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Androudi S, Kaufman AR, Kouvalakis A, Mitsios A, Sapounas S, Al-Khatib D, Schibler M, Pineda R, Baglivo E. Non-Healing Corneal Ulcer and Uveitis Following Monkeypox Disease: Diagnostic and Therapeutic Challenges. Ocul Immunol Inflamm 2024; 32:253-258. [PMID: 37140328 DOI: 10.1080/09273948.2023.2202746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 04/10/2023] [Indexed: 05/05/2023]
Abstract
PURPOSE The ocular manifestations of Monkeypox virus (Mpox) infection remain incompletely characterized. Our goal is to present a case series of non-healing corneal ulcers with associated uveitis caused by Mpox infection as well as management recommendations for Mpox-related ophthalmic disease (MPXROD). METHODS Retrospective case series. RESULTS Two male patients with recent hospitalization for systemic Mpox infection presented with non-healing corneal ulcer associated with anterior uveitis and severe IOP elevation. Despite initiation of conservative medical treatment including corticosteroid treatment for uveitis, in both cases, there was clinical progression with enlarging cornea lesions. Both cases received oral tecovirimat with complete healing of the corneal lesion. CONCLUSIONS Corneal ulcer and anterior uveitis are rare complications of Mpox infection. Although Mpox disease is generally anticipated to be self-limited, tecovirimat may be an effective intervention in poorly healing Mpox keratitis. Corticosteroids should be used with caution in Mpox uveitis, as they might lead to worsening infection.
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Affiliation(s)
- Sofia Androudi
- Department of Ophthalmology, University Hospital of Larissa, Larissa, Greece
- Department of Medicine, University of Thessaly, Volos, Greece
| | - Aaron R Kaufman
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Andreas Mitsios
- Department of Medicine, University of Thessaly, Volos, Greece
| | - Spyros Sapounas
- Department of Epidemiological Surveillance and Intervention for Infectious Diseases, National Public Health Organization of Greece, Athens, Greece
| | - Danial Al-Khatib
- Department of Ophthalmology, Clinique de L'Oeil, Geneva, Switzerland
| | - Manuel Schibler
- Infectious Disease Department, Geneva University Hospital, Geneva, Switzerland
| | - Roberto Pineda
- Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Edoardo Baglivo
- Department of Ophthalmology, Clinique de L'Oeil, Geneva, Switzerland
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2
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Gilmour S, Sapounas S, Drakopoulos K, Jaillet P, Magiorkinis G, Trichakis N. On the impact of mass screening for SARS-CoV-2 through self-testing in Greece. Front Public Health 2024; 12:1352238. [PMID: 38510354 PMCID: PMC10950936 DOI: 10.3389/fpubh.2024.1352238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/21/2024] [Indexed: 03/22/2024] Open
Abstract
Background Screening programs that pre-emptively and routinely test population groups for disease at a massive scale were first implemented during the COVID-19 pandemic in a handful of countries. One of these countries was Greece, which implemented a mass self-testing program during 2021. In contrast to most other non-pharmaceutical interventions (NPIs), mass self-testing programs are particularly attractive for their relatively small financial and social burden, and it is therefore important to understand their effectiveness to inform policy makers and public health officials responding to future pandemics. This study aimed to estimate the number of deaths and hospitalizations averted by the program implemented in Greece and evaluate the impact of several operational decisions. Methods Granular data from the mass self-testing program deployed by the Greek government between April and December 2021 were obtained. The data were used to fit a novel compartmental model that was developed to describe the dynamics of the COVID-19 pandemic in Greece in the presence of self-testing. The fitted model provided estimates on the effectiveness of the program in averting deaths and hospitalizations. Sensitivity analyses were used to evaluate the impact of operational decisions, including the scale of the program, targeting of sub-populations, and sensitivity (i.e., true positive rate) of tests. Results Conservative estimates show that the program reduced the reproduction number by 4%, hospitalizations by 25%, and deaths by 20%, translating into approximately 20,000 averted hospitalizations and 2,000 averted deaths in Greece between April and December 2021. Conclusion Mass self-testing programs are efficient NPIs with minimal social and financial burden; therefore, they are invaluable tools to be considered in pandemic preparedness and response.
