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Tzani M, Barrasa A, Vakali A, Georgakopoulou T, Mellou K, Pervanidou D. Surveillance data for human leishmaniasis indicate the need for a sustainable action plan for its management and control, Greece, 2004 to 2018. ACTA ACUST UNITED AC 2021; 26. [PMID: 33960290 PMCID: PMC8103731 DOI: 10.2807/1560-7917.es.2021.26.18.2000159] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background The World Health Organization (WHO) lists human leishmaniasis as a neglected tropical disease; it is not under surveillance at European level. Aim We present surveillance data for visceral (VL) and cutaneous (CL) leishmaniasis for the period 2004 to 2018 in Greece to assess their public health importance. Methods We extracted data from the mandatory notification system to analyse separately imported and domestic cases of VL and CL. A case was defined by clinical manifestations compatible with VL or CL and laboratory confirmation. Results Between 2004 and 2018, 881 VL (862 domestic, 19 imported) and 58 CL cases (24 domestic, 34 imported) were recorded. The mean annual notification rate of domestic VL was 0.5 per 100,000 (range: 0.12–1.43/100,000) with a statistically significant increasing trend (p = 0.013). Cases were reported by all regions. The highest notification rate occurred in the age group 0–4 years (1.3/100,000). Overall 24% (164/680) of the cases were immunocompromised and their proportion increased after 2010 (p < 0.001). The mean annual notification rate of domestic CL was 0.05 per 100,000 (range: 0.01–0.19/100,000) with the highest rate in the age group 5–14 years (0.03/100,000). Cases were recorded in six of the 13 regions. Among 34 imported CL cases, 29 were foreign nationals. Conclusion VL is endemic in Greece, with an increasing trend and a considerable burden of severe disease and young children being most affected. CL is rarely reported. A sustainable action plan is needed to reduce the burden of VL and prevent local transmission of CL.
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Affiliation(s)
- Myrsini Tzani
- National Public Health Organisation (EODY), Athens, Greece.,European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Alicia Barrasa
- Epiet (European Programme for Intervention Epidemiology Training) scientific coordinator, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Annita Vakali
- National Public Health Organisation (EODY), Athens, Greece
| | | | - Kassiani Mellou
- These authors contributed equally to this article.,National Public Health Organisation (EODY), Athens, Greece
| | - Danai Pervanidou
- These authors contributed equally to this article.,National Public Health Organisation (EODY), Athens, Greece
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2
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Mandilara G, Sideroglou T, Chrysostomou A, Rentifis I, Papadopoulos T, Polemis M, Tzani M, Tryfinopoulou K, Mellou K. The Rising Burden of Salmonellosis Caused by Monophasic Salmonella Typhimurium (1,4,[5],12:i:-) in Greece and New Food Vehicles. Antibiotics (Basel) 2021; 10:antibiotics10020185. [PMID: 33668483 PMCID: PMC7917691 DOI: 10.3390/antibiotics10020185] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/29/2021] [Accepted: 02/10/2021] [Indexed: 12/20/2022] Open
Abstract
Monophasic Salmonella typhimurium is of increasing importance worldwide. Here we present the available data regarding monophasic S. typhimurium from 2007 to 2019 in Greece, in order to assess its public health impact. Surveillance data, data on antimicrobial resistance, molecular typing by pulsed-field gel electrophoresis (PFGE), and results of the investigation of monophasic S. typhimurium outbreaks were analyzed. Overall, 403 cases were identified; 329 (81.6%) sporadic and 74 (18.4%) related to two community outbreaks in 2017. A total of 305 isolates from sporadic cases tested for antimicrobial resistance revealed resistance to ampicillin, streptomycin, sulphamethoxazole, and tetracycline (41.3%). Some 23.3% were further resistant to trimethoprim and 5.2% were also resistant to chloramphenicol. Outbreak 1 in 2017 with 37 identified cases was attributed to the consumption of raw milk from a vending machine and isolates were resistant to ampicillin, streptomycin, sulphamethoxazole, tetracycline, and trimethoprim. Outbreak 2 also with 37 cases was attributed to the consumption of pork and isolates were resistant to the five above mentioned antibiotics plus chloramphenicol. The number of human monophasic S. typhimurium isolates is low; however, since 2009, it has been among the five most frequently identified serotypes in Greece. Investigation of the outbreaks revealed that other vehicles apart from pork may be implicated in the occurrence of outbreaks.
