#Transmission #dynamics of #SARS‐CoV‐2 within #families with #children in #Greece: a study of 23 #clusters (J Med Virol., abstract)

[Source: Journal of Medical Virology, full page: (LINK). Abstract, edited.]

Transmission dynamics of SARS‐CoV‐2 within families with children in Greece: a study of 23 clusters

Helena C. Maltezou,  Rengina Vorou,  Kalliopi Papadima, Athanasios Kossyvakis, Nikolaos Spanakis,  Georgia Gioula,  Maria Exindari,  Symeon Metallidis,  Athanasia N. Lourida, Vasilios Raftopoulos,  Elisavet Froukala,  Beatriz Martinez‐Gonzalez,  Athanasios Mitsianis,  Emmanuel Roilides,  Andreas Mentis,  Athanasios Tsakris,  Anna Papa

First published: 07 August 2020 | DOI:  https://doi.org/10.1002/jmv.26394

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/jmv.26394

 

Abstract

Background

There is limited information on SARS‐CoV‐2 infection clustering within families with children. We aimed to study the transmission dynamics of SARS‐CoV‐2 within families with children in Greece.

Methods

We studied 23 family clusters of COVID‐19. Infection was diagnosed by RT‐PCR in respiratory specimens. The level of viral load was categorized as high, moderate, or low based on the cycle threshold values.

Results

There were 109 household members (66 adults and 43 children). The median attack rate per cluster was 60% (range: 33.4%‐100%). An adult member with COVID‐19 was the first case in 21 (91.3%) clusters. Transmission of infection occurred from an adult to a child in 19 clusters and/or from an adult to another adult in 12 clusters. There was no evidence of child‐to‐adult or child‐to‐child transmission. In total 68 household members (62.4%) tested positive. Children were more likely to have an asymptomatic SARS‐CoV‐2 infection compared to adults (40% versus 10.5%, p‐value=0.021). In contrast, adults were more likely to develop a severe clinical course compared to children (8.8% versus 0%, p‐value=0.021). In addition, infected children were significantly more likely to have a low viral load while adults were more likely to have a moderate viral load (40.7% and 18.5% versus 13.8% and 51.7%, respectively; p‐value=0.016).

Conclusions

While children become infected by SARS‐CoV‐2, they do not appear to transmit infection to others. Furthermore, children more frequently have an asymptomatic or mild course compared to adults. Further studies are needed to elucidate the role of viral load on these findings.

This article is protected by copyright. All rights reserved.

Keywords: SARS-CoV-2; COVID-19; Cluster of cases; Pediatrics; Greece.

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Repeated leftover #serosurvey of #SARS-CoV-2 #IgG #antibodies, #Greece, March and April 2020 (Euro Surveill., abstract)

[Source: Eurosurveillance, full page: (LINK). Abstract, edited.]

Repeated leftover serosurvey of SARS-CoV-2 IgG antibodies, Greece, March and April 2020

Zacharoula Bogogiannidou1 , Alexandros Vontas1 , Katerina Dadouli1 , Maria A Kyritsi1 , Soteris Soteriades1 , Dimitrios J Nikoulis1 , Varvara Α Mouchtouri1 , Michalis Koureas1 , Evangelos I Kazakos2 , Emmanouil G Spanos1 , Georgia Gioula3 , Evangelia E Ntzani4,5,6 , Alexandros A Eleftheriou4 , Alkiviadis Vatopoulos7 , Efthimia Petinaki8 , Vassiliki Papaevangelou9 , Matthaios Speletas10 , Sotirios Tsiodras11 , Christos Hadjichristodoulou1

Affiliations: 1 Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece; 2 Faculty of Midwifery, School of Health Sciences, University of Western Macedonia, Kozani, Greece; 3 National Influenza Reference Laboratory for Northern Greece, Microbiology Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece; 4 Department of Hygiene and Epidemiology, University of Ioannina Faculty of Medicine, Ioannina, Greece; 5 Center for Evidence Synthesis in Health, Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, United States; 6 Institute of Biosciences, University Research Center of loannina, Ioannina, Greece; 7 Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece; 8 Department of Microbiology, University Hospital of Larissa, University of Thessaly, Larissa, Greece; 9 Third Department of Paediatrics, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece; 10 Department of Immunology and Histocompatibility, Faculty of Medicine, University of Thessaly, Larissa, Greece; 11 Fourth Department of Internal Medicine, National and Kapodistrian University of Athens, School of Medicine, Attikon University Hospital, Athens, Greece

