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Forty-three West Nile virus cases were reported in EU during the past two weeks, which indicates a clear increase compared to a total of 54 cases during the whole 2016 transmission season.

Although there’s a noted peak in the reported West Nile fever transmission in EU recently, the overall number of cases is still within the expected ranges for the disease transmission season.

Thirty-two new cases were reported in the EU Member States in the past week, and 11 cases – in the week before.

During the past week countries have notified about West Nile fever cases in humans in:

  • Austria: the first two cases for the season
  • Hungary: four new cases, three in the newly affected area of Budapest
  • Italy: 10 new confirmed cases, nine in the newly affected provinces
  • Romania: 15 new cases, five in the newly affected areas
  • For the first time Cyprus has reported a West Nile fever case, but investigations are still ongoing to estimate the risk of local transmission.

During the week before, 11 new cases have been reported in EU, by Hungary, Romania and Spain.

In the neighbouring countries (Israel, Russia and Serbia), 19 and 21 new cases have been reported in the past week and the week before, respectively.

See the latest update of West Nile fever maps


West Nile spreads in Greece ,ECCMID 2015 


West Nile virus appears to have gained a foothold in Greece, spreading to new parts of the country since the first documented outbreak occurred there in 2010, according to data presented at ECCMID 2015
 

.

 Presented at: European Congress of Clinical Microbiology and Infectious Diseases; April 25-28, 2015; Copenhagen, Denmark 

In 2011, most WNV cases were confined to the Eastern Attica prefecture, particularly in the Marathon municipality, where wetlands provided a favorable environment for the reproduction of mosquito vectors. However, during the summer months of 2012 and 2013, cases spread to municipalities of southern and northern Attica. Sporadic cases also were reported from southwestern Greece, including Achaia, Ilia and the Ionian Islands. IgG antibodies were detected in patients from previously unaffected regions, suggesting the previous circulation of WNV in these areas, the researchers noted.

Although the use of larvacides in mosquito-breeding sites in 2014 had successfully reduced the number of emerging vectors and led to a significant reduction of cases, the spread of WNV in newly affected areas indicates that the disease has been established in Greece and cases may continue to occur in the future, according to the researchers. Mavrouli M, et al. Abstract P0635.



The Greek CDC WNV

Alert Guidelines

for Greeks &Travelers

The Greek CDC reminds to people of all ages that the West Nile virus is carried by birds and is transmitted to humans and animals through the bite of the common mosquitoes, that  fly around in Greece during the summer season.


  • The bites are common, unless one is protected thoroughtly over any uncovered skin during day and night, and the Greek CDC reminds that
  •                  the aim of protection measures this season, also, for Greece, is to KEEP YOU AWARE 


Urgency

for Travelers to be informed for WN fever in Greece,  ECDC underlines


The ECDC mission West Nile

 virus infection in Greece Report,  – 7 November 2012 


"Open issues which need further discussion and analysis – in close collaboration between Greek blood safety authorities, ECDC, and European blood safety groups – refer to:                                                     

• the definition of triggers for recall of implemented blood safety measures; and


the spatial definition of areas of disease outbreak with local transmission in order to inform travelers from  abroad"


by the ECDC


information FOR TRAVELERS
 by the Greek CDC

Attention 
  • Accommodation on the Greek islands includes often “rooms-to-let” , traditional local houses that keep running the authentic travel- hospitality family tourism business, and that is possible not to be adequately informed or equipped.

                              *** Ask your travel agent before you travel on that, or the hospitality desk in your hotel, or the owner of the room-to-let business wherever you are found. If not possible to be provided to you , try to find cheap, portable sieves for the windows. Use anti-repellent in room and on you, on your beloved ones, and y our pets.


  •                      Take special care for mosquito bites’ protection during sleep on camping areas 

  •            Greek CDC reminds to Greek and foreign holidaymakers that mosquitoes don’t like sea water. The dangers on the areas of a beach or at the pool areas are around any standing waters. Sun tanning oils are found by science to repel mosquitoes, but extra caution whenever nude, by anybody is always required. Go to full source article 

Personal Protection by the Greek CDC 


Everyone to avoid Any Bite .
  • No vaccine or treatment for the West Nile infection are available to World Medicine , and some cases could require Intensive units


Personal Protective Measures, to follow until the fall months in Greece

  •      using insect repellent substances in exposed skin and on top of the clothes, especially during outdoor activities in the afternoon or evening.
  •                         Since the mosquito swarms are extensively infected , though, on the areas of mainland and island Greece, skin and clothing protection is wiser to be kept constantly 24/7.