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Affiliation(s)
- Georgia Mandilara
- National Reference Centre for Salmonella, Faculty of Public Health Policies, School of Public Health, University of West Attica and Athens, 12243 Egaleo, Greece; (G.M.); (I.R.)
| | - Theologia Sideroglou
- Department of Foodborne and Waterborne Diseases, National Public Health Organization, 15123 Athens, Greece; (T.S.); (A.C.)
| | - Anthi Chrysostomou
- Department of Foodborne and Waterborne Diseases, National Public Health Organization, 15123 Athens, Greece; (T.S.); (A.C.)
| | - Iliodoros Rentifis
- National Reference Centre for Salmonella, Faculty of Public Health Policies, School of Public Health, University of West Attica and Athens, 12243 Egaleo, Greece; (G.M.); (I.R.)
| | - Theofilos Papadopoulos
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, (ECDC), 17165 Stockholm, Sweden; (T.P.); (M.T.)
- Department of Epidemiology and Public Health, Sciensano, 1050 Brussels, Belgium
| | - Michalis Polemis
- Central Laboratory of Public Health, National Public Health Organization, Vari, 16672 Attica, Greece; (M.P.); (K.T.)
| | - Myrsini Tzani
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control, (ECDC), 17165 Stockholm, Sweden; (T.P.); (M.T.)
| | - Kyriaki Tryfinopoulou
- Central Laboratory of Public Health, National Public Health Organization, Vari, 16672 Attica, Greece; (M.P.); (K.T.)
| | - Kassiani Mellou
- Department of Foodborne and Waterborne Diseases, National Public Health Organization, 15123 Athens, Greece; (T.S.); (A.C.)
- Correspondence:
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3
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Tzani M, Mandilara G, Dias JG, Sideroglou T, Chrysostomou A, Mellou K. Impact of Salmonella Control Programmes in Poultry on Human Salmonellosis Burden in Greece. Antibiotics (Basel) 2021; 10:antibiotics10020121. [PMID: 33525354 PMCID: PMC7912426 DOI: 10.3390/antibiotics10020121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 01/23/2021] [Accepted: 01/26/2021] [Indexed: 11/16/2022] Open
Abstract
Since 2008, veterinary authorities in Greece have implemented national control programmes (NSCPs) targeting S. Enteritidis (SE) and S. Typhimurium (ST) in poultry. We assessed the effect of the programs on the reported number of human isolates. Using monthly data for 2006–2017, we defined two groups (SE, ST) and one control group with serotypes unrelated to poultry or eggs. For SE we also analysed data for 2006–2015 due to a multi-county SE outbreak in 2016. We performed an interrupted time series analysis and used a negative binominal regression model. For both SE and ST, there was no significant trend of the isolation rate before or after NSCPs’ introduction. After the NSCPs’ introduction there was an increasing rate (IRR: 1.005, 95% CI: 1.001–1.008) for control serotypes and a decreasing one for SE (IRR: 0.990, 95% CI: 0.986–0.995) (for 2009 to 2015 analysis). From 2006 to 2017, NSCPs had a statistically significant impact on the number of SE isolates that decreased by 49% (IRR:0.511, 95% CI: 0.353–0.739). No impact was shown on the number of ST (p-value = 0.741) and control isolates (p = 0.069). As a conclusion, NSCP’s implementation was associated with decreased SE isolates and overall burden of salmonellosis; however further measures aiming at human salmonellosis due to ST, should be considered.
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Affiliation(s)
- Myrsini Tzani
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), 169 73 Stockholm, Sweden
- Department of Foodborne and Waterborne Diseases, Hellenic National Public Health Organisation (EODY), 3-5 Agrafon Str., 15123 Marousi-Attiki, Greece; (T.S.); (A.C.)
- Correspondence: (M.T.); (K.M.); Tel.: +30-6932645642 (M.T.); +30-6974438453 (K.M.)
| | - Georgia Mandilara
- National Reference Centre for Salmonella, Department of Public Health Policy, School of Public Health, University of West Attica, 196 Alexandras Ave., 11521 Athens, Greece;
| | - Joana Gomes Dias
- European Centre for Disease Prevention and Control (ECDC), Gustav III:s Boulevard 40, 169 73 Solna, Sweden;
| | - Theologia Sideroglou
- Department of Foodborne and Waterborne Diseases, Hellenic National Public Health Organisation (EODY), 3-5 Agrafon Str., 15123 Marousi-Attiki, Greece; (T.S.); (A.C.)
| | - Anthi Chrysostomou
- Department of Foodborne and Waterborne Diseases, Hellenic National Public Health Organisation (EODY), 3-5 Agrafon Str., 15123 Marousi-Attiki, Greece; (T.S.); (A.C.)
| | - Kassiani Mellou
- Department of Foodborne and Waterborne Diseases, Hellenic National Public Health Organisation (EODY), 3-5 Agrafon Str., 15123 Marousi-Attiki, Greece; (T.S.); (A.C.)
- Correspondence: (M.T.); (K.M.); Tel.: +30-6932645642 (M.T.); +30-6974438453 (K.M.)
