Travel-related Toscana virus infection

Serosurvey and laboratory diagnosis of imported sandfly fever virus, serotype Toscana, infection in Germany

“…At present, no data on the seroprevalence of antibodies to TOS are available from Spain and Portugal but as clinical infections have been reported from these areas, it is likely that the virus is present. To date, only a few cases of TOS infection have been reported in visitors from non-endemic areas travelling to Italy, Cyprus, Spain, and Portugal [15][16][17][18], and in view of the large number of visitors travelling to these areas during the months of vector activity, the infrequent reports of sandfly fever are surprising. In this study, most tourists had been infected in Tuscany, Italy but one patient had acquired the infection in Coimbra, Portugal, an area from where TOS infection has never been reported.…”

“…Phlebotomus sandflies are active in some Mediterranean countries, as indicated by the presence of leishmaniasis which is also transmitted by these vectors [12,13]. Recent studies in endogenous populations and case reports of infection in tourists indicate that TOS is endemic in the Italian regions of Tuscany and Marche, and also in Algarve, Catalonia and Cyprus [14][15][16][17][18][19].…”

“…SFS and SFN generally cause a febrile illness with headaches lasting for several days [7,14,20,21], whereas TOS infection is characterized by high fever, severe headaches, and aseptic meningitis with long convalescence [16][17][18]22]. At present, only a few cases of TOS infection have been reported in individuals from nonendemic areas [14][15][16][17][18][19].…”

“…At present, only a few cases of TOS infection have been reported in individuals from nonendemic areas [14][15][16][17][18][19]. Because millions of visitors travel to the Mediterranean countries each year, there is a potential risk of travel-related TOS infections, but many clinicians in most non-endemic countries are unaware of this possibility.…”

Toscana Virus Central Nervous System Infections in Southern Italy

“…TOSV has been associated with acute meningitis and encephalitis occurring during the summer in individuals living in central Italy (1,7,12), Spain (3,6), and France (5), as well as in travelers returning from Mediterranean countries (2,4,10). TOSV infection in southern Italy has not been reported previously.…”