  •            Using implementation sieves on the windows , putting nets for the sleep time

Outdoors Protection 

  • The Greek CDC reminds to all households and all greek and foreign citizens  that mosquito protection means  primarily  to avoid sources of stagnant water in 
  • backyards,
  •  balconies 
  •  little pots  (even in the pet’s water cup) , all these should not at all be left openly, especially on mosquito breeding hours from sunset to sunrise. 
go to 

 
 
 

Attention 


The common mosquitoes in Attica, Greece, and 

in Athens arinfected!

jULY 16, 2013


The public health authorities , being set in emergency mobility for any West Nile virus infections this year, expressed their enormous concern today , Tuesday July16, for the protection of the Greek population and of the foreign visitors from any possible West Nile epidemic, while the Greek CDC announced the first confirmed case of WN in the region of Attica.

The Greek CDC’s Surveillance and Public Health Protection teams are on the alert, and on behalf of the Ministry of Health, the Greek CDC has set on the Infectious Alert coordination network , so that hospitals and all the health centers in Greece are informed....






Blood 

Donation

 Safety in 

Greece

The Greek CDC in order to assure the blood donations safety in Greece keeps strong coordination, information exchange and scientific, epidemiological and laboratory surveillance on the communicable diseases control concerning the blood

donations, with the National Center for Blood Donations and the blood donation units in all hospitals. Especially for the safety control of these units for the WNV , the Greek CDC

(HCDCP) 

  •  provides a daily update for the disease, and also, 


  • Coordinates of a multisector Working Group (WG) on the definition of affected areas by vector borne diseases.

        This WG considers all available entomological and epidemiological data and decides on the characterization of affected areas, for the implementation of blood safety measures.

 The list is published on the Greek CDC  webside (www.keelpno.gr) and updated regularly. 

Provides an 24/7 update to the National Centre for Blood Donations (www.ekea.gr) by the list of affected areas in order to issue the necessary blood safety measures to the blood donation units in all hospitals

 



TOP STORY

Global threat for 

WNV        mutation in Greece


Is it Armageddon?


Mutated hybrid populations of mosquitoes have been identified  in Greece in 201O when the WNV started. While the common mosquitoes in Attica and elsewhere in Greece are infected, health officials are seriously concerned of the possibility of a new mutation of the WNV  that will allow the transmission of the virus from birds directly to humans.

Read the top story by  the Greek Researcher's statements who recently announced the findings about the hybrids . 




       What the Greek CDC did to eliminate WNV infections in four years



The following public health measures have been implemented by the Hellenic CDC and other involved stakeholders: 


1. Surveillance

1.1 Enhanced surveillance for encephalitis and WNV disease in humans. 


i. Enhancing awareness of physicians about the surveillance of encephalitis and suspected cases: testing for West Nile virus infection in suspected cases (such as cases with encephalitis, aseptic  meningitis, acute flaccid paralysis, fever of undetermined etiology) was recommended. . 


ii.Daily communication and information exchange with laboratories conducting diagnostic testing for  West Nile virus. 

iii. The Department of Epidemiological Surveillance and Intervention of HCDCP -within 24 hours- undertakes the investigation of every reported case of West Nile virus disease in order to determine the likely place of exposure, the risk factors and the severity of the disease. 

iv. 

Daily update of stakeholders on the diagnosed cases (Ministry of Health, Ministry of Rural 

Development and Food, Regions, Directorate of Public Health and Social Welfare, National Centre for Blood Donations, National Transplant Organization, laboratories). 

1.2 Entomological surveillance: In 2013, the HCDCP in collaboration with the Department of Parasitology, Entomology and Tropical Diseases of the National School of Public Health is implementing a targeted entomological surveillance program, in the Attica region. According to our findings, we recorded the circulation of West Nile virus in the area since the end of May 2013. Organized expansion of entomological surveillance nationwide has been planned in cooperation with local authorities and the subcontractors of the local mosquito control programs. 


1.3  Collaboration and exchange of information with the Veterinary Public Health (VPH) services of the Ministry of Agriculture, especially regarding WNV infection in equidae. 