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4
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Dougas G, Mavrouli M, Vrioni G, Lytras T, Mellou K, Metallidis S, Istikoglou I, Mitrou K, Tzani M, Georgopoulou I, Tsalikoglou F, Garetsou E, Poulakou G, Giannitsioti E, Moschopoulos C, Baka A, Georgakopoulou T, Tsiodras S, Tsakris A. Antibody Response Following Pre-Exposure Immunization Against Rabies in High-Risk Professionals. Vector Borne Zoonotic Dis 2019; 20:303-309. [PMID: 31794689 DOI: 10.1089/vbz.2019.2526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Vaccination against rabies and routine antibody testing of subjects participating in programs for the surveillance and control of rabies in animals is strongly recommended. The scope of this study is to describe the antibody level as measured by a commercial enzyme-linked immunosorbent assay (ELISA) after primary and booster intramuscular vaccination with a purified vero-cell rabies vaccine (PVRV) in high-risk professionals and to determine the influence of an array of factors on antibody level, that is, time elapsed since primary immunization series and booster dose, sex, age, pathologic conditions, high-risk occupation, and peak antibody level after initial scheme and booster dose. A primary series of three doses of PVRV was administered and a commercial ELISA was recommended 14 days postimmunization with continuous repetition at 6 months and yearly intervals for the laboratory personnel and the rest of the professionals, respectively. The protective antibody titer was defined as a minimum of 0.5 equivalent units/mL (EU/mL) (seroconvertion) and a booster dose was applied if the titer was determined nonprotective. The seroconversion rate (SCR) after primary vaccination was 100%, with a geometric mean titer (GMT) of 2.90 EU/mL (interquartile range [IQR]: 1.85-3.45). After booster vaccination due to nonprotective titer, the SCR was 100% and the GMT increased by 678% (95% confidence interval [CI]: 514-887) reaching 4.25 EU/mL (IQR: 4.00-4.60), 2.5 times higher than the GMT elicited by the primary vaccine scheme in the respective recipients. The titer dropped by 1.20% per month (95% CI: 0.52-1.89) regardless of booster administration or any other factor. Women had 51% higher titer compared with men (95% CI: 6-116). High-risk professionals should be verified for adequate antibody titers, but routine administration of a single booster dose of PVRV 1 year after the primary series could be considered; more evidence is needed to support the benefit in terms of immunity and logistics.
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Affiliation(s)
| | - Maria Mavrouli
- Department of Microbiology, Medical School, University of Athens, Athens, Greece
| | - Georgia Vrioni
- Department of Microbiology, Medical School, University of Athens, Athens, Greece
| | | | | | - Symeon Metallidis
- Infectious Diseases Division, 1st Internal Medicine Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Istikoglou
- Infection Control Committee, "AHEPA" University Hospital, Thessaloniki, Greece
| | | | - Myrsini Tzani
- Department of Zoonoses, Animal Health Directorate, Directorate General of Veterinary Services, Ministry of Rural Development and Food, Athens, Greece
| | - Ioanna Georgopoulou
- Department of Zoonoses, Animal Health Directorate, Directorate General of Veterinary Services, Ministry of Rural Development and Food, Athens, Greece
| | | | | | - Garyfallia Poulakou
- "Attikon" Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Efthymia Giannitsioti
- "Attikon" Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Charalampos Moschopoulos
- "Attikon" Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Agoritsa Baka
- European Centre for Disease Prevention and Control, Solna, Sweden
| | | | - Sotirios Tsiodras
- National Public Health Organization, Athens, Greece.,"Attikon" Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Athanassios Tsakris
- Department of Microbiology, Medical School, University of Athens, Athens, Greece
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5
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Dougas G, Konte V, Mitrou K, Christodoulou E, Stavrakakis M, Baka A, Georgakopoulou T, Metallidis S, Istikoglou I, Pargiana C, Liona A, Tsalikoglou F, Tzani M, Korou M, Tasioudi K, Mavrouli M, Vrioni G, Tsiodras S. 661. Surveillance of Rabies Prophylactic Treatments After Exposure to Animals: 5 Years Experience. Open Forum Infect Dis 2018. [PMCID: PMC6255578 DOI: 10.1093/ofid/ofy210.668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Rabies re-emerged in Greek fauna in October 2012, 25 years after the last report in animals. Hellenic Center for Disease Control & Prevention developed a semi-active surveillance system to monitor the medical management of potentially exposed persons to rabies. This study aims to providing insight on the biologicals administered and the epidemiological characteristics of the cases where post-exposure prophylaxis was initiated after contact with animals. Methods Data received from November 2012 to December 2017 on demographics, exposure event, animal species involved, category of exposure (COE) according to WHO, vaccination history, the veterinary evaluation of the animal and the type of treatment administered, were analyzed with Epidata Analysis V.2.2.2.180. Results A total of 1,616 cases (63.2% males) received rabies post-exposure prophylaxis. In 94.7% of cases cleansing of the wound before visiting a medical practitioner took place during the first 3 hours after the exposure whereas 75.1% of victims presented at a healthcare setting during the first 24 hours; COE III cases had shorter time interval (P < 0.01), before arrival at a hospital (mdn = 1.3 hours) compared with COE II (mdn = 3.6 hours) or COE I (mdn = 88.2 hours) (Figure 1); ![]()
55.1% were initiated on a vaccine series, 43.1% received both vaccine and immunoglobulin and 1.7% immunoglobulin alone. Exposure to stray dogs represented 67.3% of all incidents (Table 1). No human case was recorded. Conclusion The vast majority of the reported treatments involved stray dogs as Greek legislation permits free roaming of ownerless companion animals in urban settings. Bat was the fourth most frequently reported species in our treatment series. Surveillance of post-exposure prophylaxis represents a valuable tool for outlining the epidemiological profile of treated cases and for planning of effective policies for the management of rabies. Disclosures All authors: No reported disclosures.
