title: A sandfly fever virus outbreak in the East Mediterranean region of Turkey.
abstract: OBJECTIVE
  To report a sandfly fever virus (SFV) outbreak that occurred in Kahramanmaras Province, Turkey.
  
  
  METHODS
  We investigated the cases of 40 patients with a history of sandfly bites and with clinical findings, who were referred to our emergency service between July and August 2010. Serum samples of 19 patients were selected and analyzed using a commercial mosaic immunofluorescence test (IFT) to detect IgM and IgG antibodies against SFV.
  
  
  RESULTS
  Sandfly fever was diagnosed in nine patients. All cases had a history of fly bite, and the clinical findings included fever, headache, myalgia, conjunctival hyperemia, and gastrointestinal symptoms such as diarrhea, nausea, and vomiting. In two patients, the diagnosis was confirmed by real-time PCR as sandfly Sicilian virus (SFSV). Laboratory findings in the patients included leukopenia, thrombocytopenia, and elevated levels of aspartate aminotransferase, alanine aminotransferase, creatine kinase, and C-reactive protein. All patients made a complete recovery with symptomatic treatment.
  
  
  CONCLUSIONS
  SFV is endemic in the Mediterranean Basin and data regarding SFV activity in Turkey are limited. This is the first report of an SFV outbreak from Kahramanmaras Province, Turkey, and provides information on epidemiological, clinical, and laboratory aspects of SFV infections.
authors.affiliation: Department of Infectious Disease, Yenisehir State Hospital, Hastane cad. No: 50, Kahramanmaras, Turkey. selmaguler38@hotmail.com
authors.forename: Selma
authors.initials: S
authors.lastname: Guler
authors.forename: Ekrem
authors.initials: E
authors.lastname: Guler
authors.forename: Dilek Yagci
authors.initials: DY
authors.lastname: Caglayik
authors.forename: Omer Faruk
authors.initials: OF
authors.lastname: Kokoglu
authors.forename: Hasan
authors.initials: H
authors.lastname: Ucmak
authors.forename: Fatma
authors.initials: F
authors.lastname: Bayrakdar
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Uyar
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008297:Male; D019083:Mediterranean Region / Q000453:epidemiology; D010217:Phlebotomus Fever / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D016856:Phlebovirus; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult