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We report about the first imported case of Chikungunya fever in Greece in a Greek traveler returning from the Dominican Republic and the associated public health response. We investigated the case and performed focused epidemiological and entomological investigation in all areas the patient visited during the infectious period, to identify the targeted interventions needed. Entomological investigation revealed the occurrence of the competent vector Aedes albopictus (Diptera: Culicidae) in the environment surrounding the hospital where the patient was admitted and in her workplace. All captured mosquitoes tested negative for Chikungunya virus. We further conducted clinical and laboratory examination of the patient's co-travelers, gave advice on appropriate personal preventive measures against mosquito bites to the patient and co-travelers and on vector control, and raised awareness among health professionals throughout Greece. The risk of introduction and local transmission of Chikungunya and other arboviruses in Greece and other European countries is present, as the competent vector exists in many parts of Europe. Public health professionals, travel medicine specialists and clinicians should maintain awareness regarding this possibility of importation of arbovirus cases in order to provide the appropriate advice, seek the prompt diagnosis, and implement appropriate interventions. Mobilization of various stakeholders will lead to enhanced epidemiological and entomological surveillance that will allow for improved risk assessment in each area.

Linton, Yvonne-Marie, Smith, Lisa, Koliopoulos, George, Zounos, Athanassios K., Samanidou-Voyadjoglou, Anna, Patsoula, Eleni, Harbach, Ralph E. (2007): The Anopheles (Anopheles) maculipennis complex (Diptera: Culicidae) in Greece. Journal of Natural History 41 (41-44): 2683-2699, DOI: 10.1080/00222930701403255, URL: http://dx.doi.org/10.1080/00222930701403255

Tauhe essential oils contained in the rind of the fruit and the leaves of bergamot from Greece (Citrus aurantium subsp. bergamia) were studied. The bergamot trees in question were cultivated on Kefalonia Island. The plant material (leaves and fruits in different stages of maturity) was collected between December and March for a two year period. The rind of the fruit was separated manually and the essential oil was obtained either by cold pressing or by hydrodistillation. The maximum yield calculated on a wet weight of fresh rinds basis was 1.8%. The essential oils were first analyzed by GC-MS with a DB-5 column and then with a beta-Dex enantiomeric column. The main constituent of the cold pressed essential oil of the rind was (-)-linalyl acetate with optical purity >99.9%. Other important constituents were (-)-linalool, (+)-limonene and gamma-terpinene. The best value of linalool/linalyl acetate ratio was 0.38 and the maximum sum of linalool+linalyl acetate was found to be 55.8%. The larvacidal activities of the obtained essential oils and the compounds (+/-)-linalyl acetate, (+/-)-linalool and (-)-linalool were evaluated against larvae of the mosquito species Culex pipiens (Diptera: Culicidae), the West Nile virus vector, under laboratory conditions. The cold pressed essential oil showed an LC(50) value of 58 mg/L, while the LC(50) value of the corresponding essential oil obtained by hydrostillation was 106 mg/L. The essential oil of the leaves presented similar larvicidal toxicity with the cold pressed oil of the rind (LC(50)=68 mg/L). Molecules

Mosquitoes belonging to the Maculipennis Complex of Anopheles subgenus Anopheles were collected in 10 prefectures across Greece: Attiki, Evros, Florina, Fthiotida, Ioannina, Lakonia, Magnesia, Rodopi, Serres, and Xanthi. DNA was extracted from 276 specimens and sequences for the nuclear rDNA ITS2 region were obtained from 257 of these (93.1%). Four members of the An. maculipennis Meigen complex were identified: An. maculipennis, An. sacharovi Favre, An. melanoon Hackett, and An. messeae Falleroni. Species were identified based on correlation of their sequences with those available in GenBank. All four species have been incriminated as primary or secondary vectors of malaria. Species distributions in relation to potential threats of reintroduction of malaria in Greece are discussed. This study comprises the most complete study of the Maculipennis Complex in Greece to date, and contributes substantially to the current knowledge of the genetics and distributions of the four species.

BACKGROUND AND OBJECTIVES: Long-term administration of tamoxifen causes endometrial changes. The aim of this study was to evaluate the role of transvaginal sonography and vaginoscopic hysteroscopy in the screening of patients on tamoxifen. METHODS: Seventy patients with breast cancer treated with tamoxifen 20 mg daily underwent transvaginal sonography and vaginoscopic hysteroscopy, a modified relatively painless approach, at the beginning of the treatment and at a follow-up visit approximately 9 months after its initiation. RESULTS: At the follow-up visit, the mean uterine dimensions and mean endometrial thickness as measured by ultrasound were significantly larger, and pulsatility and resistance indices of the uterine arteries as measured by Doppler were significantly lower. Sonography revealed abnormal endometrial thickness in 73% (51 of 70) of the patients, and 83% (58 of 70) had hysteroscopical changes. Sonography missed 1 case of endometrial adenocarcinoma. CONCLUSIONS: Vaginoscopic hysteroscopy, an approach that causes reduced pain, can add significantly to the sensitivity of transvaginal sonography for the detection of endometrial changes in patients with breast cancer receiving tamoxifen. It is recommended for every patient prior to the initiation of treatment and at the follow-up visits. JSLS