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Tsiodras S, Spanakis N, Spanakos G, Pervanidou D, Georgakopoulou T, Campos E, Petra T, Kanellopoulos P, Georgiadis G, Antalis E, Kontos V, Giannopoulos LA, Tselentis Y, Papa A, Tsakris A, Saroglou G. Fatal human anaplasmosis associated with macrophage activation syndrome in Greece and the Public Health response. J Infect Public Health 2017; 10:819-823. [PMID: 28189511 DOI: 10.1016/j.jiph.2017.01.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [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: 07/05/2016] [Revised: 11/22/2016] [Accepted: 01/07/2017] [Indexed: 01/28/2023] Open
Abstract
Human granulocytic anaplasmosis (HGA) is a tick-borne disease caused by Anaplasma phagocytophilum that has the potential to spread in new geographical areas. The first fatal case of HGA in Greece is presented. Fever of unknown origin, renal and respiratory insufficiency and development of macrophage activation syndrome characterized the clinical presentation. Amplification and sequencing of a fragment of the groEL gene revealed the presence of A. phagocytophilum. The epidemiological and clinical features were collected during an epidemiological investigation. Public health measures were instituted by the Hellenic Centre for Disease Control and Prevention. The Public Health intervention required the collaboration of epidemiologists, veterinarians and microbiologists. Emphasis was given to communication activities and misconceptions concerning canines and their role in the disease. The emergence of human anaplasmosis in a new geographical area highlights the importance of disease awareness and of the need for continued support for tick and tick-borne disease surveillance networks.
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Affiliation(s)
- Sotirios Tsiodras
- 4th Department of Internal Medicine, University General Hospital "Attikon", National & Kapodistrian University of Athens Medical School, Athens, Greece; The Hellenic Centre for Disease Control and Prevention, Athens, Greece.
| | - Nikos Spanakis
- Department of Microbiology, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Gregory Spanakos
- The Hellenic Centre for Disease Control and Prevention, Athens, Greece
| | - Danai Pervanidou
- The Hellenic Centre for Disease Control and Prevention, Athens, Greece
| | | | | | | | | | | | - Emmanouil Antalis
- 4th Department of Internal Medicine, University General Hospital "Attikon", National & Kapodistrian University of Athens Medical School, Athens, Greece
| | - Vassileios Kontos
- Department of Parasitology, Entomology and Tropical Diseases, National School of Public Health, Athens, Greece
| | | | - Yiannis Tselentis
- Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographic Medicine, WHO Collaborating Center for Mediterranean Zoonoses, University of Crete, Heraklion, Crete, Greece
| | - Anna Papa
- Department of Microbiology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athanassios Tsakris
- Department of Microbiology, National and Kapodistrian University of Athens Medical School, Athens, Greece
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