Summary about Disease
Sandfly fever, also known as phlebotomus fever or pappataci fever, is a viral disease transmitted to humans through the bite of infected sandflies (primarily Phlebotomus and *Lutzomyia* species). It's a self-limiting, acute febrile illness characterized by flu-like symptoms. While generally not life-threatening, it can cause significant discomfort and temporary disability. The disease is prevalent in regions with warm climates, especially around the Mediterranean, Middle East, Asia, and parts of Central and South America.
Symptoms
Common symptoms include:
Fever (usually high, 38-40°C or 100.4-104°F)
Severe headache (often retro-orbital, behind the eyes)
Myalgia (muscle pain), particularly in the back and limbs
Arthralgia (joint pain)
Photophobia (sensitivity to light)
Retrobulbar pain (pain behind the eyes)
Weakness and malaise
Nausea and sometimes vomiting
Skin rash (less common)
Causes
Sandfly fever is caused by viruses belonging to the Phlebovirus genus, part of the *Phenuiviridae* family. These viruses are transmitted to humans through the bite of female sandflies, which require blood meals for egg production. The sandflies become infected when they feed on infected reservoir hosts, such as rodents or other animals. Humans are typically accidental hosts.
Medicine Used
There is no specific antiviral treatment for sandfly fever. Treatment is primarily supportive and focuses on alleviating symptoms:
Pain relievers: Acetaminophen (paracetamol) or ibuprofen for fever and pain.
Rest: Adequate rest to allow the body to recover.
Hydration: Drinking plenty of fluids to prevent dehydration.
Anti-emetics: Medications to reduce nausea and vomiting, if necessary. Antibiotics are ineffective against viral infections like sandfly fever and should not be used unless there is a secondary bacterial infection.
Is Communicable
Sandfly fever is not directly communicable from person to person. Transmission occurs only through the bite of an infected sandfly. It cannot be spread through contact with an infected individual's bodily fluids or through respiratory droplets.
Precautions
Preventing sandfly bites is the most effective way to avoid infection:
Insect repellents: Use repellents containing DEET, picaridin, or IR3535 on exposed skin and clothing.
Protective clothing: Wear long-sleeved shirts and long pants, especially during dawn and dusk when sandflies are most active.
Mosquito nets: Sleep under mosquito nets, particularly in areas where sandfly fever is endemic. Nets should be insecticide-treated for maximum effectiveness.
Screens: Install screens on windows and doors to prevent sandflies from entering buildings.
Avoidance: Avoid areas known to be heavily infested with sandflies, if possible.
Eliminate breeding sites: Reduce sandfly breeding sites by removing standing water and vegetation around homes.
How long does an outbreak last?
The duration of an outbreak is variable and depends on factors such as:
Sandfly population density: Higher populations can prolong outbreaks.
Environmental conditions: Warm, humid conditions favor sandfly breeding.
Control measures: Effective vector control can shorten outbreaks.
Geographic Location: Seasonal shifts may limit the life and proliferation of the sandfly. Individual illness typically lasts for 3-7 days. Outbreaks in a region might continue for several weeks or months, coinciding with peak sandfly activity season.
How is it diagnosed?
Diagnosis is typically based on clinical symptoms and a history of possible sandfly exposure. Laboratory tests can confirm the diagnosis but are not always readily available:
Blood tests: Detecting viral RNA (RT-PCR) or antibodies (IgM and IgG) against sandfly fever viruses. PCR is most useful during the acute phase of the illness. Antibody tests can confirm recent infection.
Differential diagnosis: Ruling out other diseases with similar symptoms, such as malaria, dengue fever, influenza, and other arboviral infections.
Timeline of Symptoms
The incubation period (time between the sandfly bite and the onset of symptoms) is typically 3-6 days.
Day 1-3: Sudden onset of fever, headache, muscle pain, and general malaise.
Day 3-5: Symptoms peak in severity. Photophobia, retro-orbital pain, and nausea may become more pronounced.
Day 5-7: Symptoms gradually subside. Fever breaks, and pain decreases. Weakness and fatigue may persist for a few days to weeks.
Convalescence: Full recovery typically occurs within 1-2 weeks, although some individuals may experience prolonged fatigue.
Important Considerations
Differential Diagnosis: Sandfly fever symptoms overlap with other diseases.
No Specific Treatment: Symptomatic management is key.
Prevention is Crucial: Reducing sandfly bites.
Debilitating Nature: Even though not life-threatening, sandfly fever can cause significant discomfort and lost workdays.
Climate Change: The geographic range of sandflies may expand due to climate change.