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. 2020 Aug;25(32):1900543.
doi: 10.2807/1560-7917.ES.2020.25.32.1900543.

West Nile virus in humans, Greece, 2018: the largest seasonal number of cases, 9 years after its emergence in the country

Danai Pervanidou  1 , Annita Vakali  1 , Theano Georgakopoulou  1 , Takis Panagiotopoulos  2 , Eleni Patsoula  2 , George Koliopoulos  3 , Constantina Politis  1 , Kostas Stamoulis  4 , Elpida Gavana  5 , Styliani Pappa  5 , Maria Mavrouli  6 , Maria Emmanouil  7 , George Sourvinos  8 , Andreas Mentis  7 , Athanassios Tsakris  6 , Christos Hadjichristodoulou  9 , Sotirios Tsiodras  1   10 , Anna Papa  5
Affiliations

West Nile virus in humans, Greece, 2018: the largest seasonal number of cases, 9 years after its emergence in the country

Danai Pervanidou et al. Euro Surveill. 2020 Aug.

Abstract

BackgroundHuman 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).AimWe describe the epidemiology of WNV human infections in Greece focusing on the 2018 season.MethodsThe 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.ResultsA 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.ConclusionsThe 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.

Keywords: 2018; Greece; West Nile Virus; vectorborne diseases.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Number of laboratory diagnosed West Nile virus neuroinvasive disease cases by week of symptom onset, Greece, 2010–2018a (n = 242)b
Figure 2
Figure 2
Incidence (per 100,000 population) of West Nile virus neuroinvasive disease by probable municipality of exposure, Greece, 2018 (n = 242)a
Figure 3
Figure 3
Number of laboratory-diagnosed West Nile virus neuroinvasive disease cases by week of symptom onset and region of exposure, Greece, 2018 (n = 241)a
Figure 4
Figure 4
Phylogenetic analysis of West Nile virus strains detected in Greece in 2018
See this image and copyright information in PMC

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