Pappataci fever

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Pappataci fever
Distribution of pappataci fever by serotype: T, Toscana, S, Sicilian; N, Naples
Specialty Infectious disease   OOjs UI icon edit-ltr-progressive.svg

Pappataci fever (also known as Phlebotomus fever and, somewhat confusingly, sandfly fever and three-day fever) is a vector-borne febrile arboviral infection caused by three serotypes of Phlebovirus. It occurs in subtropical regions of the Eastern Hemisphere. The name, pappataci fever, comes from the Italian word for sandfly, it is the union of the word "pappa" (food) and taci (silent) which distinguishes these insects from blood-feeding mosquitoes, which produce a typical noise while flying.

Vector (epidemiology) agent that carries and transmits an infectious pathogen into another living organism

In epidemiology, a disease vector is any agent which carries and transmits an infectious pathogen into another living organism; most agents regarded as vectors are organisms, such as intermediate parasites or microbes, but it could be an inanimate medium of infection such as dust particles.

Fever common medical sign characterized by elevated body temperature

Fever, also known as pyrexia and febrile response, is defined as having a temperature above the normal range due to an increase in the body's temperature set point. There is not a single agreed-upon upper limit for normal temperature with sources using values between 37.5 and 38.3 °C. The increase in set point triggers increased muscle contractions and causes a feeling of cold. This results in greater heat production and efforts to conserve heat. When the set point temperature returns to normal, a person feels hot, becomes flushed, and may begin to sweat. Rarely a fever may trigger a febrile seizure. This is more common in young children. Fevers do not typically go higher than 41 to 42 °C.

Arbovirus Virus transmitted by arthropod vectors

Arbovirus is an informal name used to refer to any viruses that are transmitted by arthropod vectors. The word arbovirus is an acronym. The word tibovirus is sometimes used to more specifically describe viruses transmitted by ticks, a superorder within the arthropods. Arboviruses can affect both animals and plants. In humans, symptoms of arbovirus infection generally occur 3–15 days after exposure to the virus and last three or four days. The most common clinical features of infection are fever, headache, and malaise, but encephalitis and hemorrhagic fever may also occur.


Signs and symptoms

A few days after the infective bite, a feeling of lassitude, abdominal distress and chills develop followed by fever of 39 °C to 40 °C, 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 few days to several weeks but complete recovery is the rule. [1]

Tachycardia Heart rate that exceeds the normal resting rate

Tachycardia, also called tachyarrhythmia, is a heart rate that exceeds the normal resting rate. In general, a resting heart rate over 100 beats per minute is accepted as tachycardia in adults. Heart rates above the resting rate may be normal or abnormal.

Bradycardia Heart rate that is below the normal range

Bradycardia is a condition typically defined wherein an individual has a resting heart rate of under 60 beats per minute (BPM) in adults. Bradycardia typically does not cause symptoms until the rate drops below 50 BPM. When symptomatic, it may cause fatigue, weakness, dizziness, sweating, and at very low rates, fainting.

Hypotension is low blood pressure, especially in the arteries of the left sided systemic circulation. Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood. A systolic blood pressure of less than 90 millimeters of mercury or diastolic of less than 60 mm Hg is generally considered to be hypotension. However, in practice, blood pressure is considered too low only if noticeable symptoms are present.


Three serotypes of Phlebovirus are known as the causative agents: Naples virus, Sicilian virus and Toscana virus.

Phlebovirus is one of four genera of the family Phenuiviridae in the order Bunyavirales. The genus currently comprises 10 species. It derives its name from Phlebotominae, the vectors of member species Sandfly fever Naples phlebovirus, which is said to be ultimately from the Greek phlebos, meaning "vein". The proper word for "vein" in ancient Greek is however phleps (φλέψ).

Toscana virus (TOSV) is an arbovirus 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 Phlebotomus. Toscana is not normally associated with disease, as indicated by high seroprevalence rates in endemic areas, but in common with other sandfly transmitted viruses such as Naples virus and Sicilian virus, infection may result in Pappataci fever, an illness with mild fever, headache and myalgia. In serious cases that go undiagnosed, acute meningitis, meningoencephalitis and encephalitis may occur. There is no specific treatment for infection, so treatment is supportive, reducing the severity of symptoms until the immune system has cleared the infection.


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 of sandfly bites, and control of sandflies and their breeding grounds with insecticides are the principal methods for prevention. Mosquito nets may not be sufficient to prevent sandfly bites.

Insecticide pesticide used against insects

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 be a major factor behind the increase in the 20th-century's agricultural productivity. Nearly all insecticides have the potential to significantly alter ecosystems; many are toxic to humans and/or animals; some become concentrated as they spread along the food chain.

Mosquito net fine net used to exclude mosquitos and other biting insects

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 diseases they may carry. Examples of such preventable insect-borne diseases include malaria, dengue fever, yellow fever, zika virus and various forms of encephalitis, including the West Nile virus.