Correspondence:  Christos Hadjichristodoulou

Citation style for this article: Bogogiannidou Zacharoula , Vontas Alexandros , Dadouli Katerina , Kyritsi Maria A , Soteriades Soteris , Nikoulis Dimitrios J , Mouchtouri Varvara Α , Koureas Michalis , Kazakos Evangelos I , Spanos Emmanouil G , Gioula Georgia , Ntzani Evangelia E , Eleftheriou Alexandros A , Vatopoulos Alkiviadis , Petinaki Efthimia , Papaevangelou Vassiliki , Speletas Matthaios , Tsiodras Sotirios , Hadjichristodoulou Christos . Repeated leftover serosurvey of SARS-CoV-2 IgG antibodies, Greece, March and April 2020. Euro Surveill. 2020;25(31):pii=2001369. https://doi.org/10.2807/1560-7917.ES.2020.25.31.2001369

Received: 12 Jul 2020;   Accepted: 03 Aug 2020

 

Abstract

A serosurvey of IgG antibodies against severe acute respiratory coronavirus 2 (SARS-CoV-2) was performed during March and April 2020. Among 6,586 leftover sera, 24 (0.36%) were positive, with higher prevalence in females, older individuals and residents of large urban areas. Seroprevalence was estimated at 0.02% and 0.25%, respectively, in March and April, infection fatality rate at 2.66% and 0.54%. Our findings confirm low COVID-19 incidence in Greece and possibly the effectiveness of early measures.

©  This work is licensed under a Creative Commons Attribution 4.0 International License.

Keywords: SARS-CoV-2; COVID-19; Serology; Seroprevalence; Greece.

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A #cluster of #COVID19 in #pilgrims to #Israel (J Travel Med., abstract)

[Source: Journal of Travel Medicine, full page: (LINK). Abstract, edited.]

A cluster of COVID-19 in pilgrims to Israel

Androula Pavli, Paraskevi Smeti, Kalliopi Papadima, Anastasia Andreopoulou, Sofia Hadjianastasiou, Eleni Triantafillou, Annita Vakali, Chrysovalantou Kefaloudi, Danai Pervanidou, Charalambos Gogos, Helena C Maltezou

Journal of Travel Medicine, taaa102, https://doi.org/10.1093/jtm/taaa102

Published: 25 June 2020

 

Abstract

This report describes a cluster of SARS-CoV-2 infections in pilgrims returning from Israel to Greece. Out of 53 pilgrims, 48 (90.5%) were tested positive for SARS-CoV-2; of them, 41 (85.4%) developed symptoms consistent with COVID-19, and 7 (14.6%) remained asymptomatic. These cases suggest a high risk of COVID-19 infection for pilgrims traveling during the pandemic. Although at that time the prevalence of the disease was low in the origin and destination countries, crowded exposure to other pilgrims from many other countries led to this cluster. Increasing awareness about the risks in pilgrims is important and particularly for elderly pilgrims and those with underlying conditions.

SARS-CoV-2, infection, pandemic, pilgrimage, transmission, travel, imported

Issue Section: Research letter

This content is only available as a PDF.

© International Society of Travel Medicine 2020. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Keywords: SARS-CoV-; COVID-19; Greece; Israel.

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High #prevalence of #SARS-CoV-2 infection in repatriation #flights to #Greece from three #European countries (J Travel Med., abstract)

[Source: Journal of Travel Medicine, full page: (LINK). Abstract, edited.]

