Anyone vacationing in the Mediterranean or the Middle East and returning home with the flu could be suffering from phlebotomus – or sandfly fever. Mosquito protection is extremely important in the distribution areas.
What is phlebotomus fever?
Phlebotomus fever is a viral infectious disease found throughout the Mediterranean Basin, North Africa, the Middle East and the Gulf States. In some cases, spreads to the Himalayas are known. See dictionaryforall for Autoimmune Thyroid Disease in Dictionary.
The disease can also be found in the tropical and subtropical regions of Asia and America. The causative agents are phleboviruses from the Bunya virus family and are transmitted by sand flies, which are also called butterfly gnats and belong to the genus Phlebotomus. Hence the name phlebotomus fever. Synonymous terms are sandfly fever, Pappataci, Dalmatia, Tuscany, Pick, Karimabad and Chitral fever.
The phlebovirus is divided into four different subgenera, the Tuscany virus, the Karimabad virus, the Tehran virus and the Sabin phlebotomus fever virus. The Tuscany virus is the most common worldwide. The other subgenera appear only in certain regions.
Phlebotomus fever is transmitted by sand flies. Infection from person to person is not possible. The phlebovirus usually lives in bats and rodents, sometimes in cattle, goats and sheep.
If a sand fly bites an animal that carries the virus, the mosquito becomes infected. Mosquito eggs and larvae can also be infected with the virus. After about six days, this has increased to such an extent that it can also be transmitted to humans. This occurs through the blood meal of an infected sandfly on a human.
Phlebotomus fever occurs more frequently in late spring and summer, as this is the time when sand flies multiply. In autumn and winter there is almost no risk of infection. It is also typical of phlebotomus fever that a particularly large number of infections occur in one year, and the frequency of the disease decreases again in the following years.
In areas where the virus occurs, most adult residents have become immune to it through repeated, symptom-free infections. Small children and foreign tourists in particular can contract phlebotomus fever.
Symptoms, Ailments & Signs
Phlebotomus fever presents with symptoms such as fever and chills. This can be accompanied by severe headaches and eye pain, which occur in phases and get worse as the fever progresses. The eye pain that occurs with every movement of the eyes is particularly painful.
They can radiate to the ears and jaw, which can result in other symptoms and discomfort. Many patients also complain of muscle, joint and limb pain. The pain is usually described as burning or throbbing. Phlebotomus fever also manifests itself through flu symptoms such as tiredness, exhaustion and sweating. Typically, the first symptoms appear three to six days after infection.
They will eventually subside after three to four days, although it may take several weeks to fully recover. Possible follow-up symptoms are a renewed increase in fever, painful skin rashes and inflammation all over the body. In severe cases, mentioned conjunctivitis develops. The Tuscany virus can also lead to paralysis and impaired consciousness. These usually also subside as soon as the fever goes down. Externally, the disease can be recognized primarily by the sickly appearance and the typical reddening of the skin.
Diagnosis & History
Phlebotomus fever is diagnosed by detecting antibodies. The immune system begins to form antibodies directly after infection, which are precisely tailored to the attacking virus. The doctor can also recognize the disease from the symptoms, the last vacation or business destination abroad and the history of the disease.
The course of the disease is similar to that of the flu: fever, joint, muscle and headache pains and a general feeling of illness follow about three to six days after infection. Extremely severe pain when the eyes move is particularly typical. The symptoms usually disappear after three to four days, but it can take several weeks for the final healing.
In more severe cases, there may be a renewed increase in fever, an exanthema (skin rash) or conjunctivitis. The Tuscany virus can cause meningitis. Disturbances of consciousness and symptoms of paralysis may possibly occur, but in most cases these disappear completely.
Although West Nile fever is a serious illness that requires medical attention, it is rarely associated with serious complications in healthy adults.
The flu-like symptoms that patients develop can become extremely stressful if the course is severe. A very high fever can set in, or the headache and body aches can become so severe that drug treatment is required. If a patient suffers from severe diarrhea and vomiting, they are at risk of becoming dehydrated and suffering a circulatory collapse.
In rare cases, dangerous complications can occur. In some patients, the pathogens invade the brain, causing severe encephalitis (inflammation of the brain) or meningitis (inflammation of the brain). In these cases, there is a risk that the patient will suffer long-term damage due to brain damage.
Acute symptoms of paralysis that do not or only partially resolve are occasionally observed in sick people. In addition, both encephalitis and meningitis are potentially life-threatening. Occasionally, the virus also affects other organs such as the pancreas, heart or eyes. However, these serious complications almost exclusively affect children and the elderly as well as people who suffer from a weakened immune system. People suffering from AIDS have a particularly high risk of serious complications.