There is no specific treatment for the disease. Pain killers and fluid replacement may be useful. [2]


Phlebotomus papatasi taking a bloodmeal Phlebotomus pappatasi bloodmeal continue2.jpg
Phlebotomus papatasi taking a bloodmeal

Pappataci fever is prevalent in the subtropical zone of the Eastern Hemisphere between 20°N and 45°N, [1] particularly in Southern Europe, North Africa, the Balkans, Eastern Mediterranean, Iraq, Iran, Pakistan, Afghanistan and India. [3]

The disease is transmitted by the bites of phlebotomine sandflies of the Genus Phlebotomus , in particular, Phlebotomus papatasi , Phlebotomus perniciosus and Phlebotomus perfiliewi . 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. [1] 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. [4]

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. [5]

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Dengue fever tropical disease caused by the dengue virus, transmitted by mosquito

Dengue fever is a mosquito-borne tropical disease caused by the dengue virus. Symptoms typically begin three to fourteen days after infection. This may include a high fever, headache, vomiting, muscle and joint pains, and a characteristic skin rash. Recovery generally takes two to seven days. In a small proportion of cases, the disease develops into severe dengue, also known as dengue hemorrhagic fever, resulting in bleeding, low levels of blood platelets and blood plasma leakage, or into dengue shock syndrome, where dangerously low blood pressure occurs.

La Crosse encephalitis is an encephalitis caused by an arbovirus which has a mosquito vector.

Tick-borne diseases, which afflict humans and other animals, are caused by infectious agents transmitted by tick bites. Tick-borne illnesses are caused by infection with a variety of pathogens, including rickettsia and other types of bacteria, viruses, and protozoa. Because individual ticks can harbor more than one disease-causing agent, patients can be infected with more than one pathogen at the same time, compounding the difficulty in diagnosis and treatment. As of 2016, 16 tick-borne diseases of humans are known.

Sandfly name of several types of biting fly

Sandfly is a colloquial name for any species or genus of flying, biting, blood-sucking dipteran (fly) encountered in sandy areas. In the United States, sandfly may refer to certain horse flies that are also known as "greenheads", or to members of the family Ceratopogonidae, also known in Florida and elsewhere as a sand gnat, sandflea, granny nipper, chitra, punkie, or punky. Outside the United States, sandfly may refer to members of the subfamily Phlebotominae within the Psychodidae. Biting midges (Ceratopogonidae) are sometimes called sandflies or no-see-ums. New Zealand sandflies are in the genus Austrosimulium, a type of black fly.

<i>Lutzomyia</i> genus of insects

Lutzomyia is a genus of phlebotomine sand flies consisting of nearly 400 species, at least 33 of which have medical importance as vectors of human disease. Species of the genus Lutzomyia are found only in the New World, distributed in southern areas of the Nearctic and throughout the Neotropic zone. Lutzomyia is one of the two genera of the subfamily Phlebotominae to transmit the Leishmania parasite, with the other being Phlebotomus, found only in the Old World. Lutzomyia sand flies also serve as vectors for the bacterial Carrion’s disease and a number of arboviruses.

<i>Phlebotomus</i> genus of insects

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.

Medical entomology study of insect impacts on human health

The discipline of medical entomology, or public health entomology, and also veterinary entomology is focused upon insects and arthropods that impact human health. Veterinary entomology is included in this category, because many animal diseases can "jump species" and become a human health threat, for example, bovine encephalitis. Medical entomology also includes scientific research on the behavior, ecology, and epidemiology of arthropod disease vectors, and involves a tremendous outreach to the public, including local and state officials and other stake holders in the interest of public safety, finally in current situation related to one health approach mostly health policy makers recommends to widely applicability of medical entomology for disease control efficient and best fit on achieving development goal and to tackle the newly budding zoonotic diseases. Thoughtful to have and acquaint with best practice of Med. Entomologist to tackle the animal and public health issues together with controlling arthropods born diseases by having Medical Entomologists’ the right hand for bringing the healthy world [Yon w].

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Jamestown Canyon encephalitis is an infectious disease caused by the Jamestown Canyon virus, an orthobunyavirus of the California serogroup. It is mainly spread during the summer by different mosquito species in the United States and Canada.

The Keystone virus is a mosquito-borne virus which can infect mammals. It was first discovered in animals in the Florida area, where it is spread in part by local species of Aedes mosquitoes. In 1964, a case of human infection, producing minor symptoms of a rash and fever, was circumstantially diagnosed. Conclusive laboratory demonstration of the virus in humans was first obtained and reported in 2018.


  1. 1 2 3 Encyclopædia Britannica. "Pappataci fever" . Retrieved 2009-07-03.
  2. Tavana AM. Sandfly fever in the world. Ann Trop Med Public Health 2015;8:83–7
  3. Gratz N.G. (2004). The vector-borne human diseases in Europe. Their distribution and burden on public health (PDF). Copenhagen, Denmark. pp. 25–6.
  4. Tesh, R.B. (1984). "Transovarial transmission of arboviruses in their invertebrate vectors". In K.F. Harris (ed.). Current topics in vector research. 2. pp. 57–76. ISBN   0-275-91433-X. Archived from the original on 2012-12-20.
  5. Sabin A.B. (1955). "Recent advances in our knowledge of dengue and sandfly fever". American Journal of Tropical Medicine and Hygiene. 4 (2): 198–207. doi:10.4269/ajtmh.1955.4.198. PMID   14361897.