title: Laboratory and surveillance studies following a suspected Dengue case in Greece, 2012.
abstract: OBJECTIVE
  To describe the laboratory assays used to investigate a suspected dengue case in summer 2012 in western Greece and to report the public health response.
  Samples from the patient were tested for detection of Dengue virus (DENV) antibodies, NS1 antigen and RNA. Public health professionals interviewed residents of the village, and blood samples taken from 132 persons were tested for antibodies for DENV and West Nile virus (WNV). Samples from 10 persons who reported symptoms in the prior 15 days (including 3 persons who had fever at the time of sampling) were tested for DENV, WNV and additional arboviruses. Entomological missions were organized in the area of potential exposure to investigate the presence of competent DENV vectors.
  
  
  RESULTS
  Based on a combination of serological and molecular methods, DENV infection was excluded, and the problems in the serology, especially in the DENV NS1 antigen, were attributed to interfering factors. A 6.1% WNV seroprevalence was detected in the region, and phlebovirus IgM and IgG antibodies were detected in two of three persons who had fever at the time of sampling. Aedes albopictus adult mosquitoes were present in the region.
  
  
  CONCLUSIONS
  A multi-disciplinary field and laboratory investigation showed no evidence of DENV infection. There is a need for industries to improve the immunometric assays to avoid interference with rheumatoid or other factors, and increased awareness is needed for the evaluation of the diagnostic assays. The high WNV seroprevalence in the investigated region highlights the need for strengthening awareness on vector borne diseases. The presence of Ae. albopictus suggests that the possibility of introduction of DENV exists, and preparedness plans are needed.
authors.affiliation: National Reference Centre for Arboviruses, Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece. Electronic address: annap@med.auth.gr.
authors.forename: Anna
authors.initials: A
authors.lastname: Papa
authors.affiliation: National Reference Centre for Arboviruses, Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki 54124, Greece.
authors.forename: Elpida
authors.initials: E
authors.lastname: Gavana
authors.affiliation: Hellenic Centre for Disease Control and Prevention (HCDCP), Athens 15123, Greece.
authors.forename: Marios
authors.initials: M
authors.lastname: Detsis
authors.affiliation: Hellenic Centre for Disease Control and Prevention (HCDCP), Athens 15123, Greece.
authors.forename: Eirini
authors.initials: E
authors.lastname: Terzaki
authors.affiliation: Hellenic Centre for Disease Control and Prevention (HCDCP), Athens 15123, Greece.
authors.forename: Lambrini
authors.initials: L
authors.lastname: Veneti
authors.affiliation: Hellenic Centre for Disease Control and Prevention (HCDCP), Athens 15123, Greece.
authors.forename: Danai
authors.initials: D
authors.lastname: Pervanidou
authors.affiliation: Hellenic Centre for Disease Control and Prevention (HCDCP), Athens 15123, Greece.
authors.forename: Theano
authors.initials: T
authors.lastname: Georgakopoulou
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, University Hospital of Patras, 26500 Patras, Greece.
authors.forename: Markos
authors.initials: M
authors.lastname: Marangos
authors.affiliation: Laboratory of Biological Control of Pesticides, Benaki Phytopathological Institute, Athens 14561, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Koliopoulos
authors.affiliation: Hellenic Centre for Disease Control and Prevention (HCDCP), Athens 15123, Greece.
authors.forename: Agoritsa
authors.initials: A
authors.lastname: Baka
authors.affiliation: Hellenic Centre for Disease Control and Prevention (HCDCP), Athens 15123, Greece.
authors.forename: Sotirios
authors.initials: S
authors.lastname: Tsiodras
authors.affiliation: Department of Microbiology, School of Medicine, University of Athens, 11527 Athens, Greece.
authors.forename: Athanasios
authors.initials: A
authors.lastname: Tsakris
authors.affiliation: Hellenic Centre for Disease Control and Prevention (HCDCP), Athens 15123, Greece; Department of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa 41222, Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Hadjichristodoulou
mesh_terms: D000293:Adolescent; D000328:Adult; D000330:Aedes; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000914:Antibodies, Viral / Q000097:blood; D002648:Child; D003715:Dengue / Q000453:epidemiology*; D003716:Dengue Virus / Q000276:immunology; D062665:Epidemiological Monitoring; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016036:Seroepidemiologic Studies; D014902:West Nile virus / Q000276:immunology; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral
keywords: Dengue fever; Greece; West Nile virus; arbovirus