ABSTRACT
Phlebotomus fever (PF) has been a disease mainly of military importance. Typically, epidemics have occurred when large numbers of nonimmune adults enter an area of endemic virus activity. The recovery of phleboviruses from acutely ill patients is difficult, since the viremia associated with PF is quite transient. The incidence of PF is directly related to the abundance of vector sand flies in any given region. In many of the rural areas where PF is endemic, medical facilities are limited or nonexistent. Surveillance of phlebovirus activity in animals is difficult because most of the serotypes have a limited host range and do not cause recognizable illness in domestic or wild animals. Surveillance in humans is not much easier, since PF is clinically indistinguishable from a number of other common nonspecific febrile illnesses. One of the unanswered questions about the epidemiology of PF is the role that vertebrates play in the maintenance and amplification of phleboviruses.
