Sandfly fever Sicilian virus (SFSV) is a member of the Phlebovirus genus that is transmitted by phlebotomine sand flies and causes Pappataci (three-day) fever in humans.
Biology and epidemiology
Sandfly fever Sicilian virus is a negative-sense RNA virus with three genome segments (L, M and S) belonging to the Phlebovirus genus of the family Phenuiviridae. It was first identified in Sicily in 1943 during World War II as the cause of Pappataci fever among troops. The virus is spread by phlebotomine sand flies, chiefly Phlebotomus papatasi, which are active during warm months; other vectors such as P. ariasi and members of the Larroussius group may also transmit the virus. Humans become infected when bitten by an infected female sand fly, but they are incidental hosts and there is no clear evidence of a vertebrate reservoir. Most infections are asymptomatic; symptomatic cases present as sudden fever, headache, muscle pain, nausea and vomiting, and typically resolve within three days. Infections peak during summer when sand fly activity is highest and are endemic across the Mediterranean Basin, parts of North Africa, the Middle East and Asia, with serologic evidence reported from countries as diverse as Bangladesh, Djibouti, Ethiopia, Iraq, Morocco, Saudi Arabia and Somalia. Seroprevalence in humans varies widely: studies show rates from 0–2.2 % in Spain and southern France up to about 12 % in Turkey.
Outbreaks and seroprevalence highlights
For decades, SFSV has caused self-limiting fevers among soldiers and civilians. In 2011 a large outbreak of acute febrile illness in Ethiopia’s Afar region led to more than 12 000 suspected cases; molecular testing identified SFSV as the etiologic agent, and patients experienced mild fever, headache and myalgia with no fatalities. The virus was first recognised in Sicily during World War II among Allied troops. Serological surveys reveal varying exposure levels across the Mediterranean; human seroprevalence is around 0–2.2 % in Spain and southern France, up to 9.2 % in Italy and about 12 % in Turkey, while domestic animals can show high antibody rates but are not considered reservoirs. Field studies detect SFSV RNA or antibodies in wild rodents, insectivores and birds, including quails and bats, suggesting a broad ecology. Sandfly fever Sicilian virus remains an endemic phlebovirus causing febrile illness in regions where sand flies flourish. Because symptoms are nonspecific and often mistaken for malaria or dengue, laboratory testing is needed for diagnosis during outbreaks. There is no specific therapy; management is supportive, and prevention depends on reducing exposure to sand flies through vector control and personal protection. Related Terms: Sandfly Fever Naples Virus, Toscana Virus, Rift Valley Fever Virus, Phlebovirus, Arboviral encephalitis