Mediterranean Spotted Fever in Crete, Greece

Germanakis, Antonis; Psaroulaki, Anna; Gikas, Achilleas; Tselentis, Yiannis

doi:10.1196/annals.1374.049

Cited by 17 publications

(13 citation statements)

References 8 publications

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“…Although no ticks from Crete were PCR-positive for R. conorii [37], the bacterium was isolated from R. sanguineus and humans in other areas of Greece with high seroprevalence in people [38, 39]. More importantly, several cases of human Mediterranean spotted fever have been reported in Greece [40, 41].…”

Section: Resultsmentioning

confidence: 99%

Endoparasites and vector-borne pathogens in dogs from Greek islands: pathogen distribution and zoonotic implications

Diakou

Cesare

Morelli

et al. 2018

Preprint

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29The present study investigated the presence of endo-and ecto-parasites, and vector-borne pathogens, 30 in dogs from four islands of Greece. A total of 200 owned and sheltered dogs were examined with 31 different microscopic, serological and molecular methods. 32Of the examined dogs, 130 (65%) were positive for one or more parasites and/or vector-borne 33 pathogens. The most common zoonotic intestinal helminths recorded were Ancylostomatidae 34 (12.5%) and Toxocara canis (3.5%). Ninety-three dogs (46.5%) seroreacted to Rickettsia conorii. 35 Twenty-two (11%) of them were also PCR positive and 7 (3.5%) showed corpuscoles suggestive of 36 Rickettsia spp. on the blood smears. Nineteen dogs (9.5%) were seropositive for Ehrlichia canis, three 37 of them being also PCR positive. Dogs positive for Anaplasma phagocytophilum-Anaplasma platys 38 (1%), Dirofilaria immitis (0.5%) and Babesia canis (0.5%) were also found. Fleas and ticks were 39 recorded in 53 (26.5%) and 50 (25%) dogs and all specimens were identified as Ctenocephalides felis 40 felis and Rhipicephalus sanguineus sensu latu. Binary multiple univariate Generalized Linear Models 41 were used to investigate factors and clinical signs related to the recorded positivity, while the 42 association of specific signs with the pathogens was evaluated using tests of independence. 43 Knowledge of occurrence and impact of zoonotic parasites and vector-borne pathogens in dog 44 populations is crucial to prevent the infection in animals and people, and to control the risk of 45 spreading of these pathogens in endemic and non-endemic areas. 46 47 Author summary 48 Both owned and sheltered dogs can harbor a variety of intestinal and extra-intestinal endoparasites, 49as well as vector-borne pathogens and ectoparasites, of zoonotic concern. Dog shelters and stray dogs 50 are present in several touristic areas of Greece, including Sporades and Cyclades islands, where 51 tourists often bring their pets with them, likely travelling from non-endemic to endemic areas. The 52 present study has been carried out with the aim to evaluate the occurrence of the aforementioned 53 pathogens. Data obtained showed that they are present in canine populations of Greece, with 54 possibilities of infection for travelling dogs, which can also contribute to the spreading of zoonotic 55 vector-borne diseases, introducing new pathogens in previously non-endemic areas. For these 56 reasons, a constant monitoring of the epidemiological situation, improving control measures and 57 correct diagnostic approaches are of primary importance for the prevention of canine and human 58 infections, decreasing the spreading of potentially deadly pathogens. 59 60 61 62 65circulation of zoonotic infections are difficult to control. Because of a lifestyle that implies a low-66 grade of sanitary management, stray and free-roaming dogs are at high risk of becoming infected with 67 a wide range of pathogens. Consequently, they act as a permanent source of infection for vectors, 68 other animals an...

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Section: Resultsmentioning

confidence: 99%

Endoparasites and vector-borne pathogens in dogs from Greek islands: pathogen distribution and zoonotic implications

Diakou

Cesare

Morelli

et al. 2018

Preprint

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“…Recent studies (213,226,227) have confirmed that this disease is characterized by fever (94 to 100%), flu-like symptoms (78%), prostration (64%), an eschar at the tick bite site (53 to 77%), and a rash spreading to the palms and soles (87 to 96%) that is either maculopapular (94%) or petechial (6%) (Fig. 8).…”

Section: Tick-borne Rickettsiae In Europe Species Identified As Pathomentioning

confidence: 91%

Update on Tick-Borne Rickettsioses around the World: a Geographic Approach

et al. 2013

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SUMMARY Tick-borne rickettsioses are caused by obligate intracellular bacteria belonging to the spotted fever group of the genus Rickettsia . These zoonoses are among the oldest known vector-borne diseases. However, in the past 25 years, the scope and importance of the recognized tick-associated rickettsial pathogens have increased dramatically, making this complex of diseases an ideal paradigm for the understanding of emerging and reemerging infections. Several species of tick-borne rickettsiae that were considered nonpathogenic for decades are now associated with human infections, and novel Rickettsia species of undetermined pathogenicity continue to be detected in or isolated from ticks around the world. This remarkable expansion of information has been driven largely by the use of molecular techniques that have facilitated the identification of novel and previously recognized rickettsiae in ticks. New approaches, such as swabbing of eschars to obtain material to be tested by PCR, have emerged in recent years and have played a role in describing emerging tick-borne rickettsioses. Here, we present the current knowledge on tick-borne rickettsiae and rickettsioses using a geographic approach toward the epidemiology of these diseases.

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“…MSF cases have been reported in Greece, and R. conorii has been isolated both from patients and ticks [5][6][7][8][9]. However, the disease is likely to be underestimated in this country and diagnosis is based mainly on clinical symptoms or only on serology.…”

Section: Introductionmentioning

confidence: 99%

Fatal Mediterranean spotted fever in Greece

Papa

Dalla

et al. 2010

Clinical Microbiology and Infection

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Forty-five days after the first confirmed and fatal Crimean-Congo haemorrhagic fever (CCHF) case in Greece in 2008, a female patient with similar signs and symptoms (high fever, thrombocytopaenia) and resident of the same area, was admitted to the University General Hospital of Alexandroupolis. Before admission, she had visited a local hospital where a cephalosporin was prescribed. A rash manifested over subsequent days, which was misdiagnosed as an allergy to the drug. Upon admission to the University Hospital, she was given further antibiotics, including doxycycline; a few hours later, ribavirin was added because CCHF was suspected. After the patient's death, rickettsiosis caused by Rickettsia conorii conorii (Meditteranean spotted fever; MSF) was diagnosed. Extremely high values of interleukin (IL)-1ra, IL-6, interferon-gamma-inducible protein-10, monocyte chemoattractant protein-1 and an absence of tumour necrosis factor-alpha were observed. MSF is a potentially severe and even fatal disease resembling viral haemorrhagic fevers that has to be included in the differential diagnosis of febrile syndromes combined with thrombocytopaenia, even when a tick bite is not reported, and an eschar is absent. Physicians have to be aware of MSF in patients with severe disease who are returning from the Mediterranean area.

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Mediterranean Spotted Fever in Crete, Greece

Cited by 17 publications

References 8 publications

Endoparasites and vector-borne pathogens in dogs from Greek islands: pathogen distribution and zoonotic implications

Endoparasites and vector-borne pathogens in dogs from Greek islands: pathogen distribution and zoonotic implications

Update on Tick-Borne Rickettsioses around the World: a Geographic Approach

Fatal Mediterranean spotted fever in Greece

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