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Affiliation(s)
- Samuel Gilmour
- Operations Research Center, Massachusetts Institute of Technology, Cambridge, MA, United States
| | | | - Kimon Drakopoulos
- Department of Data Sciences and Operations, Marshall School of Business, University of Southern California, Los Angeles, CA, United States
| | - Patrick Jaillet
- Operations Research Center, Massachusetts Institute of Technology, Cambridge, MA, United States
| | - Gkikas Magiorkinis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Trichakis
- Operations Research Center, Massachusetts Institute of Technology, Cambridge, MA, United States
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Mellou K, Tryfinopoulou K, Emmanouil M, Gkolfinopoulou K, Sapounas S, Evangelidou M, Moulopoulou P, Miaoulis E, Angelakis E, Sourvinos G, Zaoutis T, Paraskevis D. Influenza transmission during COVID-19 measures downscaling in Greece, August 2022: evidence for the need of continuous integrated surveillance of respiratory viruses. Euro Surveill 2023; 28:2200754. [PMID: 37440348 PMCID: PMC10347892 DOI: 10.2807/1560-7917.es.2023.28.28.2200754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 04/05/2023] [Indexed: 07/15/2023] Open
Abstract
After the near absence of influenza and other respiratory viruses during the first 2 years of the COVID-19 pandemic, an increased activity of mainly influenza A(H3N2) was detected at the beginning of August 2022 in Greece on three islands. Of 33 cases with respiratory symptoms testing negative for SARS-CoV-2 with rapid antigen tests, 24 were positive for influenza: 20 as A(H3N2) subtype and four as A(H1N1)pdm09 subtype. Phylogenetic analysis of selected samples from both subtypes was performed and they fell into clusters within subclades that included the 2022/23 vaccine strains. Our data suggest that influenza can be transmitted even in the presence of another highly infectious pathogen, such as SARS-CoV-2, with a similar transmission mode. We highlight the need for implementing changes in the current influenza surveillance and suggest a move from seasonal to continuous surveillance, especially in areas with a high number of tourists. Year-round surveillance would allow for a timelier start of vaccination campaigns and antiviral drugs procurement processes.
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Affiliation(s)
| | | | - Mary Emmanouil
- Diagnostic Department and Public Health Laboratories, Hellenic Pasteur Institute, Athens, Greece
| | | | | | - Maria Evangelidou
- Diagnostic Department and Public Health Laboratories, Hellenic Pasteur Institute, Athens, Greece
| | | | | | - Emmanouil Angelakis
- Diagnostic Department and Public Health Laboratories, Hellenic Pasteur Institute, Athens, Greece
| | - George Sourvinos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, Heraklion, Greece
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4
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Mellou K, Tryfinopoulou K, Pappa S, Gkolfinopoulou K, Papanikou S, Papadopoulou G, Vassou E, Kostaki EG, Papadima K, Mouratidou E, Tsintziloni M, Siafakas N, Florou Z, Katsoulidou A, Sapounas S, Sourvinos G, Pournaras S, Petinaki E, Goula M, Paparizos V, Papa A, Zaoutis T, Paraskevis D. Overview of Mpox Outbreak in Greece in 2022-2023: Is It Over? Viruses 2023; 15:1384. [PMID: 37376683 PMCID: PMC10303940 DOI: 10.3390/v15061384] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/11/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
In May 2022, for the first time, multiple cases of mpox were reported in several non-endemic countries. The first ever case of the disease in Greece was confirmed on 8 June 2022, and a total of 88 cases were reported in the country until the end of April 2023. A multidisciplinary response team was established by the Greek National Public Health Organization (EODY) to monitor and manage the situation. EODY's emergency response focused on enhanced surveillance, laboratory testing, contact tracing, medical countermeasures, and the education of health care providers and the public. Even though management of cases was considered successful and the risk from the disease was downgraded, sporadic cases continue to occur. Here, we provide epidemiological and laboratory features of the reported cases to depict the course of the disease notification rate. Our results suggest that measures for raising awareness as well as vaccination of high-risk groups of the population should be continued.
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Affiliation(s)
| | - Kyriaki Tryfinopoulou
- National Public Health Organization, 15123 Athens, Greece
- Central Public Health Laboratory, 16672 Athens, Greece
| | - Styliani Pappa
- Department of Microbiology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | | | | | | | - Evangelia Vassou
- National Public Health Organization, 15123 Athens, Greece
- Central Public Health Laboratory, 16672 Athens, Greece
| | - Evangelia-Georgia Kostaki
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, Kapodistrian University of Athens, 11527 Athens, Greece
| | | | | | | | - Nikolaos Siafakas
- Clinical Microbiology Laboratory, Attikon General University Hospital of Athens, 12462 Athens, Greece
| | - Zoi Florou
- Department of Medical Biopathology, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece
| | - Antigoni Katsoulidou
- National Public Health Organization, 15123 Athens, Greece
- Central Public Health Laboratory, 16672 Athens, Greece
| | | | - George Sourvinos
- Laboratory of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Spyridon Pournaras
- Clinical Microbiology Laboratory, Attikon General University Hospital of Athens, 12462 Athens, Greece
| | - Efthymia Petinaki
