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acute, infectious, febrile disease caused by a phlebovirus (family Bunyaviridae) and producing temporary incapacitation. It is transmitted to humans by the bloodsucking female sand fly (notably Phlebotomus papatasii, P. perniciosus, and P. perfiliewsi) and is prevalent in the moist subtropical countries of the Eastern Hemisphere lying between latitude 20 and 45 N, particularly around the Mediterranean Sea, in the Middle East, and in parts of India. It breaks out in epidemic form during the summer season following sand fly breeding. Hosts may include warm- and cold-blooded vertebrates and possibly plants and thrips (tiny winged insects of the order Thysanoptera). The sand fly can become infected as a result of biting an infected person any time from 48 hours before until 24 hours after the onset of fever. Once it has been transmitted, the virus requires 7 to 10 days to incubate, after which the sand fly remains infected for life.