High prevalence of SARS-CoV-2 infection in repatriation flights to Greece from three European countries

Theodore Lytras, MD, George Dellis, BSc, Anastasia Flountzi, MD, Sophia Hatzianastasiou, MD, Georgia Nikolopoulou, MD, Katerina Tsekou, BSc, Zafiris Diamantis, MD, Grigoria Stathopoulou, BSc, Marianthi Togka, BSc, Gerasimos Gerolymatos, BSc, George Rigakos, MD, Spiridon Sapounas, MD, Sotirios Tsiodras, MD

Journal of Travel Medicine, taaa054, https://doi.org/10.1093/jtm/taaa054

Published: 16 April 2020

 

Highlight

Passengers on repatriation flights to Greece from the UK, Spain and Turkey were screened with oropharyngeal swabs on arrival for SARS-CoV-2 infection. Despite almost all passengers being asymptomatic, many tested positive (3.6% from UK, 6.3% from Spain and 6.3% from Turkey), indicating widespread transmission of SARS-CoV-2 in these countries.

COVID, pandemic, coronavirus, air travel, asymptomatic transmission, screening, real-time PCR

Issue Section: RAPID COMMUNICATION

This content is only available as a PDF.

© International Society of Travel Medicine 2020. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Keywords: SARS-CoV-2; COVID-19; Greece.

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#Epidemiological #trends of #fungemia in #Greece with focus on candidemia during recent #financial #crisis:… (Antimicrob Agents Chemother., abstract)

[Source: Antimicrobial Agents and Chemotherapy, full page: (LINK). Abstract, edited.]

Epidemiological trends of fungemia in Greece with focus on candidemia during recent financial crisis: a 10-year survey in a tertiary care academic hospital and review of literature

Maria Siopi, Aikaterini Tarpatzi, Eleni Kalogeropoulou, Sofia Damianidou, Alexandra Vasilakopoulou, Sophia Vourli, Spyros Pournaras, Joseph Meletiadis

DOI: 10.1128/AAC.01516-19

 

ABSTRACT

Background.

Updated information on the epidemiology of candidemia particularly during severe socioeconomic events is important for proper management of these infections.

Materials/Methods.

A systematic literature review on candidemia in Greece and a retrospective surveillance study were conducted in a tertiary university hospital during the years of recent financial crisis(2009-2018) in order to assess changes in incidence rates, patient characteristics, species distribution, antifungal susceptibility and drug consumption.

Results.

The average annual incidence of 429 candidemic episodes was 2.03/10000 bed days with 9.88 in adult ICU, 1.74 in surgical and 1.81 in internal medicine wards where a significant increase was observed (1.15, 1.85 and 2.23/10000 bed days in 2009-2011, 2012-2014 and 2015-2018, respectively, p=0.004). C. albicans was the commonest species (41%), followed by C. parapsilosis species complex [SC](37%), C. glabrataSC(11%), C. tropicalis(7%), C. krusei(1%) and other rare Candida spp.(3%). Mixed infections were found in 20/429(4.7%) while 33(7%) cases were due to non-Candida spp. Overall, 44/311(14%) isolates were resistant/non-WT to the nine antifungals tested, with 24/113(20%) C. parapsilosisSC and 3/34(9%) of C. glabrataSC isolates being resistant to fluconazole (1 panechinocandin- and 2 panazole-resistant). All isolates were susceptible/WT to amphotericin B and flucytosine. While the overall consumption of antifungals diminished(p=0.02) with a mean of 17.93 DDD/100 bed days, the increased micafungin use was correlated with the rise in C. parapsilosisSC(p=0.04).

Conclusions.

A significant increase of candidemia in internal medicine wards and C. parapsilosisSC infections was found during the years of financial crisis. Although resistance rates remain low(<14%), fluconazole-resistant C. parapsilosisSC and multi-drug resistant C. glabrataSC are of major concern.

Copyright © 2019 American Society for Microbiology. All Rights Reserved.

Keywords: Antibiotics; Drugs Resistance; Candida spp.; Candidemia; Greece.

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#Entomological Data and #Detection of #WNV in #Mosquitoes in #Greece (2014–2016), Before Disease Re-Emergence in 2017 (Vector Borne Zoo Dis., abstract)

[Source: Vector Borne and Zoonotic Diseases, full page: (LINK). Abstract, edited.]

