Health Protection Agency  Message on the Outbreak of West Nile Virus in Greece

The public health authorities in Greece have confirmed an outbreak of West Nile virus (WNV) on the Greek mainland, with 164 cases and 14 deaths reported [1] since early August 2010. Although WNV had been previously identified in animals in Greece, these are the first reports of human cases from that country [2]. Cases have been confirmed in Central Macedonia and in the capital of the region, Thessaloniki.

Cases of West Nile Fever have also been reported from Romania (7 confirmed cases, scattered throughout the country and include the districts of Alba, Bucharest, Cluj, Constanta, Dolj, Galati, Mures, Sibiu, and Teleorman) and Hungary (3 cases, one from Budapest, and one each from Bekes and Pest counties) during August.

WNV is caused by a flavivirus; the primary hosts are birds and horses and the virus is transmitted by mosquitoes. The incubation period is usually 3 to 15 days. Most (80%) of those infected with WNV have no symptoms at all, and 20% have a mild influenza-like illness (fever, headache, body ache), sometimes with swollen lymph glands or a rash on the chest, stomach and back. However, a small proportion (less than 1%, about one in 150 people infected) develop more severe disease; usually an encephalitis, meningitis or meningo-encephalitis. Patients may suffer headaches, fever, stiff neck, sore eyes, disorientation, muscle weakness, convulsions and coma. Numbness and paralysis may also occur. People over the age of 50 are more likely to develop serious symptoms of WNV.

Physicians who see travellers with a characteristic febrile illness, who have returned from WNV endemic areas, including the affected areas of the Greek mainland, should be alert to the possibility of WNV infection.

In response to this increased West Nile activity in Europe, the National Travel Health Network and Centre (NaTHNaC) have developed a clinical update for health professionals advising travellers. This is available at

http://www.nathnac.org/. CfI has also developed information for health professionals advising returning travellers which is available on the HPA website at http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/WestNileVirus/GeneralInformation/wnile02WestNilevirusadviceforhealthprofessionals/

1. Centre of Control and Prevention of Disease. Athens, Greece. Daily Report of Epidemiological Surveillance of West Nile Virus Infection in Greece. 2 September 2010 {Accessed 2 September 2010} Available at:

http://www.keelpno.gr/keelpno/2010/id990/daily_report_20100902_en.pdf

2. ECDC. West Nile virus outbreak in Greece [online]. [Accessed 2 September 2010]. Available at:

http://ecdc.europa.eu/en/activities/sciadvice/Lists/ECDC%20Reviews/ECDC_DispForm.aspx?List=512ff74f%2D77d4%2D4ad8%2Db6d6%2Dbf0f23083f30&ID=932&RootFolder=%2Fen%2Factivities%2Fsciadvice%2FLists%2FECDC%20Reviews

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Dr Jack, Catriona and their team, Jackie and Rosalie are delighted to announce the scheduled move to    120 Harley Street took place on Friday 16th October 2009.
We look forward to welcoming you to our newly refurbished rooms, managed by The London Clinic. 
Please note that all references to Pinero House no longer apply. 
Please do ensure you note this information in your address book. 
WE ARE NO LONGER AT Pinero House - 115a Harley Street, nor at 121 Harley Street.