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Affiliation(s)
- Georgios Dougas
- Hellenic Center for Disease Control and Prevention, Athens, Greece
| | - Vasileia Konte
- Hellenic Center for Disease Control and Prevention, Athens, Greece
| | | | - Emmanuel Christodoulou
- Department of Internal Medicine, Papanikolaou General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Michail Stavrakakis
- Department of Internal Medicine, Papanikolaou General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Agoritsa Baka
- Hellenic Center for Disease Control and Prevention, Athens, Greece
| | | | - Symeon Metallidis
- Internal Medicine Department, Infectious Diseases Division, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Istikoglou
- Infection Control Committee, “AHEPA” University Hospital, Thessaloniki, Greece
| | - Chrysa Pargiana
- Infectious Diseases Hospital of Thessaloniki, Thessaloniki, Greece
| | - Aikaterini Liona
- Hellenic Center for Disease Control and Prevention, Athens, Greece
| | | | - Myrsini Tzani
- Department of Zoonoses, Animal Health Directorate, Directorate General of Veterinary Services, Ministry of Rural Development and Food, Athens, Greece
| | - Marilina Korou
- Department of Zoonoses, Animal Health Directorate, Directorate General of Veterinary Services, Ministry of Rural Development and Food, Athens, Greece
| | - Konstantia Tasioudi
- Virology Laboratory – National Reference Laboratory for Rabies in animals, Department of Molecular Diagnostics, FMD, Virological, Rickettsial & Exotic Diseases, Athens Veterinary Center, Ministry of Rural Development and Food, Athens, Greece
| | - Maria Mavrouli
- Department of Microbiology, Medical School, University of Athens, Athens, Greece
| | - Georgia Vrioni
- Department of Microbiology, Medical School, University of Athens, Athens, Greece
| | - Sotirios Tsiodras
- National and Kapodistrian University of Athens Medical School, Athens, Greece
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6
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Dougas G, Konte V, Mitrou K, Georgakopoulou T, Baka A, Liona A, Tatsiou D, Metallidis S, Istikoglou I, Christodoulou E, Stavrakakis M, Pargiana C, Tsalikoglou F, Tzani M, Korou LM, Tasioudi K, Mavrouli M, Vrioni G, Tsiodras S. Surveillance of Rabies Postexposure Prophylaxis in Greece: 4 Years Experience. Vector Borne Zoonotic Dis 2018; 19:295-301. [PMID: 30251935 DOI: 10.1089/vbz.2018.2344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Rabies reemerged in Greek fauna during October 2012, 25 years after the last report in animals and 42 after the last human case. This study examined the administration of rabies postexposure prophylaxis (PEP) in humans over the period 2012-2016. A total of 1,454 individuals (62.6% males) received PEP. The vast majority (92.3%) of regimens was initiated in high risk for animal rabies areas (11.1 PEP per 100,000 residents per year). Among the exposed, 77.0% presented at a healthcare setting during the first 24 h after the incident; more severe injuries were associated with faster presentation (p < 0.05). A vaccine series was administered in 54.5% of exposed persons whereas 43.7% received both vaccine and immunoglobulin and 1.7% immunoglobulin only. Exposure to stray dogs represented 68.4% of all incidents. In exposures occurring in nonhigh risk for rabies areas, bat was the second most frequently involved animal (13.4% of incidents). All dogs and cats evaluated by a veterinarian and laboratory-confirmed rabid were initially deemed suspect for rabies during clinical examination or according to history. No human rabies cases were recorded during the period of the study. Surveillance of PEP represents a valuable tool for aiding assessment of present and future demands in prophylaxis biologicals, outlining the epidemiological profile of exposures and planning effective policies for the management of exposure incidents.