Entomological Data and Detection of West Nile Virus in Mosquitoes in Greece (2014–2016), Before Disease Re-Emergence in 2017

Eleni Patsoula, Stavroula Beleri, Nikolaos Tegos, Rima Mkrtsian, Annita Vakali, and Danai Pervanidou

Published Online: 11 Nov 2019 / DOI: https://doi.org/10.1089/vbz.2018.2422

 

Abstract

West Nile virus (WNV) cases were seasonally recorded in humans and animals in Greece, from 2010 to 2014, and circulation of the virus was detected in different Regional Units of the country. Small scale entomological surveillance activities were carried out by several regions and regional units in Greece, during 2014–2016, with the participation of subcontractors for the vector control programs aiming to record presence/absence of mosquito species, and monitor and control mosquito populations. Mosquito traps were placed in rural and urban sites; specimens were collected, morphologically characterized, and pooled by date of collection, location, and species types. Mosquito pools containing Culex pipiens, Aedes caspius, and Aedes albopictus were examined for the presence of WNV and positive pools were detected in different areas of the country. Sequencing of a selected number of amplicons revealed WNV lineage 2 partial NS5 gene sequences. In this study, we present data on the mosquito species composition in the areas of study and WNV detection from several parts of Greece, in 6, 11, and 26 mosquito pools corresponding to the years 2014, 2015, and 2016, respectively. A total of 15 WNV human infections were reported to the public health authorities of the country in 2014, whereas no human cases were detected for 2015–2016. Taking into consideration the complex epidemiological profile of WNV and unforeseen changes in its circulation, re-emergence of WNV human cases in Greece was possible and expected, thus rendering surveillance activities imperative.

Keywords: West Nile Virus; Mosquitoes; Aedes spp.; Culex spp.; Greece.

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#Phylogenetic Analysis of #Bird-Virulent #WNV Strain, #Greece (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 25, Number 12—December 2019 / Research Letter

Phylogenetic Analysis of Bird-Virulent West Nile Virus Strain, Greece

George Valiakos, Konstantinos Plavos, Alexandros Vontas, Marina Sofia, Alexios Giannakopoulos, Themis Giannoulis, Vassiliki Spyrou, Constantina N. Tsokana, Dimitrios Chatzopoulos, Maria Kantere, Vasilis Diamantopoulos, Angeliki Theodorou, Spyridoula Mpellou, Athanasios Tsakris, Zissis Mamuris, and Charalambos Billinis

Author affiliations: University of Thessaly, Karditsa, Greece (G. Valiakos, K. Plavos, A. Vontas, M. Sofia, A. Giannakopoulos, T. Giannoulis, V. Spyrou, C.N. Tsokana, D. Chatzopoulos, M. Kantere, Z. Mamuris, C. Billinis); Public Health Director—Region of Peloponnese, Tripoli, Greece (V. Diamantopoulos); Directorate-General for Regional Agricultural Economics and Veterinary—Region of Peloponnese, Nafplio, Greece (A. Theodorou); Bioefarmoges Eleftheriou LP—Integrated Mosquito Control, Marathon, Greece (S. Mpellou); University of Athens, Athens, Greece (A. Tsakris)

 

Abstract

We report the full polyprotein genomic sequence of a West Nile virus strain isolated from Eurasian magpies dying with neurologic signs in Greece. Our findings demonstrate the local genetic evolution of the West Nile virus strain responsible for a human disease outbreak in the country that began in 2010.

Keywords: West Nile Virus; Wild birds; Human; Greece.

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A case of #CCHF imported in #Greece: #Contact #tracing and #management of exposed #HCWs (J Infect Prev., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

J Infect Prev. 2019 Jul;20(4):171-178. doi: 10.1177/1757177419852666. Epub 2019 Jun 6.

A case of Crimean-Congo haemorrhagic fever imported in Greece: Contact tracing and management of exposed healthcare workers.

Maltezou HC1, Papa A2, Ventouri S3, Tseki C4, Pervanidou D5, Pavli A1, Panagopoulos P3,6, Markatou P7, Gavana E2, Maltezos E3,6.

Author information: 1 Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, Athens, Greece. 2 Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece. 3 Department of Infection Control, University Hospital of Alexandroupolis, Alexandroupolis, Greece. 4 Department of Infection Control, General Hospital of Xanthi, Xanthi, Greece. 5 Department for Epidemiological Surveillance and Intervention, Hellenic Center for Disease Control and Prevention, Athens, Greece. 6 Second Department of Internal Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece. 7 Department of Internal Medicine, University Hospital of Alexandroupolis, Alexandroupolis, Greece.

