Vector-borne diseases in Cyprus: A detailed review of the literature.

Vector-borne diseases have been a growing health concern in recent decades due to the global warming, globalization, and increased international travel. With the typical Mediterranean climate and geographical features, Cyprus provides favorable conditions for the growth and survival of arthropod species. For the purpose of this review article, the terms "Cyprus", "vectors" and "vectorborne diseases" were searched in the National Library of Medicine ('PubMed') and the Google Scholar databases. Published articles in the literature have documented mosquito (including Anopheles, Aedes, Culex, and Culiseta), sandfly (Phlebotomus, Sergentomyia), flea (including Ctenocephalides, Xenopsylla, Leptopsylla), and tick (including Rhipicephalus, Ixodes, Hyalomma, Haemaphysalis) species in the island. The presence of these arthropods poses a risk to public health as they can transmit a variety of diseases to both humans and animals. Research studies in Cyprus have identified infectious agents such as West Nile virus, Leishmania spp., sandfly viruses, Rickettsia spp., Coxiella burnetii, and Bartonella spp. in the local arthropods. More importantly, West Nile virus infection and imported malaria cases (mosquitoborne diseases); leishmaniasis and sandfly fever (sandfly-borne diseases); rickettsiosis, tularemia, Q fever, anaplasmosis, tick-borne relapsing fever, and Lyme disease (tick-borne diseases); and flea-borne rickettsiosis were reported in Cyprus. Taken together with the presence of arthropod vectors, published evidence in the literature suggests that Cyprus is an important region for VBDs. In addition to its climatic and geographical conditions, international travels particularly from endemic countries pose a risk for the circulation of VBDs on the island. Therefore, vector control programs should be continuously implemented, and public awareness must be raised in the region. This review, which to the best of our knowledge is the first comprehensive report on VBDs from Cyprus, will provide insight into future islandwide studies and also will be an important contribution to the elimination of VBDs in the region.