- Department of Medical Biopathology, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece
| | - Maria Goula
- State Dermatology Department, Hospital of Skin and Venereal Diseases, 54643 Thessaloniki, Greece
| | - Vassilios Paparizos
- 1st Department of Dermatology and Venereology, National and Kapodistrian University of Athens Medical School, "Andreas Syggros" Hospital for Skin and Venereal Diseases, 16121 Athens, Greece
| | - Anna Papa
- Department of Microbiology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
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Papachristou E, Rokka C, Sotiriadou T, Maneka L, Vassilakis A, Sapounas S, Paraskevis D, Jahaj E, Kotanidou A, Lagiou P, Magiorkinis G. Low circulation of respiratory syncytial and influenza viruses during autumn-winter 2021 in the industrial workplace and long-term healthcare facilities in Athens, Greece. Front Med (Lausanne) 2023; 9:1025147. [PMID: 36698808 PMCID: PMC9869044 DOI: 10.3389/fmed.2022.1025147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 08/22/2022] [Accepted: 12/16/2022] [Indexed: 01/12/2023] Open
Abstract
The emergence of SARS-CoV-2 has pinpointed the importance of non-pharmaceutical interventions (NPIs), which have been traditionally used for the prevention of the spread of respiratory viruses among individuals. The aim of our study was to capture the level of circulation of respiratory syncytial and influenza viruses during a period of medium severity NPIs due to SARS-CoV-2 pandemics in Greece. A total of 2,225 nasopharyngeal samples were received during the year 2021 as a part of the routine diagnostic service and were divided into two study groups: (a) January to September 2021 and (b) October to the end of December 2021. The latter is the time of the year when there is a peak of infections from most respiratory viruses, and thus, most of the samples were tested in that period. The samples were taken from three different sites, i.e., (a) industrial workers in a factory, (b) elderly homecare facilities, and c) people who actively asked to be tested for SARS-CoV-2. All the samples were tested simultaneously for SARS-CoV2, RSV, and influenza virus. A total of 2,110 samples were negative for either of the three viruses, 106 were SARS-CoV-2-positive, and 9 were RSV-positive from which 7 were found in the workers' group. None of the samples was found to be positive for the influenza virus, and no sample had co-infection. Our study shows the low-level circulation of RSV and influenza viruses during autumn-winter 2021 and will provide a reference for future studies of RSV and influenza in Greece.
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Affiliation(s)
- Eleni Papachristou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Chrysoula Rokka
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Triantafyllia Sotiriadou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Leukothea Maneka
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexandros Vassilakis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Dimitrios Paraskevis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Eddison Jahaj
- First Department of Critical Care Medicine and Pulmonary Services, School of Medicine, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Kotanidou
- First Department of Critical Care Medicine and Pulmonary Services, School of Medicine, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Gkikas Magiorkinis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece,*Correspondence: Gkikas Magiorkinis,
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Strati A, Zavridou M, Paraskevis D, Magiorkinis G, Sapounas S, Lagiou P, Thomaidis NS, Lianidou ES. Development and Analytical Validation of a One-Step Five-Plex RT-ddPCR Assay for the Quantification of SARS-CoV-2 Transcripts in Clinical Samples. Anal Chem 2022; 94:12314-12322. [PMID: 35960711 PMCID: PMC9397566 DOI: 10.1021/acs.analchem.2c00868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 08/01/2022] [Indexed: 11/28/2022]
Abstract
Highly sensitive methodologies for SARS-CoV-2 detection are essential for the control of COVID-19 pandemic. We developed and analytically validated a highly sensitive and specific five-plex one-step RT-ddPCR assay for SARS-CoV-2. We first designed in-silico novel primers and probes for the simultaneous absolute quantification of three different regions of the nucleoprotein (N) gene of SARS-CoV-2 (N1, N2, N3), a synthetic RNA as an external control (RNA-EC), and Beta-2-Microglobulin (B2M) as an endogenous RNA internal control (RNA-IC). The developed assay was analytically validated using synthetic DNA and RNA calibrator standards and then was applied to 100 clinical specimens previously analyzed with a commercially available CE-IVD RT-qPCR assay. The analytical validation of the developed assay resulted in very good performance characteristics in terms of analytical sensitivity, linearity, analytical specificity, and reproducibility and recovery rates even at very low viral concentrations. The simultaneous absolute quantification of the RNA-EC and RNA-IC provides the necessary metrics for quality control assessment. Direct comparison of the developed one-step five-plex RT-ddPCR assay with a CE-IVD RT-qPCR kit revealed a very high concordance and a higher sensitivity [concordance: 99/100 (99.0%, Spearman's correlation coefficient: -0.850, p < 0.001)]. The developed assay is highly sensitive, specific, and reproducible and has a broad linear dynamic range, providing absolute quantification of SARS-COV-2 transcripts. The inclusion of two RNA quality controls, an external and an internal, is highly important for standardization of SARS-COV-2 molecular testing in clinical and wastewater samples.