1.4. HCDCP is collaborating with the University of Thessaly for the project: “Control of West Nile Virus and Malaria- Strengthening of Surveillance in the Greek territory”, funded by the NSRF (2007-2013). The various work packages include 

the development of geographical information systems (GIS)

the strengthening of epidemiological surveillance for both diseases, 

the mapping of mosquito habitats and mosquito sampling from high-risk areas,

 the strengthening of wild bird and horse monitoring for WNV transmission, 

2. Awareness

2.1. Awareness raising among health professionals by providing guidelines for the recognition and diagnosis of WNV disease and the recommended laboratory investigation of suspected cases (e.g. encephalitis cases). 

      The Hellenic CDC website,  www.keelpno.gr.  includes updated information for health professionals (case definition, instructions for samples, laboratory diagnosis, management) 




2.2. Communication and health promotion activities for the public (schools, healthcare facilities) in 

various areas around the country. 

    The Hellenic CDC website includes educational material for the public regarding the disease and the recommended protective measures against mosquito bites. 


2.3 .informative campaigns addressing the public, especially high-risk groups

professionals who are involved directly with the control and treatment of both diseases




In Greece, year by year 


WEST NILE FEVER DATA, 2014 The figures for the 2014 season are as follows: 74 autochthonous cases were detected in the EU and 136 cases in neighbouring countries. In the EU, cases were reported from the following countries: Austria (1), Greece (15), Hungary (11), Italy (24) and Romania (23). In neighbouring countries, cases were reported in Bosnia and Herzegovina, Israel, Palestine*, the Russian Federation and Serbia. 



86 laboratory confirmed WNV cases in 2013, 

161 cases in 2012,

100 cases in 2011 and

262 cases in 2010

This year the epidemic was significally diminished to less than thwe one third of the number of cases that have occured in Greece, since the start of the WNV epidemic in 2010 Still , the disease of West Nile Virus Infection remains fatal, and there are quite enough Greeks, and people all over the world that have paid with their valuable  life a single insect bite .


     

 Weekly Epidemiological Report Hellenic CDC (HCDCP), October 2013

From the beginning of 2013 until 30/10/2013 (11:00am)        , 

  • 86 laboratory diagnosed cases of WNV infection  have been reported to the Greek CDC, (KEELPNO, HCDCP) , 
  • including 8 deaths, of which
  • 51 presented with neuro-invasive disease 

(WNND, encephalitis and/or meningitis and/or acute flaccid paralysis) and 

  • 35 cases with mild symptoms 

(febrile syndrome)  One more death in a patient with WNND was attributed to other causes.




  West Nile in Greece since 2010


West Nile virus cases surfaced in 2010 and has affected more 500 people . Greece confirmed 262 West Nile cases in 2010, 100 in 2011, and 161 in 2012. Of those 523 cases, 381 (73%) involved neuroinvasive disease. "Based on the observed dynamic in the last 3 years, further human cases can be expected in the coming years", according to the Greek CDC assessement and the ECDC estimation.


The Department of Surveillance and Intervention at the Hellenic CDC ensures the daily communication and information exchange with the laboratories responsible for the testing of West Nile virus cases as well as the daily dissemination of information to stakeholders, i.e. the local/regional public health and vector control authorities (source: Nov.2012 ECDC Mission Report)  

.

ANNUAL EPIDEMIOLOGICAL REPORT WEST NILE VIRUS INFECTION, GREECE, 2012 of the Greek CDC , (HCDC) and check accurately the places and area you might visit this summer for possi previous WNV infections




The West Nile virus infection epidemic in Greece, is now in its fourth year. During the outbreaks in 2010, 2011 and 2012, the same virus was identified.


• The 2010 outbreak occurred from 6 July to 5 October, with the peak in mid-August. The episode involved 262 patients. Cases were primarily reported in northern and central Greece (including central Macedonia)

• The 2011 outbreak took place from 16 July to 18 October, peaking at the end of July. The episode involved 100 patients. Cases were reported in northern, central and southern Greece

• The 2012 outbreak (20 June to 7 October, peaking in the second week of August) involved 161 patients. Cases were mainly reported in Attiki, East and Central Macedonia, and Thrace  (Xanthi, Kavala, Drama). 

Click here to edit text

 

note Special attention should be given to immunosuppressed and elderly patients who are at higher risk of acquiring neuroinvasive disease


Never stop taking precautions
No bug must bite you 
in Greece 

Protection Tips


  • Use a repellent that contains 20% or more DEET for protection that lasts up to several hours. Products containing DEET include Off!, Cutter, Sawyer, and Ultrathon.

  • Always follow product directions and reapply as directed.