 

Abstract

BACKGROUND:

Nosocomial transmission is a major mode of infection of Crimean-Congo haemorrhagic fever (CCHF). In May 2018, a patient with CCHF was hospitalised in Greece.

OBJECTIVE:

Our aim was to present the management of healthcare workers (HCWs) to the CCHF case.

METHODS:

Contact tracing, risk assessment and follow-up of exposed HCWs were performed. Testing (RT-PCR and/or serology) was offered to contacts. Post-exposure prophylaxis (PEP) with ribavirin was considered for high-risk exposures.

RESULTS:

Ninety-one HCWs were exposed to the case. Sixty-six HCWs were grouped as high-risk exposures. Ribavirin PEP was offered to 29 HCWs; seven agreed to receive prophylaxis. Forty-one HCWs were tested for CCHF infection; none was found positive. Gaps in infection control occurred.

DISCUSSION:

CCHF should be considered in patients with compatible travel history and clinical and laboratory findings. Early clinical suspicion and laboratory confirmation are imperative for the implementation of appropriate infection control measures. Ribavirin should be considered for high-risk exposures. Infection control capacity for highly pathogenic agents should increase.

KEYWORDS: Crimean-Congo haemorrhagic fever; contact tracing; healthcare workers; infection control; ribavirin

PMID: 31428197 PMCID: PMC6683607 [Available on 2020-07-01] DOI: 10.1177/1757177419852666

Keywords: CCHF; HCWs; Greece.

——

A #paediatric #influenza #update 100 years after the #Skyros island #Spanishflu #outbreak (Exp Ther Med., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Exp Ther Med. 2019 Jun;17(6):4327-4336. doi: 10.3892/etm.2019.7515. Epub 2019 Apr 22.

A paediatric influenza update 100 years after the Skyros island Spanish flu outbreak.

Mammas IN1, Theodoridou M2, Thiagarajan P3, Melidou A4, Papaioannou G5, Korovessi P6, Koutsaftiki C7, Papatheodoropoulou A8, Calachanis M9, Dalianis T10, Spandidos DA1.

Author information: 1 Department of Clinical Virology, School of Medicine, University of Crete, 71003 Heraklion, Greece. 2 First Department of Paediatrics, ‘Aghia Sophia’ Children’s Hospital, University of Athens School of Medicine, 115 27 Athens, Greece. 3 Neonatal Unit, Division for Women’s & Children Health, Noble’s Hospital, IM4 4RJ Douglas, Isle of Man, British Isles. 4 Second Laboratory of Microbiology, School of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece. 5 Department of Paediatric Radiology, ‘Mitera’ Children’s Hospital, 151 23 Athens, Greece. 6 Department of Paediatrics, ‘Penteli’ Children’s Hospital, 152 36 Penteli, Greece. 7 Paediatric Intensive Care Unit (PICU), ‘Penteli’ Children’s Hospital, 152 36 Penteli, Greece. 8 Paediatric Intensive Care Unit (PICU), ‘P. and A. Kyriakou’ Children’s Hospital, 115 27 Athens, Greece. 9 Department of Paediatric Cardiology, ‘Penteli’ Children’s Hospital, 152 36 Penteli, Greece. 10 Karolinska Institutet, Karolinska University Hospital, SE-117 77 Stockholm, Sweden.

 

Abstract

This year marks the 100th anniversary of the 1918 Spanish flu outbreak on the Greek Aegean Sea island of Skyros, which devastated its population in less than 30 days. According to Constantinos Faltaits’s annals published in 1919, the influenza attack on the island of Skyros commenced acutely ‘like a thunderbolt’ on the 27th of October, 1918 and was exceptionally severe and fatal. At that time, the viral cause of the influenza had not been detected, while the total number of victims of the Spanish flu outbreak has been estimated to have surpassed 50 million, worldwide. Almost one century after this Aegean Sea island’s tragedy, the ‘4th Workshop on Paediatric Virology’, organised on the 22nd of September, 2018 in Athens, Greece, was dedicated to the 100 years of the ‘Spanish’ flu pandemic. This review article highlights the plenary and key lectures presented at the workshop on the recent advances on the epidemiology, clinical management and prevention of influenza in childhood.

