title: Imported Chikungunya fever case in Greece in June 2014 and public health response.
abstract: We report about the first imported case of Chikungunya fever in Greece in a Greek traveler returning from the Dominican Republic and the associated public health response. We investigated the case and performed focused epidemiological and entomological investigation in all areas the patient visited during the infectious period, to identify the targeted interventions needed. Entomological investigation revealed the occurrence of the competent vector Aedes albopictus (Diptera: Culicidae) in the environment surrounding the hospital where the patient was admitted and in her workplace. All captured mosquitoes tested negative for Chikungunya virus. We further conducted clinical and laboratory examination of the patient's co-travelers, gave advice on appropriate personal preventive measures against mosquito bites to the patient and co-travelers and on vector control, and raised awareness among health professionals throughout Greece. The risk of introduction and local transmission of Chikungunya and other arboviruses in Greece and other European countries is present, as the competent vector exists in many parts of Europe. Public health professionals, travel medicine specialists and clinicians should maintain awareness regarding this possibility of importation of arbovirus cases in order to provide the appropriate advice, seek the prompt diagnosis, and implement appropriate interventions. Mobilization of various stakeholders will lead to enhanced epidemiological and entomological surveillance that will allow for improved risk assessment in each area.
authors.affiliation: a 4th Department of Internal Medicine , Attikon University Hospital, Athens University Medical School , Athens , Greece.|b Hellenic Center for Disease Control and Prevention , Athens , Greece.
authors.forename: Sotirios
authors.initials: S
authors.lastname: Tsiodras
authors.affiliation: b Hellenic Center for Disease Control and Prevention , Athens , Greece.
authors.forename: Danai
authors.initials: D
authors.lastname: Pervanidou
authors.affiliation: c A' Department of Microbiology, Medical School, National Reference Centre for Arboviruses and Hemorrhagic Fever Viruses , Aristotle University of Thessaloniki , Thessaloniki , Greece.
authors.forename: Elpida
authors.initials: E
authors.lastname: Papadopoulou
authors.affiliation: a 4th Department of Internal Medicine , Attikon University Hospital, Athens University Medical School , Athens , Greece.
authors.forename: Dimitra
authors.initials: D
authors.lastname: Kavatha
authors.affiliation: b Hellenic Center for Disease Control and Prevention , Athens , Greece.
authors.forename: Agoritsa
authors.initials: A
authors.lastname: Baka
authors.affiliation: d Benaki Phytopathological Institute , Kifissia, Athens , Greece.
authors.forename: George
authors.initials: G
authors.lastname: Koliopoulos
authors.affiliation: d Benaki Phytopathological Institute , Kifissia, Athens , Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Badieritakis
authors.affiliation: d Benaki Phytopathological Institute , Kifissia, Athens , Greece.
authors.forename: Antonios
authors.initials: A
authors.lastname: Michaelakis
authors.affiliation: c A' Department of Microbiology, Medical School, National Reference Centre for Arboviruses and Hemorrhagic Fever Viruses , Aristotle University of Thessaloniki , Thessaloniki , Greece.
authors.forename: Elpida
authors.initials: E
authors.lastname: Gavana
authors.affiliation: e Department of Parasitology, Entomology and Tropical Diseases , National School of Public Health , Athens , Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Patsoula
authors.affiliation: a 4th Department of Internal Medicine , Attikon University Hospital, Athens University Medical School , Athens , Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Tsimpos
authors.affiliation: a 4th Department of Internal Medicine , Attikon University Hospital, Athens University Medical School , Athens , Greece.
authors.forename: Thalia
authors.initials: T
authors.lastname: Gioksari
authors.affiliation: a 4th Department of Internal Medicine , Attikon University Hospital, Athens University Medical School , Athens , Greece.
authors.forename: Evdoxia
authors.initials: E
authors.lastname: Kyriazopoulou
authors.affiliation: b Hellenic Center for Disease Control and Prevention , Athens , Greece.
authors.forename: Annita
authors.initials: A
authors.lastname: Vakali
authors.affiliation: b Hellenic Center for Disease Control and Prevention , Athens , Greece.
authors.forename: Androula
authors.initials: A
authors.lastname: Pavli
authors.affiliation: b Hellenic Center for Disease Control and Prevention , Athens , Greece.
authors.forename: Helena C
authors.initials: HC
authors.lastname: Maltezou
authors.affiliation: b Hellenic Center for Disease Control and Prevention , Athens , Greece.
authors.forename: Theano
authors.initials: T
authors.lastname: Georgakopoulou
authors.affiliation: b Hellenic Center for Disease Control and Prevention , Athens , Greece.|f Department of Hygiene and Epidemiology , University of Thessaly , Larisa , Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Hadjichristodoulou
authors.affiliation: b Hellenic Center for Disease Control and Prevention , Athens , Greece.
authors.forename: Jenny
authors.initials: J
authors.lastname: Kremastinou
authors.affiliation: c A' Department of Microbiology, Medical School, National Reference Centre for Arboviruses and Hemorrhagic Fever Viruses , Aristotle University of Thessaloniki , Thessaloniki , Greece.
authors.forename: Anna
authors.initials: A
authors.lastname: Papa
mesh_terms: D000328:Adult; D000330:Aedes / Q000821:virology*; D000818:Animals; D018771:Arthralgia; D065632:Chikungunya Fever / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D002646:Chikungunya virus / Q000235:genetics / Q000302:isolation & purification*; D004293:Dominican Republic; D004772:Entomology; D005260:Female; D005602:France; D006115:Greece / Q000453:epidemiology; D006801:Humans; D007303:Insect Vectors / Q000821:virology*; D008297:Male; D010063:Ovum; D011634:Public Health; D017422:Sequence Analysis, DNA; D014195:Travel
keywords: Alphaviruses; Arboviruses; Medical entomology; Public Health; Vector-borne diseases; Viral infection