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Affiliation(s)
- Areti Strati
- Lab of Analytical Chemistry, Department of Chemistry,
National and Kapodistrian University of Athens, 15771 Athens,
Greece
| | - Martha Zavridou
- Lab of Analytical Chemistry, Department of Chemistry,
National and Kapodistrian University of Athens, 15771 Athens,
Greece
| | - Dimitrios Paraskevis
- Department of Hygiene, Epidemiology and Medical
Statistics, Medical School, National and Kapodistrian University of
Athens, 11527 Athens, Greece
| | - Gkikas Magiorkinis
- Department of Hygiene, Epidemiology and Medical
Statistics, Medical School, National and Kapodistrian University of
Athens, 11527 Athens, Greece
| | | | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical
Statistics, Medical School, National and Kapodistrian University of
Athens, 11527 Athens, Greece
| | - Nikolaos S. Thomaidis
- Lab of Analytical Chemistry, Department of Chemistry,
National and Kapodistrian University of Athens, 15771 Athens,
Greece
| | - Evi S. Lianidou
- Lab of Analytical Chemistry, Department of Chemistry,
National and Kapodistrian University of Athens, 15771 Athens,
Greece
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7
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Sapounas S, Bistaraki A, Jahaj E, Kotanidou A, Lagiou P, Magiorkinis G. Cold-Season Epidemic Dynamics of COVID-19 in Two Major Metropolitan Areas in Greece: Hypotheses and Implications for Public Health Interventions. Front Med (Lausanne) 2022; 9:861185. [PMID: 35707523 PMCID: PMC9189356 DOI: 10.3389/fmed.2022.861185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 05/06/2022] [Indexed: 11/14/2022] Open
Abstract
Many respiratory viruses, including coronaviruses, follow seasonal transmission dynamics. Analyzing the social and environmental mechanics of the emergence of SARS-CoV-2 over the first cold season provides insight into designing targeted interventions. We analyzed all fully anonymized SARS-CoV-2 case data in two metropolitan areas, Attika and Thessaloniki, diagnosed between September 1st and December 31st, 2020. The emergence of the second wave in Greece occurred in October-November. SARS-CoV-2 diagnoses in Thessaloniki increased quasi-exponentially in mid-October, coinciding with the increase in the proportion of diagnoses in young people aged 18–39. The same pattern was observed in Attika with an almost 2-week delay, even though Attika had a higher prevalence of cases throughout summer until the second wave. Crucially, the nighttime temperature in Thessaloniki dropped below 18°C 3 weeks earlier than that in Attika. Epidemic growth was independently associated with the proportion of cases attributed to the 18–39 age group as well as with the drop in nighttime temperature below 18°C in both metropolitan areas but with a time difference. This pattern can be explained by a shift of nighttime entertainment activities from open-air to closed spaces, which occurs as nighttime temperature drops. Vaccination of young individuals can be crucial in decelerating the cold-season dynamics of SARS-CoV-2.
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Affiliation(s)
| | - Angeliki Bistaraki
- Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, Crete, Greece
| | - Edison Jahaj
- First Department of Critical Care Medicine & Pulmonary Services - Evangelismos Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Kotanidou
- First Department of Critical Care Medicine & Pulmonary Services - Evangelismos Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Gkikas Magiorkinis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- *Correspondence: Gkikas Magiorkinis
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8
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Kostaki EG, Pavlopoulos GA, Verrou KM, Ampatziadis-Michailidis G, Harokopos V, Hatzis P, Moulos P, Siafakas N, Pournaras S, Hadjichristodoulou C, Chatzopoulou F, Chatzidimitriou D, Panagopoulos P, Lourida P, Argyraki A, Lytras T, Sapounas S, Gerolymatos G, Panagiotakopoulos G, Prezerakos P, Tsiodras S, Sypsa V, Hatzakis A, Anastassopoulou C, Spanakis N, Tsakris A, Dimopoulos MA, Kotanidou A, Sfikakis P, Kollias G, Magiorkinis G, Paraskevis D. Molecular Epidemiology of SARS-CoV-2 in Greece Reveals Low Rates of Onward Virus Transmission after Lifting of Travel Restrictions Based on Risk Assessment during Summer 2020. mSphere 2021; 6:e0018021. [PMID: 34190583 PMCID: PMC8265632 DOI: 10.1128/msphere.00180-21] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 06/06/2021] [Indexed: 12/16/2022] Open
Abstract
The novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spread rapidly during the first months of 2020 and continues to expand in multiple areas across the globe. Molecular epidemiology has provided an added value to traditional public health tools by identifying SARS-CoV-2 clusters or providing evidence that clusters based on virus sequences and contact tracing are highly concordant. Our aim was to infer the levels of virus importation and to estimate the impact of public health measures related to travel restrictions to local transmission in Greece. Our phylogenetic and phylogeographic analyses included 389 full-genome SARS-CoV-2 sequences collected during the first 7 months of the pandemic in Greece and a random collection in five replicates of 3,000 sequences sampled globally, as well as the best hits to our data set identified by BLAST. Phylogenetic trees were reconstructed by the maximum likelihood method, and the putative source of SARS-CoV-2 infections was inferred by phylogeographic analysis. Phylogenetic analyses revealed the presence of 89 genetically distinct viruses identified as independent introductions into Greece. The proportion of imported strains was 41%, 11.5%, and 8.8% during the three periods of sampling, namely, March (no travel restrictions), April to June (strict travel restrictions), and July to September (lifting of travel restrictions based on thorough risk assessment), respectively. The results of phylogeographic analysis were confirmed by a Bayesian approach. Our findings reveal low levels of onward transmission from imported cases during summer and underscore the importance of targeted public health measures that can increase the safety of international travel during a pandemic. IMPORTANCE Our study based on current state-of-the-art molecular epidemiology methods suggests that virus screening and public health measures after the lifting of travel restrictions prevented SARS-CoV-2 onward transmission from imported cases during summer 2020 in Greece. These findings provide important data on the efficacy of targeted public health measures and have important implications regarding the safety of international travel during a pandemic. Our results can provide a roadmap about prevention policy in the future regarding the reopening of borders in the presence of differences in vaccination coverage, the circulation of the virus, and the presence of newly emergent variants across the globe.