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Affiliation(s)
- Georgios Dougas
- 1 Hellenic Center for Disease Control and Prevention, Athens, Greece
| | - Vasileia Konte
- 1 Hellenic Center for Disease Control and Prevention, Athens, Greece
| | | | | | - Agoritsa Baka
- 1 Hellenic Center for Disease Control and Prevention, Athens, Greece
| | - Aikaterini Liona
- 1 Hellenic Center for Disease Control and Prevention, Athens, Greece
| | - Dimitra Tatsiou
- 1 Hellenic Center for Disease Control and Prevention, Athens, Greece
| | - Symeon Metallidis
- 2 First Internal Medicine Department, Infectious Diseases Division, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Istikoglou
- 3 Infection Control Committee, "AHEPA" University Hospital, Thessaloniki, Greece
| | - Emmanuel Christodoulou
- 4 Department of Internal Medicine, "G. Papanikolaou" General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Michalis Stavrakakis
- 4 Department of Internal Medicine, "G. Papanikolaou" General Hospital of Thessaloniki, Thessaloniki, Greece
| | - Chrysa Pargiana
- 5 Infectious Diseases Hospital of Thessaloniki, Thessaloniki, Greece
| | | | - Myrsini Tzani
- 7 Department of Zoonoses, Animal Health Directorate, Directorate General of Veterinary Services, Ministry of Rural Development and Food, Athens, Greece
| | - Laskarina-Maria Korou
- 7 Department of Zoonoses, Animal Health Directorate, Directorate General of Veterinary Services, Ministry of Rural Development and Food, Athens, Greece
| | - Konstantia Tasioudi
- 8 Virology Laboratory - National Reference Laboratory for Rabies in Animals, Department of Molecular Diagnostics, FMD, Virological, Rickettsial & Exotic Diseases, Athens Veterinary Center, Ministry of Rural Development and Food, Athens, Greece
| | - Maria Mavrouli
- 9 Department of Microbiology, Medical School, University of Athens, Athens, Greece
| | - Georgia Vrioni
- 9 Department of Microbiology, Medical School, University of Athens, Athens, Greece
| | - Sotirios Tsiodras
- 10 National and Kapodistrian University of Athens Medical School, Athens, Greece
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7
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Papatheodorou DP, Tasioudi KE, Korou LM, Georgiou V, Iliadou P, Markantonatos G, Kirtzalidou A, Tzani M, Chondrokouki E, Mangana-Vougiouka O. First four Oral Rabies Vaccination campaigns of the red foxes in Greece: Evaluating factors and assessment. Vet Microbiol 2018. [PMID: 29519504 DOI: 10.1016/j.vetmic.2018.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Following the last animal rabies outbreak in Greece in 2012, Oral Rabies Vaccination (ORV) campaigns of red foxes (Vulpes vulpes) were conducted in order to halt the spread of the disease, as widely and effectively have also been implemented in other countries. The present study aims to report the main outcomes following the first Greek ORV campaigns during autumn 2013, 2014, 2015 and spring 2016, to assess their effectiveness and to investigate factors potentially related to their success. Blood samples, mandible bones and teeth, derived by 452 foxes, were tested for rabies antibody titration, animal age determination and tetracycline (TTC) detection. The laboratory results obtained were statistically analyzed. High seroprevalence and TTC detection rates were obtained following the autumn campaigns studied, while these rates were significantly reduced following the spring campaign. The year or the season of the vaccination campaign, the estimated age group of the animal and the geographical Regional Unit (RU), where the animal was hunted, were identified as important factors. On the contrary, no significance could be ascertained for TTC detection based on exclusively previous uptake, use of filter paper, blood sample type and quality, as well as sex of animal. Based on the monitoring results achieved, the first ORV campaigns conducted in the country can be generally considered to be satisfactory. No positives cases were detected since May 2014. Seasonal, geographical parameters and factors related to fox ecology may interfere with monitoring results and should be always considered when planning future ORV programs.
