The National Public Health Organization advised physicians to test all suspect WNV infection cases and refer samples to reference laboratories. Laboratories notified diagnosed cases on a daily basis. Treating physicians, patients, and infected blood donors were interviewed within 48 hours after diagnosis and the probable infection location was identified. Hospitalised cases were followed up until discharge.
A total of 317 autochthonous WNV infection cases were diagnosed in 2018. Among them, 243 cases had neuroinvasive disease (WNND), representing a 23% increase of WNND cases compared with 2010, the previous most intense season. There were 51 deaths. Cases started occurring from week 22, earlier than usual. Both rural and urban areas were affected, with 86 (26% of the total) municipalities belonging to seven (54% of the total) regions recording cases. Two major epicentres were identified in Attica and Central Macedonia regions.
The largest number of human cases of WNV infection ever recorded in Greece occurred in 2018, with a wide geographical distribution, suggesting intense virus circulation. Enhanced surveillance is vital for the early detection of human cases and the prompt implementation of response measures.
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