Crimean congo hemorrhagic fever, 2013 and 2014 Sudan

Abstract

Purpose: The German Partnership Program for Excellence in Biological and Health Security was launched in 2013 and is funded by the German Federal Foreign Office. Currently, the program funds projects in 18 countries in the fields of infectious disease surveillance, detection & diagnostics, biosafety & biosecurity, capacity building and networking. In Sudan one focus of the partnership is the detection of highly pathogenic viruses and identification of known and yet unknown etiological agents in outbreak situations. Methods & Materials: In 2014 an outbreak of hemorrhagic fever in humans was reported from different states of Sudan (South Darfur, West Kordofan, South Kordofan). The NPHL investigated the cases and forwarded 29 sera samples from patients suffering from hemorrhagic fever to the RKI. The sample-set included a panel of 10 sera collected during former hemorrhagic fever outbreaks in the same region in 2013. All sera were tested with qPCR assays for Marburg virus, Ebola virus and CCHFV. Additionally all samples were subjected to metagenomic deep sequencing on an Illumina MiSeq sequencer. Results: CCHF was identified by two independent qPCR assays in a sample from November 2013 and November 2014, respectively. Deep sequencing confirmed these results. Based on the available sequences the novel CCHFV strain ‘Sudan 2014’ shares 96% identity (na) with its closest relative CCHFV SPU 187/90 from South Africa. Conclusion: CCHFV is reported to be transmitted by ticks in Europe, Asia and Africa and known as etiological agent of severe hemorrhagic fever in humans and livestock. Beside insect-repellent no preventive measures are available. The pathogenicity and characteristics of this novel strain have yet to be determined by cell-culture isolation and serology. Further molecular analysis will contribute to clarify the divergence of the CCHFV strains detected in 2013 and 2014. First results including possible co-infections will be presented.