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Affiliation(s)
- Dimos P Papatheodorou
- Virology Laboratory-National Reference Laboratory for Rabies in Animals, Department of Molecular Diagnostics, FMD, Virological, Rickettsial & Exotic Diseases, Directorate of Veterinary Center of Athens, Directorate General of Veterinary Services, Ministry of Rural Development and Food, Athens, Greece.
| | - Konstantia E Tasioudi
- Virology Laboratory-National Reference Laboratory for Rabies in Animals, Department of Molecular Diagnostics, FMD, Virological, Rickettsial & Exotic Diseases, Directorate of Veterinary Center of Athens, Directorate General of Veterinary Services, Ministry of Rural Development and Food, Athens, Greece
| | - Laskarina-Maria Korou
- Department of Zoonoses, Animal Health Directorate, Directorate General of Veterinary Services, Ministry of Rural Development and Food, Athens, Greece
| | | | - Peristera Iliadou
- Virology Laboratory-National Reference Laboratory for Rabies in Animals, Department of Molecular Diagnostics, FMD, Virological, Rickettsial & Exotic Diseases, Directorate of Veterinary Center of Athens, Directorate General of Veterinary Services, Ministry of Rural Development and Food, Athens, Greece
| | - Gerasimos Markantonatos
- Virology Laboratory-National Reference Laboratory for Rabies in Animals, Department of Molecular Diagnostics, FMD, Virological, Rickettsial & Exotic Diseases, Directorate of Veterinary Center of Athens, Directorate General of Veterinary Services, Ministry of Rural Development and Food, Athens, Greece
| | - Aikaterini Kirtzalidou
- Virology Laboratory-National Reference Laboratory for Rabies in Animals, Department of Molecular Diagnostics, FMD, Virological, Rickettsial & Exotic Diseases, Directorate of Veterinary Center of Athens, Directorate General of Veterinary Services, Ministry of Rural Development and Food, Athens, Greece
| | - Myrsini Tzani
- Department of Zoonoses, Animal Health Directorate, Directorate General of Veterinary Services, Ministry of Rural Development and Food, Athens, Greece
| | - Eleni Chondrokouki
- Virology Laboratory-National Reference Laboratory for Rabies in Animals, Department of Molecular Diagnostics, FMD, Virological, Rickettsial & Exotic Diseases, Directorate of Veterinary Center of Athens, Directorate General of Veterinary Services, Ministry of Rural Development and Food, Athens, Greece
| | - Olga Mangana-Vougiouka
- Virology Laboratory-National Reference Laboratory for Rabies in Animals, Department of Molecular Diagnostics, FMD, Virological, Rickettsial & Exotic Diseases, Directorate of Veterinary Center of Athens, Directorate General of Veterinary Services, Ministry of Rural Development and Food, Athens, Greece
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8
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Tasioudi KE, Korou LM, Iliadou P, Agianniotaki EI, Kostoglou P, Tzani M, Anastasiadis I, Athanasiadis I, Doudounakis S, Mangana-Vougiouka O. Bovine rabies in Greece in 2013. Vet Rec 2015; 177:598. [PMID: 26612858 DOI: 10.1136/vr.103434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2015] [Indexed: 11/03/2022]
Affiliation(s)
- K E Tasioudi
- Virology Laboratory, Department of Molecular Diagnostics, FMD, Virological, Rickettsial and Exotic Diseases, Athens Veterinary Center, Ministry of Rural Development and Food, Athens, Greece
| | - L M Korou
- Animal Health Directorate, Ministry of Rural Development and Food, Athens, Greece
| | - P Iliadou
- Virology Laboratory, Department of Molecular Diagnostics, FMD, Virological, Rickettsial and Exotic Diseases, Athens Veterinary Center, Ministry of Rural Development and Food, Athens, Greece
| | - E I Agianniotaki
- Virology Laboratory, Department of Molecular Diagnostics, FMD, Virological, Rickettsial and Exotic Diseases, Athens Veterinary Center, Ministry of Rural Development and Food, Athens, Greece
| | - P Kostoglou
- Animal Health Directorate, Ministry of Rural Development and Food, Athens, Greece
| | - M Tzani
- Animal Health Directorate, Ministry of Rural Development and Food, Athens, Greece
| | - I Anastasiadis
- Veterinary Department, Regional Unit of Kilkis, Kilkis, Greece
| | - I Athanasiadis
- Veterinary Department, Regional Unit of Kilkis, Kilkis, Greece
| | - S Doudounakis
- Animal Health Directorate, Ministry of Rural Development and Food, Athens, Greece
| | - O Mangana-Vougiouka
- Virology Laboratory, Department of Molecular Diagnostics, FMD, Virological, Rickettsial and Exotic Diseases, Athens Veterinary Center, Ministry of Rural Development and Food, Athens, Greece
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9
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Korou LM, Tasioudi KE, Tzani M, Konstantinidis A, Plevraki A, Iliadou P, Kostoglou P, Kaimaras D, Doudounakis S, Mangana-Vougiouka O. Evaluation of the first oral rabies vaccination campaign of the red foxes in Greece. Vaccine 2015; 34:41-8. [PMID: 26616552 DOI: 10.1016/j.vaccine.2015.11.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 10/31/2015] [Accepted: 11/12/2015] [Indexed: 11/17/2022]
Abstract
Following the late 2012 recurrence of rabies in wild foxes (Vulpes vulpes) in central and north-western Greece, the first oral fox vaccination campaign co-financed by the European Union (EU) and the Greek state budget, was implemented. Initially, it involved 24 regional units of the Greek territory during the period October-December 2013. Vaccine-baits were aerially distributed by fixed-wing aircrafts. Vaccines were scattered along parallel flight paths 500m apart in order to optimize aerial missions and achieve homogeneous distribution. A geographical information system was used to objectively evaluate bait distribution. This system identified areas of inadequate bait density that would require additional flights. A total number of 1,504,821 baits were distributed covering an area of 54,584.29km(2). To assess the effectiveness of oral vaccination campaign a monitoring program was introduced, which entailed examination of serum samples and canine teeth derived from red foxes collected in the field. The laboratory analysis revealed 60% seropositivity and detection of tetracycline biomarker in 70% of the foxes tested.