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Affiliation(s)
- Evangelia Georgia Kostaki
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios A. Pavlopoulos
- Center of New Biotechnologies & Precision Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Institute for Fundamental Biomedical Research, Biomedical Sciences Research Center “Alexander Fleming,” Vari, Greece
| | - Kleio-Maria Verrou
- Center of New Biotechnologies & Precision Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Giannis Ampatziadis-Michailidis
- Center of New Biotechnologies & Precision Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vaggelis Harokopos
- Institute for Fundamental Biomedical Research, Biomedical Sciences Research Center “Alexander Fleming,” Vari, Greece
| | - Pantelis Hatzis
- Center of New Biotechnologies & Precision Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Institute for Fundamental Biomedical Research, Biomedical Sciences Research Center “Alexander Fleming,” Vari, Greece
| | - Panagiotis Moulos
- Center of New Biotechnologies & Precision Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Institute for Fundamental Biomedical Research, Biomedical Sciences Research Center “Alexander Fleming,” Vari, Greece
| | - Nikolaos Siafakas
- Laboratory of Clinical Microbiology, ATTIKON University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Spyridon Pournaras
- Laboratory of Clinical Microbiology, ATTIKON University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Dimitrios Chatzidimitriou
- Labnet, Laboratories, Thessaloniki, Greece
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Periklis Panagopoulos
- 2nd Department of Internal Medicine, General Hospital of Alexandroupoli, Democritus University of Thrace, Alexandroupoli, Greece
| | - Panagiota Lourida
- Infectious Diseases Clinic A, Thoracic Diseases General Hospital Sotiria, Athens, Greece
| | - Aikaterini Argyraki
- Infectious Diseases Clinic A, Thoracic Diseases General Hospital Sotiria, Athens, Greece
| | | | | | | | | | | | - Sotirios Tsiodras
- 4th Department of Internal Medicine, Attikon University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vana Sypsa
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Angelos Hatzakis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Cleo Anastassopoulou
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Spanakis
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Athanasios Tsakris
- Department of Microbiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Meletios Athanasios Dimopoulos
- Center of New Biotechnologies & Precision Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Department of Therapeutics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasia Kotanidou
- 1st Intensive Care Unit, General Hospital Evangelismos, National and Kapodistrian University of Athens, Athens, Greece
| | - Petros Sfikakis
- Center of New Biotechnologies & Precision Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- 1st Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Kollias
- Center of New Biotechnologies & Precision Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Institute for Bioinnovation, Biomedical Sciences Research Center “Alexander Fleming,” Vari, Greece
- Department of Physiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Gkikas Magiorkinis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Dimitrios Paraskevis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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Hatzianastasiou S, Mouchtouri VA, Pavli A, Tseroni M, Sapounas S, Vasileiou C, Dadouli K, Kyritsi M, Koureas M, Prezerakos P, Speletas M, Panagiotakopoulos G, Tsiodras S, Hadjichristodoulou C. COVID-19 Outbreak on a Passenger Ship and Assessment of Response Measures, Greece, 2020. Emerg Infect Dis 2021; 27:1927-1930. [PMID: 33979565 PMCID: PMC8237900 DOI: 10.3201/eid2707.210398] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We describe response measures to an outbreak involving 128 (33.4%) coronavirus disease cases (46.1% asymptomatic) among 383 persons onboard a passenger ship. Multivariate analysis indicated that dining in certain rooms and bar areas, nationality, working department (for crew members), and quarantining onboard the ship were significantly associated with infection.
