SEROSURVEY AND LABORATORY DIAGNOSIS OF IMPORTED SANDFLY FEVER VIRUS, SEROTYPE TOSCANA, INFECTION IN GERMANY

Of eight acute infections in German tourists caused by sandfly fever v irus, serotype Toscana (TOS), and diagnosed clinically and serological ly, seven were acquired during visits to Tuscany, Italy, and one to Co imbra, Portugal. An indirect immunofluorescence assay (IFA) using infe cted cells, and a newly developed enzyme-immunoassay (EIA) using crude virus antigen prepared from infected Vero-EB cells was used to detect anti-TOS IgM and IgG. Ina seroepidemiological survey of 859 health ca re workers and medical students, anti-TOS IgG was detected in 1.0 % by IFA, and in 0.7 % by EIA. In 2034 German patients hospitalized for va rious diseases, 1.6 % were positive for anti-TOS IgG by IFA, and 0.8 % by EIA. Anti-TOS Ig Gi was detected in 43 samples of commercial immun oglobulins at titres of 10-1000 by EIA. Although the seroprevalence of antibodies to TOS is low in Germany, TOS infection should be consider ed in patients returning from endemic areas who complain of fever, and headaches, and have symptoms of meningitis.