Pappataci fever
Encyclopedia
Pappataci fever is a vector-borne febrile
arboviral
infection caused by three serotype
s of Phlebovirus. Occurs in subtropical regions
of the Eastern Hemisphere
. The name, pappataci fever, comes from the Italian
word for sandfly
.
are known causative agents.
Pappataci fever is prevalent in the subtropical zone
of the Eastern Hemisphere
between 20°N and 45°N, particularly in Southern Europe
, North Africa
, the Balkans
, Eastern Mediterranean
, Iraq
, Iran
, Pakistan
, Afghanistan
and India
.
The disease is transmitted by the bites of phlebotomine
sandflies of the Genus Phlebotomus
, in particular, Phlebotomus papatasi, Phlebotomus perniciosus and Phlebotomus perfiliewi. The sandfly becomes infected when biting an infected human in the period between 48 hours before the onset of fever and 24 hours after the end of the fever, and remains infected for its lifetime. Besides this «horizontal» virus transmission from man to sandfly, the virus can be transmitted in insects transovarially
, from an infected female sandfly to its offspring.
Pappataci fever is seldom recognised in endemic populations because it is mixed with other febrile illnesses of childhood, but it is more well-known among immigrants and military personnel from non-endemic regions.
develop followed by fever of 39°C to 40°C, severe frontal headaches, muscle and joint aches, flushing of the face and tachycardia
. After two days the fever begins to subside and the temperature returns to normal. Fatigue, bradycardia
and subnormal blood pressure may persist from few days to several weeks but complete recovery is the rule.
s may not be sufficient to prevent sandfly bites.
Fever
Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...
arboviral
Arbovirus
Arbovirus is a term used to refer to a group of viruses that are transmitted by arthropod vectors. The word arbovirus is an acronym . Some arboviruses are able to cause emergent disease.-Transmission:...
infection caused by three serotype
Serotype
Serotype or serovar refers to distinct variations within a subspecies of bacteria or viruses. These microorganisms, viruses, or cells are classified together based on their cell surface antigens...
s of Phlebovirus. Occurs in subtropical regions
Subtropics
The subtropics are the geographical and climatical zone of the Earth immediately north and south of the tropical zone, which is bounded by the Tropic of Cancer and the Tropic of Capricorn, at latitudes 23.5°N and 23.5°S...
of the Eastern Hemisphere
Eastern Hemisphere
The Eastern Hemisphere, also Eastern hemisphere or eastern hemisphere, is a geographical term for the half of the Earth that is east of the Prime Meridian and west of 180° longitude. It is also used to refer to Europe, Asia, Africa, and Australasia, vis-à-vis the Western Hemisphere, which includes...
. The name, pappataci fever, comes from the Italian
Italian language
Italian is a Romance language spoken mainly in Europe: Italy, Switzerland, San Marino, Vatican City, by minorities in Malta, Monaco, Croatia, Slovenia, France, Libya, Eritrea, and Somalia, and by immigrant communities in the Americas and Australia...
word for sandfly
Phlebotomus
Phlebotomus is a genus of "sand fly" in the Dipteran family Psychodidae. In the past, they have sometimes been considered to belong in a separate family, Phlebotomidae, but this alternative classification has not gained wide acceptance.-Epidemiology:...
.
Etiology
Three serotypes of Phlebovirus, Naples virus, Sicilian virus and Toscana virusToscana virus
Toscana virus is an arthropod-borne virus arbovirus that was first isolated from the sandfly, Phlebotomus perniciosus collected from the Grosseto province of the Tuscany region in Italy, although has subsequently been identified isolated from P. perfiliewi, and found across a wider Mediterranean...
are known causative agents.
Epidemiology
Subtropics
The subtropics are the geographical and climatical zone of the Earth immediately north and south of the tropical zone, which is bounded by the Tropic of Cancer and the Tropic of Capricorn, at latitudes 23.5°N and 23.5°S...
of the Eastern Hemisphere
Eastern Hemisphere
The Eastern Hemisphere, also Eastern hemisphere or eastern hemisphere, is a geographical term for the half of the Earth that is east of the Prime Meridian and west of 180° longitude. It is also used to refer to Europe, Asia, Africa, and Australasia, vis-à-vis the Western Hemisphere, which includes...
between 20°N and 45°N, particularly in Southern Europe
Southern Europe
The term Southern Europe, at its most general definition, is used to mean "all countries in the south of Europe". However, the concept, at different times, has had different meanings, providing additional political, linguistic and cultural context to the definition in addition to the typical...
, North Africa
North Africa
North Africa or Northern Africa is the northernmost region of the African continent, linked by the Sahara to Sub-Saharan Africa. Geopolitically, the United Nations definition of Northern Africa includes eight countries or territories; Algeria, Egypt, Libya, Morocco, South Sudan, Sudan, Tunisia, and...