When should you go to the doctor?
In case of fever, severe headache and an increasing feeling of illness, the doctor should be consulted. The symptoms indicate an infectious disease that needs to be treated with medication. If phlebotomus fever is actually the cause, rapid medical clarification is necessary in any case. It is best for the sick person to consult their family doctor immediately and have the symptoms examined. There is a particular danger after a tick bite or other contact with potentially infected animals. If the above-mentioned symptoms occur in this context, the best thing to do is to contact the medical emergency service.
A visit to the doctor is recommended at the latest when neck stiffness, tremors or paralysis are added to the symptoms described. Phlebotomus fever is treatable if diagnosed early. The diagnosis and treatment is carried out by the general practitioner or an internist. Children should be presented to the pediatrician if the symptoms described appear. Due to the high risk of complications, close consultation with the doctor responsible should be maintained during therapy. Regular follow-up visits are also indicated, as meningitis can persist long after recovery.
Treatment & Therapy
Since there is currently no treatment option against the virus itself, only the symptoms of phlebotomus fever are treated. For example, antipyretics and painkillers are administered. These therapy methods are usually sufficient, and the prognosis of a complete cure is generally very good, even in the more severe cases. Overall, complications are rather rare.
Outlook & Forecast
The further course of phlebotomus fever is primarily very dependent on the time of diagnosis, so that a general prediction cannot be made. The person concerned should therefore consult a doctor as soon as the first symptoms and signs of the disease appear and also have treatment initiated in order to prevent the occurrence of further complaints or compilations. Phlebotomus fever cannot heal on its own, so treatment by a doctor is always necessary. The symptoms of phlebotomus fever usually do not heal until medication is taken. In the worst case, it can lead to the death of the affected person if left untreated.
Treatment usually does not lead to complications. Even relatively severe infections can be fought well with the help of medicines. After the treatment, however, the person affected can become infected again with this disease and should therefore protect themselves particularly well against mosquitoes in the affected regions. There is no immunity after an illness. Follow-up care is also rarely necessary, so that the disease can ideally be cured after a few days. Only rarely does this fever reduce the life expectancy of the person affected.
There is currently no vaccination against phlebotomus fever. In the distribution areas, the infected mosquito populations are controlled to prevent the disease. Mosquito nets and repellent sprays are also good precautions.
The mesh size of the net should be less than two millimeters, since sandflies are very small. Especially at night you should protect yourself sufficiently against mosquito bites, since the insects are particularly active then. Long pants and sleeves also protect the body from mosquito bites. Body oils made from eucalyptus, cedar wood or citrus fruits can also deter the annoying bloodsuckers, but each person has to try out which body oil works best for them.
Phlebotomus fever is treated symptomatically by the doctor prescribing appropriate medicines for the individual symptoms. In addition to treatment with antibiotics, the patient must first and foremost rest. Avoid stress and strenuous physical activity.
In addition, contact with other people should be limited or avoided altogether. Otherwise, the pathogens can be transmitted. The diet should be changed to bland food. In addition, sufficient liquid must be consumed, since the body loses a large amount of water through symptoms such as diarrhea and vomiting.
Symptoms of phlebotomus fever should go away on their own after a few days. If they persist or even get worse, a doctor must be consulted. The doctor will help treat the symptoms by prescribing a stronger antibiotic or by using alternative medicine.
In severe cases, inpatient treatment in the clinic is necessary. After hospitalization, the sick need rest in bed so that they can fully recover. If the symptoms occur on vacation in one of the risk areas, it is advisable to cancel the trip and, if possible, to be treated by the family doctor.
You can do that yourself
People who have contracted phlebotomus fever after traveling to the Mediterranean or Middle East should speak to their GP or receptionist on a daily basis. After administration of fever-reducing medication, the disease usually subsides within three to four days. The patient must take it easy during this period and relieve the individual symptoms with the help of home remedies.
For headaches and eye pain, it helps to darken the bedroom and spend some time in bed. Any ear and jaw pain is treated by cooling. Cool packs from the pharmacy help, as do cooling pads or gauze bandages with soothing ointments. Possible skin rashes must not be scratched. The skin changes should disappear as the fever subsides and usually do not leave any scars or pigment changes.
If the measures do not help and the fever gets worse instead, the family doctor must be informed. In-patient treatment in a hospital may then be necessary. People with phlebotomus fever should be monitored by a family member or friend so that necessary steps can be taken quickly if complications arise.