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Crimean-Congo hemorrhagic fever virus (CCHFV) is transmitted to humans mainly through the bite of infected ticks. In Greece, only one clinical case has been observed, in 2008, but the seroprevalence in humans is relatively high (4.2%). To have a first insight into the circulation of CCHFV in Greece, 2000 ticks collected from livestock during 2012-2014 were tested. CCHFV was detected in 36 of the 1290 (2.8%) tick pools (1-5 ticks per pool). Two genetic lineages were identified: Europe 1 and Europe 2. Most Europe 1 sequences were obtained from Rhipicephalus sanguineus sensu lato ticks, while most Europe 2 sequences were recovered from Rhipicephalus bursa ticks. The number of collected Hyalomma marginatum ticks (the principal vector of CCHFV) was low (0.5% of ticks) and all were CCHFV negative. Since it is not known how efficient ticks of the Rhipicephalus genus are as vectors of the virus, laboratory studies will be required to explore the role of Rhipicephalus spp. ticks in CCHFV maintenance and transmission. [ABSTRACT FROM AUTHOR]

Background West Nile virus (WNV) emerged in central Macedonia, northern Greece, in 2010. The aim of the study was to test Culex mosquitoes for genetic detection of WNV and other flaviviruses, and to check whether the detection of WNV in mosquitoes was correlated with the occurrence of human WNV cases. Methods During 2013, 25 780 Culex spp. mosquitoes were collected from central Macedonia, grouped into 295 pools, according to collection site and date, and tested for the presence of flavivirus RNA. Results Thirteen (4.4%) pools were flavivirus-positive. WNV lineage 2 was detected in nine (3.1%) pools, and insect-specific flaviviruses (ISFV) in four (1.4%). Three ISFV nucleotide sequences were 98% identical to Culex theileri flavivirus, previously detected in the Iberian peninsula, while the fourth sequence differed by >25% from all known flaviviruses. In most units of central Macedonia WNV detection in mosquitoes preceded the occurrence of human cases by approximately one month. Conclusions Detection of WNV lineage 2 in mosquitoes for a fourth consecutive year suggests that the virus is established in Greece. Entomological surveillance provides an early warning system for the circulation of the virus. The detection of Culex theileri flavivirus extends the known range of this virus. [ABSTRACT FROM AUTHOR]

Clostridioides difficile infection (CDI) is one of the most significant causes of diarrhea in hospitalized patients. The aim of this study was to investigate the incidence and epidemiology of CDI after the COVID-19 pandemic in hospitalized patients in a rehabilitation center in Thessaloniki, Greece. Α retrospective observational cohort study was performed in inpatients diagnosed with diarrhea of all ages (January 2023 - December 2023) who were initially screened for CDI. From the total cohort of patients with proven CDI, some patients were randomly selected based on their monthly isolation incidence throughout the study period, to investigate their epidemiological data and clinical characteristics. Laboratory diagnosis of CDI was performed by enzyme immunoassay, followed by specific anaerobic culture and molecular testing for detection of toxigenic C. difficile. The isolated C. difficile strains were further characterized by PCR ribotyping. The annual incidence of CDI during the study period was 27.1% (130/480). The linear trend of CDI incidence decreased from 32.5% to 18.2% (P = 0.024). The all-cause mortality rate was 5.0% (3/60). A positive correlation was observed between the length of hospital stay and the number of recurrences (r = 0.546, P < 0.001), while 28 patients (46.7%) experienced recurrence of the infection. Seven different PCR ribotypes were identified in this study. C. difficile tcdA+, tcdB+, cdtA+, cdtB+ PCR ribotype 181 (RT181) was the predominant (76.6%, 46/60), followed by toxin A-negative PCR RT017 (11.6%, 7/60). The annual incidence of CDI decreased after the COVID-19 pandemic. Our study demonstrates predominance of C. difficile RT181 with tcdA+, tcdB+, cdtA+, cdtB+ toxin gene profile after COVID-19 pandemic in Northern Greece.