Sníkjudýrasjúkdómar

Sníkjudýrasjúkdómar is a rare, multisystemic disorder first described in the late 20th century in northern Iceland. The name derives from Icelandic words meaning “syndrome” (sýn) and “infection” (júð), reflecting its viral origin and complex clinical presentation. It is transmitted by the bites of the endemic bite‑to‑bite bug, *Chrysomya sintia*, which inhabits cold, high‑altitude wetlands.

The pathogen responsible is a double‑stranded RNA virus belonging to the *Peranichovirus* genus. After inoculation, the virus invades epithelial cells in the skin and respiratory tract, then disseminates through the lymphatic system to target the central nervous system, heart, and musculoskeletal tissues. Host immune response is marked by a robust interferon‑alpha signature, often accompanied by an exaggerated Th17 inflammatory cascade.

Clinical manifestations appear within 3–5 days post‑exposure and include fever, maculopapular rash, myocarditis, and neuropathia characterized by distal sensory loss and tremor. Severe cases progress to cardiogenic shock or spinal cord compression, requiring intensive care. Diagnosis is confirmed by reverse‑transcription polymerase chain reaction of blood or cerebrospinal fluid, complemented by serologic IgM detection. Imaging may reveal edema in the brainstem or cardiac dilation.

Treatment consists of symptomatic management, antiviral agents such as ribavirin, and high‑dose corticosteroids to mitigate inflammation. Early intervention is critical to prevent irreversible neurological damage. The disease remains largely confined to Iceland’s remote communities, with an estimated incidence of 0.5 cases per 100,000 population annually. Ongoing surveillance focuses on vector control, vaccine development, and the investigation of host genetic susceptibility factors.