, the Balkans
Balkans
The Balkans is a geopolitical and cultural region of southeastern Europe...
, Eastern Mediterranean
Eastern Mediterranean
The Eastern Mediterranean is a term that denotes the countries geographically to the east of the Mediterranean Sea. This region is also known as Greater Syria or the Levant....
, Iraq
Iraq
Iraq ; officially the Republic of Iraq is a country in Western Asia spanning most of the northwestern end of the Zagros mountain range, the eastern part of the Syrian Desert and the northern part of the Arabian Desert....
, Iran
Iran
Iran , officially the Islamic Republic of Iran , is a country in Southern and Western Asia. The name "Iran" has been in use natively since the Sassanian era and came into use internationally in 1935, before which the country was known to the Western world as Persia...
, Pakistan
Pakistan
Pakistan , officially the Islamic Republic of Pakistan is a sovereign state in South Asia. It has a coastline along the Arabian Sea and the Gulf of Oman in the south and is bordered by Afghanistan and Iran in the west, India in the east and China in the far northeast. In the north, Tajikistan...
, Afghanistan
Afghanistan
Afghanistan , officially the Islamic Republic of Afghanistan, is a landlocked country located in the centre of Asia, forming South Asia, Central Asia and the Middle East. With a population of about 29 million, it has an area of , making it the 42nd most populous and 41st largest nation in the world...
and India
India
India , officially the Republic of India , is a country in South Asia. It is the seventh-largest country by geographical area, the second-most populous country with over 1.2 billion people, and the most populous democracy in the world...
.
The disease is transmitted by the bites of phlebotomine
Phlebotominae
Members of the subfamily Phlebotominae are known outside of the United States by the name sand fly. This subfamily includes numerous genera of blood-feeding flies, including the primary vectors of leishmaniasis, bartonellosis and pappataci fever...
sandflies of the Genus Phlebotomus
Phlebotomus
Phlebotomus is a genus of "sand fly" in the Dipteran family Psychodidae. In the past, they have sometimes been considered to belong in a separate family, Phlebotomidae, but this alternative classification has not gained wide acceptance.-Epidemiology:...
, in particular, Phlebotomus papatasi, Phlebotomus perniciosus and Phlebotomus perfiliewi. The sandfly becomes infected when biting an infected human in the period between 48 hours before the onset of fever and 24 hours after the end of the fever, and remains infected for its lifetime. Besides this «horizontal» virus transmission from man to sandfly, the virus can be transmitted in insects transovarially
Transovarial transmission
Transovarian transmission occurs in certain arthropod vectors as they transmit disease-causing bacteria from parent arthropod to offspring arthropod. For instance, Rickettsia rickettsii, carried within ticks, is passed on from parent to offspring tick by transovarial transmission...
, from an infected female sandfly to its offspring.
Pappataci fever is seldom recognised in endemic populations because it is mixed with other febrile illnesses of childhood, but it is more well-known among immigrants and military personnel from non-endemic regions.
Clinical course
A few days after the infective bite, a feeling of lassitude, abdominal distress and chillsRigor (medicine)
Rigor is a shaking occurring during a high fever. It occurs because cytokines and prostaglandins are released as part of an immune response and increase the set point for body temperature in the hypothalamus....
develop followed by fever of 39°C to 40°C, severe frontal headaches, muscle and joint aches, flushing of the face and tachycardia
Tachycardia
Tachycardia comes from the Greek words tachys and kardia . Tachycardia typically refers to a heart rate that exceeds the normal range for a resting heart rate...
. After two days the fever begins to subside and the temperature returns to normal. Fatigue, bradycardia
Bradycardia
Bradycardia , in the context of adult medicine, is the resting heart rate of under 60 beats per minute, though it is seldom symptomatic until the rate drops below 50 beat/min. It may cause cardiac arrest in some patients, because those with bradycardia may not be pumping enough oxygen to their heart...
and subnormal blood pressure may persist from few days to several weeks but complete recovery is the rule.
Diagnosis
Although commercial tests are not readily available, diagnosis can be confirmed by serology-based assays or real-time PCR by laboratories that have developed assays to perform such identification.Prevention
Prevention of sandfly bites, and control of sandflies and their breeding grounds with insecticides are the principal methods for prevention. Mosquito netMosquito net
A mosquito net offers protection against mosquitos, flies, and other insects, and thus against diseases such as malaria, dengue fever, yellow fever, and various forms of encephalitis, including the West Nile virus, if used properly and especially if treated with an insecticide, which can double...
s may not be sufficient to prevent sandfly bites.