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Affiliation(s)
| | - Konstantia E Tasioudi
- Virology Laboratory, Department of Molecular Diagnostics, FMD, Virological, Rickettsial and Exotic Diseases, Athens Veterinary Center, Ministry of Rural Development and Food, Athens, Greece
| | - Myrsini Tzani
- Animal Health Directorate, Ministry of Rural Development and Food, Athens, Greece
| | | | | | - Peristera Iliadou
- Virology Laboratory, Department of Molecular Diagnostics, FMD, Virological, Rickettsial and Exotic Diseases, Athens Veterinary Center, Ministry of Rural Development and Food, Athens, Greece
| | - Petroula Kostoglou
- Animal Health Directorate, Ministry of Rural Development and Food, Athens, Greece
| | - Dimitrios Kaimaras
- Directorate of Technical Studies, Structures and Topography, Ministry of Rural Development and Food, Athens, Greece
| | - Spyridon Doudounakis
- Animal Health Directorate, Ministry of Rural Development and Food, Athens, Greece
| | - Olga Mangana-Vougiouka
- Virology Laboratory, Department of Molecular Diagnostics, FMD, Virological, Rickettsial and Exotic Diseases, Athens Veterinary Center, Ministry of Rural Development and Food, Athens, Greece
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10
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Tsiodras S, Korou LM, Tzani M, Tasioudi KE, Kalachanis K, Mangana-Vougiouka O, Rigakos G, Dougas G, Seimenis AM, Kontos V. Rabies in Greece; historical perspectives in view of the current re-emergence in wild and domestic animals. Travel Med Infect Dis 2014; 12:628-35. [PMID: 25459432 DOI: 10.1016/j.tmaid.2014.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 09/25/2014] [Accepted: 10/14/2014] [Indexed: 10/24/2022]
Abstract
Greece has been rabies free since 1987 while no human cases have been seen since 1970. The re-emergence of rabies in Northern Greece during 2012-2013 in wild and domestic animals prompted a systematic review of historical evidence of the presence of the disease in the country from ancient years till the present. Historical data is presented along with efforts to prevent disease in animals and humans especially during the high prevalent periods in the country in the mid-20th century. These efforts serve as a guide to current extensive efforts to prevent spread especially in the wild and domestic animal populations.
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Affiliation(s)
- Sotirios Tsiodras
- Hellenic Center for Disease Control and Prevention, Athens, Greece; National and Kapodistrian University of Athens Medical School, Athens, Greece.
| | - Laskarina-Maria Korou
- Department of Zoonoses, Animal Health Directorate, Directorate General of Veterinary Services, Ministry of Rural Development and Food, Athens, Greece
| | - Myrsini Tzani
- Department of Zoonoses, Animal Health Directorate, Directorate General of Veterinary Services, Ministry of Rural Development and Food, Athens, Greece
| | - Konstantia E Tasioudi
- Virology Department, Institute of Infectious and Parasitic Diseases, Athens Center of Veterinary Institutes, Ministry of Rural Development and Food, Athens, Greece
| | - Kostantinos Kalachanis
- University of Athens, Faculty of Physics, Department of Astrophysics-Astronomy-Mechanics, Athens, Greece
| | - Olga Mangana-Vougiouka
- Virology Department, Institute of Infectious and Parasitic Diseases, Athens Center of Veterinary Institutes, Ministry of Rural Development and Food, Athens, Greece
| | - George Rigakos
- Hellenic Center for Disease Control and Prevention, Athens, Greece
| | - George Dougas
- Hellenic Center for Disease Control and Prevention, Athens, Greece
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11
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Tsiodras S, Dougas G, Baka A, Billinis C, Doudounakis S, Balaska A, Georgakopoulou T, Rigakos G, Kontos V, Tasioudi KE, Tzani M, Tsarouxa P, Iliadou P, Mangana-Vougiouka O, Iliopoulos D, Sapounas S, Efstathiou P, Tsakris A, Hadjichristodoulou C, Kremastinou J. Re-emergence of animal rabies in northern Greece and subsequent human exposure, October 2012 – March 2013. Euro Surveill 2013. [DOI: 10.2807/ese.18.18.20474-en] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Greece has been rabies-free since 1987 with no human cases since 1970. During 2012 to 2013, rabies has re-emerged in wild and domestic animals in northern Greece. By end March 2013, rabies was diagnosed in 17 animals including 14 red foxes, two shepherd dogs and one cat; 104 subsequent human exposures required post-exposure prophylaxis according to the World Health Organization criteria. Human exposures occurred within 50 km radius of a confirmed rabies case in a wild or domestic animal, and most frequently stray dogs were involved.