  • If you are also using sunscreen, apply sunscreen first and insect repellent second.

  • Prevent mosquito bites.

    • Cover exposed skin by wearing long-sleeved shirts, long pants, and hats.
    • Stay and sleep in screened or air-conditioned rooms.
    • Use a bed net if the area where you are sleeping is exposed to the outdoors.


  • Prevent tick bites

    • Cover exposed skin by wearing long-sleeved shirts, long pants, and hats.
      • Tuck in shirts, tuck pants into socks, and wear closed shoes instead of sandals to prevent bites.                                                  

    • Avoid wooded and brushy areas with high grass, brush, and leaves. Walk in the center of hiking trails.

  • If you are bitten by mosquitoes

  • Avoid scratching mosquito bites.

  • Apply hydrocortisone

  • Find and remove ticks from your body.
    • Bathe or shower as possible after coming indoors.
  • Check your entire body
(under your arms,
 in and around your ears, 
in your belly button, 
behind your knees, 
between your legs, 
around your waist 
and especially in your hair  
                      
    Use a hand-held or full-length mirror to view all parts of your body.

    • Be sure to remove ticks properly.
        • Parents should check their children for ticks.
      • Check your pets and belongings. Ticks can be on outdoor equipment and clothes.                                                         

    Premier Tip for Greece 

    News by Greek2m

     

    West Nile Virus Infection in Belgian Traveler Returning from Greece

    A 73-year-old Belgian woman, who had a medical history of lymphoma, traveled to Kavala city (Macedonia, Greece). On August 14, 2012, she sought treatment at the Kavala General Hospital with a 6-day history of fever, headache, malaise, nausea, confusion, decline of consciousness, and neck stiffness.


    This WNV infection was acquired in Greece speciffically  the Kavala region, which was highly affected by WNV in 2012. The lineage responsible for the WNV encephalitis was identified as lineage 2, the currently circulating strain in Greece.


    The report highlights  the need for physicians and laboratory staff  of all foreign countries to be aware of imported WNV infections originating from southeastern Europe, especially Greece and its neighboring countries, where recent and recurrent outbreaks have occurred (3,4).


    Special attention should be given to immunosuppressed and elderly patients who are at higher risk of acquiring neuroinvasive disease. The 73-year-old patient described here was unconscious when she arrived in Belgium. After a short period of relative improvement (more reactive and cooperative), her condition deteriorated, and she died on November 23, 2012.

    go to US CDC on this story

    go to US CDC on this story


    Transmission in Attica region, has  the Greek CDC since 2013 warned

    Entomological data that the Greek CDC  has recieved up to date in 2013 

    from the region of  Attica, capital's 

    Athens county, suggest that

    in this region the circulation and transmission 

    of West Nile virus for 2013 has started...



    Since 2013 International Press had noted the fatal cut of air spraying budgets in Greece 

    "Even diseases that were thought to have been wiped out in Europe, such as malaria, are making a comeback. In 2011, Greece recorded its first locally transmitted malaria infection since the 1950s. Willem de Jonge from Doctors without Borders in Greece , in an interview with Deutsche Welle puts the blame on politicians.
    The fact that there were a lot of these mosquitoes is due to the fact that the budget from the government to spray the fields and to control the mosquito population had been cut - effectively, completely stopped in 2011. So that allowed the mosquito population to grow to new sizes," the doctor explained .
    DEUTSCHE WELLE, July 19.2013


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    If WNN attacks you, you might not even have any symptoms at all

    No symptoms in most people


    • .Most people (70-80%) who become infected with West Nile virus do not develop any symptoms.


    •  Febrile illness in some people. 

    About 1 in 5 people who are infected will develop a fever with other symptoms such as headache, body aches, joint pains, vomiting, diarrhea, or rash.

    Most people with this type of West Nile virus disease recover completely, but fatigue and weakness can last for weeks or months.


    •  Severe symptoms in a few people. Less than 1% of people who are infected will develop a serious neurological illness such as encephalitis or meningitis (inflammation of the brain or surrounding tissues).

    • The symptoms of neurological illness can include 
    headache, high fever, neck stiffness, disorientation, coma, tremors, seizures, or paralysis.
    Treatment
    • No vaccine or specific antiviral treatments for West Nile virus infection are available.

    • Over-the-counter pain relievers can be used to reduce fever and relieve some symptoms

    • In severe cases, patients often need to be hospitalized to receive supportive treatment, such as intravenous fluids, pain medication, and nursing care.