Pappataci fever (also known as Phlebotomus fever and, somewhat confusingly, sandfly fever and three-day fever) is a

vector-borne In epidemiology, a disease vector is any living agent that carries and transmits an infectious pathogen to another living organism; agents regarded as vectors are organisms, such as Parasitism, parasites or Microorganism, microbes. The first major ...

febrile

arboviral Arbovirus is an informal name for any virus that is Transmission (medicine), transmitted by arthropod Vector (epidemiology), vectors. The term ''arbovirus'' is a portmanteau word (''ar''thropod-''bo''rne ''virus''). ''Tibovirus'' (''ti''ck-''bo ...

infection caused by three

serotype A serotype or serovar is a distinct variation within a species of bacteria or virus or among immune cells of different individuals. These microorganisms, viruses, or cells are classified together based on their surface antigens, allowing the epi ...

s of Phlebovirus. It occurs in subtropical regions of the

Eastern Hemisphere The Eastern Hemisphere is the half of the planet Earth which is east of the prime meridian (which crosses Greenwich, London, United Kingdom) and west of the antimeridian (which crosses the Pacific Ocean and relatively little land from pole to pol ...

. The name, pappataci fever, comes from the Italian word for sandfly; it is the union of the words ''pappa'' (usually this is used as a generic name for food, but in this case it is a ''verb'' meaning "eating") and ''taci'' (silent), distinguishing these insects from blood-feeding mosquitoes, which produce a typical noise while flying.

Signs and symptoms

A few days after the infective bite, a feeling of lassitude, abdominal distress and

chills Chills is a feeling of coldness occurring during a high fever, but sometimes is also a common symptom which occurs alone in specific people. It occurs during fever due to the release of cytokines and prostaglandins as part of the inflammatory r ...

develop followed by fever of , severe frontal headaches, muscle and joint aches, flushing of the face and a fast heart rate. After two days the fever begins to subside and the temperature returns to normal. Fatigue, a slow heart rate and low blood pressure may persist from a few days to several weeks but complete recovery is the rule.

Cause

Three serotypes of Phlebovirus are known as the causative agents:

Naples virus ''Naples phlebovirus'' is an antigenic species of genus ''Phlebovirus'' within the family ''Phenuiviridae'' of the order ''Bunyavirales''. It is an enveloped RNA virus with a tripartite genome e Uukuniemi (UUK) serogroup. The Sandfly group's natu ...

Sicilian virus ''Sicilian phlebovirus'' is a phlebovirus associated with sandfly fever. It is related to the Naples and Toscana viruses, which also cause Pappataci fever, sandfly fever. Discovery The virus was discovered in Palermo, Sicilia, Italy where it a ...

and

Toscana virus ''Toscana phlebovirus'' (TOSV) is an arbovirus (arthropod-borne virus) belonging to ''Bunyavirales'', an order of negative-stranded, enveloped RNA viruses. The virus can be transmitted to humans by the bite of an infected sandfly of the genus ' ...

Diagnosis

Although commercial tests are not readily available, diagnosis can be confirmed by serology-based assays or quantitative 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

insecticide Insecticides are substances used to kill insects. They include ovicides and larvicides used against insect eggs and larvae, respectively. Insecticides are used in agriculture, medicine, industry and by consumers. Insecticides are claimed to b ...

s are the principal methods for prevention.

Mosquito net A mosquito net is a type of meshed curtain that is circumferentially draped over a bed or a sleeping area, to offer the sleeper barrier protection against bites and stings from mosquitos, flies, and other pest insects, and thus against the di ...

s may not be sufficient to prevent sandfly bites.

Treatment

There is no specific treatment for the disease. Pain killers and fluid replacement may be useful.Tavana AM. Sandfly fever in the world. Ann Trop Med Public Health 2015;8:83–7

Epidemiology

Phlebotomus pappatasi bloodmeal continue2

Pappataci fever is prevalent in the

subtropical zone The subtropical zones or subtropics are geographical and climate zones to the north and south of the tropics. Geographically part of the temperate zones of both hemispheres, they cover the middle latitudes from to approximately 35° north an ...

of the

between 20°N and 45°N, particularly in Southern Europe, North Africa, the Balkans,

Eastern Mediterranean Eastern Mediterranean is a loose definition of the eastern approximate half, or third, of the Mediterranean Sea, often defined as the countries around the Levantine Sea. It typically embraces all of that sea's coastal zones, referring to communi ...

, Iraq, Iran, Pakistan, Afghanistan and India. The disease is transmitted by the bites of

phlebotomine The Phlebotominae are a subfamily of the family Psychodidae. In several countries, their common name is sandfly; but that name is also applied to other flies. The Phlebotominae include many genera of blood-feeding (hematophagous) flies, including ...

sandflies of the Genus '' Phlebotomus'', in particular, ''

Phlebotomus papatasi ''Phlebotomus'' is a genus of " sand flies" in the Diptera 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. E ...

'', ''

Phlebotomus perniciosus ''Phlebotomus'' is a genus of "sand fly, sand flies" in the fly, Diptera 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 ...

'' and ''

Phlebotomus perfiliewi ''Phlebotomus'' is a genus of " sand flies" in the Diptera 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. ...

''. 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.

References

External links

{{Zoonotic viral diseases Arthropod-borne viral fevers and viral haemorrhagic fevers Insect-borne diseases