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Affiliation(s)
- S Tsiodras
- National and Kapodistrian University of Athens Medical School, Athens, Greece
- Hellenic Center for Disease Control and Prevention (KEELPNO), Ministry of Health, Athens, Greece
| | - G Dougas
- Hellenic Center for Disease Control and Prevention (KEELPNO), Ministry of Health, Athens, Greece
| | - A Baka
- Hellenic Center for Disease Control and Prevention (KEELPNO), Ministry of Health, Athens, Greece
| | - C Billinis
- School of Veterinary Medicine, University of Thessaly, Karditsa, Greece
| | - S Doudounakis
- Directorate General of Veterinary Services / Animal Health Directorate, Ministry of Rural Development and Food, Athens, Greece
| | - A Balaska
- Hellenic Center for Disease Control and Prevention (KEELPNO), Ministry of Health, Athens, Greece
| | - T Georgakopoulou
- Hellenic Center for Disease Control and Prevention (KEELPNO), Ministry of Health, Athens, Greece
| | - G Rigakos
- Hellenic Center for Disease Control and Prevention (KEELPNO), Ministry of Health, Athens, Greece
| | - V Kontos
- National School of Public Health, Athens, Greece
| | - K E Tasioudi
- Virology Department, Institute of Infectious and Parasitic Diseases, Athens Center of Veterinary Institutes, Ministry of Rural Development and Food, Athens, Greece
| | - M Tzani
- Department of Zoonoses, Animal Health Directorate, General Veterinary Directorate, Ministry of Rural Development and Food, Athens, Greece
| | - P Tsarouxa
- Department of Zoonoses, Animal Health Directorate, General Veterinary Directorate, Ministry of Rural Development and Food, Athens, Greece
| | - P Iliadou
- Virology Department, Institute of Infectious and Parasitic Diseases, Athens Center of Veterinary Institutes, Ministry of Rural Development and Food, Athens, Greece
| | - O Mangana-Vougiouka
- Virology Department, Institute of Infectious and Parasitic Diseases, Athens Center of Veterinary Institutes, Ministry of Rural Development and Food, Athens, Greece
| | - D Iliopoulos
- Hellenic Center for Disease Control and Prevention (KEELPNO), Ministry of Health, Athens, Greece
| | - S Sapounas
- Hellenic Center for Disease Control and Prevention (KEELPNO), Ministry of Health, Athens, Greece
| | - P Efstathiou
- National Health Operations Center of the Ministry of Health (EKEPY), Athens, Greece
| | - A Tsakris
- National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - C Hadjichristodoulou
- Department of Hygiene and Epidemiology, University of Thessaly, School of Medicine, Larissa, Greece
| | - J Kremastinou
- National School of Public Health, Athens, Greece
- Hellenic Center for Disease Control and Prevention (KEELPNO), Ministry of Health, Athens, Greece
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12
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Tsiodras S, Dougas G, Baka A, Billinis C, Doudounakis S, Balaska A, Georgakopoulou T, Rigakos G, Kontos V, Tasioudi KE, Tzani M, Tsarouxa P, Iliadou P, Mangana-Vougiouka O, Iliopoulos D, Sapounas S, Efstathiou P, Tsakris A, Hadjichristodoulou C, Kremastinou J. Re-emergence of animal rabies in northern Greece and subsequent human exposure, October 2012 - March 2013. Euro Surveill 2013; 18:20474. [PMID: 23725773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Greece has been rabies-free since 1987 with no human cases since 1970. During 2012 to 2013, rabies has re-emerged in wild and domestic animals in northern Greece. By end March 2013, rabies was diagnosed in 17 animals including 14 red foxes, two shepherd dogs and one cat; 104 subsequent human exposures required post-exposure prophylaxis according to the World Health Organization criteria. Human exposures occurred within 50 km radius of a confirmed rabies case in a wild or domestic animal, and most frequently stray dogs were involved.
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Affiliation(s)
- S Tsiodras
- Hellenic Center for Disease Control and Prevention (KEELPNO), Ministry of Health, Athens, Greece.
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