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10
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Koureas M, Speletas M, Bogogiannidou Z, Babalis D, Pinakas V, Pinaka O, Komnos A, Tsoutsa S, Papadamou G, Kyritsi MA, Vontas A, Nakoulas V, Sapounas S, Kanellopoulos N, Kalompatsios D, Papadouli V, Dadouli K, Soteriades S, Mina P, Mouchtouri VA, Anagnostopoulos L, Stamoulis KE, Agorastos K, Petinaki EA, Prezerakos P, Tsiodras S, Hadjichristodoulou C. Transmission Dynamics of SARS-CoV-2 during an Outbreak in a Roma Community in Thessaly, Greece-Control Measures and Lessons Learned. Int J Environ Res Public Health 2021; 18:2878. [PMID: 33799791 PMCID: PMC8002111 DOI: 10.3390/ijerph18062878] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/26/2021] [Accepted: 03/07/2021] [Indexed: 11/17/2022]
Abstract
A COVID-19 outbreak occurred among residents of a Roma settlement in Greece (8 April-4 June 2020). The aim of this study was to identify factors associated with an increased risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and to evaluate the effectiveness of control measures implemented. Data were analyzed from individuals that were tested for SARS-CoV-2 during contact tracing, population screening or hospital visits. RT-PCR was used for the detection of SARS-CoV-2 in oropharyngeal samples. Risk factors for household secondary attack rates (SAR) and hospitalization with COVID-19 were examined using chi-square tests, Fisher's exact tests and logistic regression analyses. During the outbreak, 142 cases, 20 hospitalizations and 1 death were recorded, with a total of 2273 individuals tested. The risk of hospitalization was associated with age (OR: 1.04, 95% CI: 1.02-1.07) and Cycle threshold (Ct) values (OR for a decrease in Ct values by 1: 1.18, 95% CI: 1.07-1.31). Household SAR was estimated at 38.62% (95% CI: 32.50-45.01%). After the designation of an isolation facility for cases, household SAR declined from 74.42% to 31.03%. Household size was associated with the risk of infection (OR: 2.65, 95% CI: 1.00-7.07). The presence of COVID-19 symptoms among index cases was correlated with higher transmission (OR: 23.68, 95% CI 2.21-253.74) in multivariate analysis, while age was found to be associated with SAR only in univariate analysis. Roma communities can be particularly vulnerable to the spread of SARS-CoV-2. In similar settings, symptomatic cases are more important transmitters of SARS-CoV-2. Within these communities, immediate measures should be implemented to mitigate disease spread.
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Affiliation(s)
- Michalis Koureas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
| | - Matthaios Speletas
- Department of Immunology and Histocompatibility, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece;
| | - Zacharoula Bogogiannidou
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
| | - Dimitris Babalis
- General Hospital of Larissa, 41221 Larissa, Greece; (D.B.); (A.K.); (S.T.)
| | - Vassilios Pinakas
- Region of Thessaly, Koumoundourou & Papanastasiou str, 41222 Larissa, Greece; (V.P.); (N.K.); (K.A.)
| | - Ourania Pinaka
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
| | - Apostolos Komnos
- General Hospital of Larissa, 41221 Larissa, Greece; (D.B.); (A.K.); (S.T.)
| | - Stella Tsoutsa
- General Hospital of Larissa, 41221 Larissa, Greece; (D.B.); (A.K.); (S.T.)
| | - Georgia Papadamou
- Emergency Department, University Hospital of Larissa, Mezourlo, 41110 Larissa, Greece;
| | - Maria A. Kyritsi
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
| | - Alexandros Vontas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
| | - Vasileios Nakoulas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
| | - Spyros Sapounas
- Hellenic National Public Health Organization, 15123 Athens, Greece;
| | - Nikolaos Kanellopoulos
- Region of Thessaly, Koumoundourou & Papanastasiou str, 41222 Larissa, Greece; (V.P.); (N.K.); (K.A.)
| | - Dimitrios Kalompatsios
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
| | - Vassiliki Papadouli
- Local Health Unit of Ampelokipi, 5th Regional Health Authority of Thessaly & Sterea, Ministry of Health, 41447 Larissa, Greece;
| | - Katerina Dadouli
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
| | - Soteris Soteriades
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
| | - Paraskevi Mina
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
| | - Varvara A. Mouchtouri
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
| | - Lemonia Anagnostopoulos
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
| | | | - Kostantinos Agorastos
- Region of Thessaly, Koumoundourou & Papanastasiou str, 41222 Larissa, Greece; (V.P.); (N.K.); (K.A.)
| | - Efthimia A. Petinaki
- Department of Microbiology, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece;
| | | | - Sotirios Tsiodras
- Medical School, National and Kapodistrian University of Athens, 15772 Athens, Greece;
| | - Christos Hadjichristodoulou
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, 41222 Larissa, Greece; (M.K.); (Z.B.); (O.P.); (M.A.K.); (A.V.); (V.N.); (D.K.); (K.D.); (S.S.); (P.M.); (V.A.M.); (L.A.)
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11
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Magaziotou I, Tsiodras S, Xirogianni A, Tseroni M, Syrigonaki K, Stoli A, Tsekou A, Papandreou A, Sapounas S, Panagiotakopoulos G, Theodoridou M, Tzanakaki G, Georgakopoulou T. 1429. Meningococcal Disease Outbreak in a Refugee Reception Identification Center in Greece and Administration of Mass Antibiotic Prophylaxis. Open Forum Infect Dis 2020. [PMCID: PMC7776406 DOI: 10.1093/ofid/ofaa439.1611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
An increased likelihood of transmission of communicable diseases such as invasive meningococcal disease (IMD) exists in refugee camps. Herein, we describe an outbreak investigation of 5 IMD cases among immigrants in Greece.
Methods
Epidemiological, clinical and laboratory data (culture and molecular identification) as well as the public health management concerning an outbreak of meningococcal disease in a refugee Reception Identification Center (RIC), are described.