KEYWORDS: H1N1; Paediatric Intensive Care Unit; antiviral drugs; influenza; myocarditis; neurological complications; paediatric virology; probiotics; radiology; vaccination

PMID: 31186675 PMCID: PMC6507498 DOI: 10.3892/etm.2019.7515

Keywords: Pandemic Influenza; Spanish Flu; Pediatrics; History; Greece.

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On #lifestyle trends, #health and #mosquitoes: Formulating welfare levels for control of the Asian tiger mosquito in #Greece (PLoS Negl Trop Dis., abstract)

[Source: PLoS Neglected Tropical Diseases, full page: (LINK). Abstract, edited.]

OPEN ACCESS /  PEER-REVIEWED / RESEARCH ARTICLE

On lifestyle trends, health and mosquitoes: Formulating welfare levels for control of the Asian tiger mosquito in Greece

Antonios Kolimenakis , Kostas Bithas, Dionysis Latinopoulos, Clive Richardson

Published: June 4, 2019 / DOI: https://doi.org/10.1371/journal.pntd.0007467 / This is an uncorrected proof.

 

Abstract

The expansion of urban ecosystems and climate change, both outcomes of massive lifestyle changes, contribute to a series of side effects such as environmental deterioration, spread of diseases, increased greenhouse gas emissions and introduction of invasive species. In the case of the Athens metropolitan area, an invasive mosquito species—the Asian tiger mosquito (Aedes albopictus)–has spread widely in the last decade. This spread is favoured within urban environments and is also affected by changing climatic trends. The Asian tiger mosquito is accompanied by risks of mosquito-borne diseases, greater nuisance levels, and increased expenses incurring for its confrontation. The main aims of this paper are (i) to estimate the various costs associated with their control of this invasive species, as well as its health and nuisance impacts, (ii) to evaluate the level of citizens’ well-being from averting these impacts and (iii) to record citizens’ and experts’ perceptions regarding alternative control measures. Evidence shows that experts tend to place a high value on mosquito control when associated with serious health risks, while citizens are more sensitive and concerned about the environmental impacts of control methods. The synthesis of results produced by the current study could act as a preliminary guide for the estimation of societal welfare from the confrontation of similar problems in the context of a complex ecosystem.

 

Author summary

This paper is based on several years’ collaboration among researchers from various disciplines, key health policy makers and stakeholders in an attempt to evaluate the economic dimensions related to the presence of the Asian Tiger Mosquito (Aedes albopictus) and the challenges of tackling mosquito-borne disease outbreaks in Greece and Southern Europe. Similar studies have been conducted and continue to be published in Europe and the USA examining the socioeconomic benefit from the implementation of relevant control and prevention strategies. These studies conclude that there are significant benefits related both to the reduction of nuisance levels and the reduction of the health risks posed by various mosquito species. In our case, the application of an updated economic analysis on the effectiveness of relevant public control and prevention programs provides essential information for public health decision-making, bearing in mind the significant restructuring of the public sector and the fiscal crisis apparent in the European South.

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Citation: Kolimenakis A, Bithas K, Latinopoulos D, Richardson C (2019) On lifestyle trends, health and mosquitoes: Formulating welfare levels for control of the Asian tiger mosquito in Greece. PLoS Negl Trop Dis 13(6): e0007467. https://doi.org/10.1371/journal.pntd.0007467

Editor: Olaf Horstick, University of Heidelberg, GERMANY

Received: October 2, 2018; Accepted: May 14, 2019; Published: June 4, 2019

Copyright: © 2019 Kolimenakis et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the manuscript and its Supporting Information files.

Funding: Part of this research has been co-financed by the European Union (EU Environmental Funding Programme LIFE+ Environment Policy and Governance) and Greek national funds through the LIFE CONOPS project “Development & demonstration of management plans against—the climate change enhanced—invasive mosquitoes in S. Europe” (LIFE12ENV/GR/000466). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Keywords: Climate change; Mosquitoes; Aedes albopictus; Society; Poverty; Greece.

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