Results
During the period 17th January - 17th February 2020, five cases of IMD in refugees were reported to the National Public Health Organization (NPHO). Four cases were from Afghanistan and resided in the RIC of Lesvos Island; two females aged 2 yo and 21 yo and two males 13 yo and 6 yo. The fifth case, a 4 month old male of Syrian nationality, exhibited symptoms after moving to an inland accommodation center (AC) from Lesvos RIC, on December 2019. Four of the cases presented with meningitis and septicaemia. All cases recovered and had no common exposure other than shared geographic space. Neisseria meningitidis was identified by molecular typing (mPCR, PorA, MLST, WGS) in all cases at the National Meningitis Reference Laboratory; 3/5 cases were identified as MenB, porA 7-2,4, and ST-3129 (new clone) while 2/5 (21 yo female, 13 yo male) as MenY, porA: 5.2, ST-22cc. To prevent secondary cases, antimicrobial chemoprophylaxis via Directly Observed Therapy (DOT) was administered to 4.024 Afgan close contacts (26.7% of the total Afgan population). MenACWY and MenB vaccination was recommended in response to outbreak among persons aged < 20 years old. No new IMD case occurred in the RIC during a follow-up period of 4 months.
Conclusion
The detection of a new clone in Greece of Chinese and Taiwanese origin through migrants, further underlines the need of enhanced surveillance for early detection, molecular typing, immediate intervention with antibiotic prophylaxis and/or supplemental vaccination in order to prevent IMD in refugee camps.
Disclosures
All Authors: No reported disclosures
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Affiliation(s)
| | - Sotirios Tsiodras
- National & Kapodistrian University of Athens, Medical School, Athens Greece, Athens, Attiki, Greece
| | - Athanasia Xirogianni
- National Meningitis Reference Laboratory, Dept of Public Health Policy, School of Public Health, University of West Attica, Athens, Attiki, Greece
| | - Maria Tseroni
- National Public Health Organization, ATHENS, Attiki, Greece
| | | | - Artemis Stoli
- National Public Health Organization, ATHENS, Attiki, Greece
| | | | - Anastasia Papandreou
- National Meningitis Reference Laboratory, Dept of Public Health Policy, School of Public Health, University of West Attica, Athens, Attiki, Greece
| | | | | | - Maria Theodoridou
- Athens Medical School, National and Kapodistrian University of Athens, Athens, Attiki, Greece
| | - Georgina Tzanakaki
- National Meningitis Reference Laboratory, Dept of Public Health Policy, School of Public Health, University of West Attica, Athens, Attiki, Greece
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12
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Mouchtouri VA, Koureas M, Kyritsi M, Vontas A, Kourentis L, Sapounas S, Rigakos G, Petinaki E, Tsiodras S, Hadjichristodoulou C. Environmental contamination of SARS-CoV-2 on surfaces, air-conditioner and ventilation systems. Int J Hyg Environ Health 2020; 230:113599. [PMID: 32823069 PMCID: PMC7425762 DOI: 10.1016/j.ijheh.2020.113599] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 07/17/2020] [Accepted: 07/19/2020] [Indexed: 12/23/2022]
Abstract
Background COVID-19 can be transmitted directly through respiratory droplets or indirectly through fomites. SARS-CoV-2 has been detected on various environmental surfaces, air samples and sewage in hospital and community settings. Methods Environmental samples were collected from a ferryboat during a COVID-19 ongoing outbreak investigation and a nursing home and from three COVID-19 isolation hospital wards and a long-term care facility where asymptomatic COVID-19 cases were isolated. Samples were tested by real-time reverse transcriptase–polymerase chain reaction. Results SARS-CoV-2 was detected on swab samples taken from surfaces of food preparation and service areas, hospital isolation wards, an air exhaust duct screen, air-conditioning filter, sewage treatment unit and air sample during investigations conducted in response to COVID-19 outbreaks on a ferryboat, nursing home, isolation facility and COVID-19 hospital wards. Discussion Food preparation areas and utensils can be contaminated during COVID-19 outbreaks. Respiratory droplets/nuclei from infected persons can be displaced by the air flow and deposited on surfaces. It can be assumed that in the same manner, air flow could transfer and deposit infected respiratory droplets/nuclei from infected persons to the mucous membranes of persons standing against the air flow direction.
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Affiliation(s)
| | - Michalis Koureas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, Larisa, Greece
| | - Maria Kyritsi
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, Larisa, Greece
| | - Alexandros Vontas
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, Larisa, Greece
| | - Leonidas Kourentis
- Laboratory of Hygiene and Epidemiology, Faculty of Medicine, Larisa, Greece
| | - Spyros Sapounas
- Hellenic National Public Health Organization, Athens, Greece
| | - George Rigakos
- Hellenic National Public Health Organization, Athens, Greece
| | - Efthimia Petinaki
- Department of Microbiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - Sotirios Tsiodras
- National and Kapodistrian University of Athens, Medical School, Athens, Greece
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13
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Tsiodras S, Dougas G, Baka A, Billinis C, Doudounakis S, Balaska A, Georgakopoulou T, Rigakos G, Kontos V, Tasioudi KE, Tzani M, Tsarouxa P, Iliadou P, Mangana-Vougiouka O, Iliopoulos D, Sapounas S, Efstathiou P, Tsakris A, Hadjichristodoulou C, Kremastinou J. Re-emergence of animal rabies in northern Greece and subsequent human exposure, October 2012 – March 2013. Euro Surveill 2013. [DOI: 10.2807/ese.18.18.20474-en] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Greece has been rabies-free since 1987 with no human cases since 1970. During 2012 to 2013, rabies has re-emerged in wild and domestic animals in northern Greece. By end March 2013, rabies was diagnosed in 17 animals including 14 red foxes, two shepherd dogs and one cat; 104 subsequent human exposures required post-exposure prophylaxis according to the World Health Organization criteria. Human exposures occurred within 50 km radius of a confirmed rabies case in a wild or domestic animal, and most frequently stray dogs were involved.
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Affiliation(s)
- S Tsiodras
- National and Kapodistrian University of Athens Medical School, Athens, Greece
- Hellenic Center for Disease Control and Prevention (KEELPNO), Ministry of Health, Athens, Greece
| | - G Dougas
- Hellenic Center for Disease Control and Prevention (KEELPNO), Ministry of Health, Athens, Greece
| | - A Baka
- Hellenic Center for Disease Control and Prevention (KEELPNO), Ministry of Health, Athens, Greece
| | - C Billinis
- School of Veterinary Medicine, University of Thessaly, Karditsa, Greece
| | - S Doudounakis
- Directorate General of Veterinary Services / Animal Health Directorate, Ministry of Rural Development and Food, Athens, Greece
| | - A Balaska
- Hellenic Center for Disease Control and Prevention (KEELPNO), Ministry of Health, Athens, Greece
| | - T Georgakopoulou
- Hellenic Center for Disease Control and Prevention (KEELPNO), Ministry of Health, Athens, Greece
| | - G Rigakos
- Hellenic Center for Disease Control and Prevention (KEELPNO), Ministry of Health, Athens, Greece
| | - V Kontos
- National School of Public Health, Athens, Greece
| | - K E Tasioudi
- Virology Department, Institute of Infectious and Parasitic Diseases, Athens Center of Veterinary Institutes, Ministry of Rural Development and Food, Athens, Greece
| | - M Tzani
- Department of Zoonoses, Animal Health Directorate, General Veterinary Directorate, Ministry of Rural Development and Food, Athens, Greece
| | - P Tsarouxa
- Department of Zoonoses, Animal Health Directorate, General Veterinary Directorate, Ministry of Rural Development and Food, Athens, Greece
| | - P Iliadou
- Virology Department, Institute of Infectious and Parasitic Diseases, Athens Center of Veterinary Institutes, Ministry of Rural Development and Food, Athens, Greece
| | - O Mangana-Vougiouka
- Virology Department, Institute of Infectious and Parasitic Diseases, Athens Center of Veterinary Institutes, Ministry of Rural Development and Food, Athens, Greece
| | - D Iliopoulos
- Hellenic Center for Disease Control and Prevention (KEELPNO), Ministry of Health, Athens, Greece
| | - S Sapounas
- Hellenic Center for Disease Control and Prevention (KEELPNO), Ministry of Health, Athens, Greece
| | - P Efstathiou
- National Health Operations Center of the Ministry of Health (EKEPY), Athens, Greece
| | - A Tsakris
- National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - C Hadjichristodoulou
- Department of Hygiene and Epidemiology, University of Thessaly, School of Medicine, Larissa, Greece
| | - J Kremastinou
- National School of Public Health, Athens, Greece
- Hellenic Center for Disease Control and Prevention (KEELPNO), Ministry of Health, Athens, Greece
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14
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Tsiodras S, Dougas G, Baka A, Billinis C, Doudounakis S, Balaska A, Georgakopoulou T, Rigakos G, Kontos V, Tasioudi KE, Tzani M, Tsarouxa P, Iliadou P, Mangana-Vougiouka O, Iliopoulos D, Sapounas S, Efstathiou P, Tsakris A, Hadjichristodoulou C, Kremastinou J. Re-emergence of animal rabies in northern Greece and subsequent human exposure, October 2012 - March 2013. Euro Surveill 2013; 18:20474. [PMID: 23725773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Greece has been rabies-free since 1987 with no human cases since 1970. During 2012 to 2013, rabies has re-emerged in wild and domestic animals in northern Greece. By end March 2013, rabies was diagnosed in 17 animals including 14 red foxes, two shepherd dogs and one cat; 104 subsequent human exposures required post-exposure prophylaxis according to the World Health Organization criteria. Human exposures occurred within 50 km radius of a confirmed rabies case in a wild or domestic animal, and most frequently stray dogs were involved.
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Affiliation(s)
- S Tsiodras
- Hellenic Center for Disease Control and Prevention (KEELPNO), Ministry of Health, Athens, Greece.
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