Crimean-Congo Hemorrhagic Fever Research Articles

Crimean-Congo Hemorrhagic Fever Virus for Clinicians—Epidemiology, Clinical Manifestations, and Prevention

Crimean-Congo Hemorrhagic Fever Virus for Clinicians—Epidemiology, Clinical Manifestations, and Prevention

Crimean-Congo Hemorrhagic Fever Virus for Clinicians—Diagnosis, Clinical Management, and Therapeutics

Crimean-Congo Hemorrhagic Fever Virus for Clinicians—Diagnosis, Clinical Management, and Therapeutics

Crimean-Congo haemorrhagic fever virus in questing non-Hyalomma spp. ticks in Northwest Spain, 2021.

Crimean-Congo haemorrhagic fever (CCHF) unexpectedly emerged in humans in Northwest Spain in 2021, and two additional cases were reported in the region in 2022. The 2021 case was associated with a tick bite on the outskirts of the city where the patient lived. PCR analysis of 95 questing ticks collected in the outskirts of that city in 2021, none of the genus Hyalomma, revealed a prevalence of confirmed CCHF virus (CCHFV) infection of 10.5%. Our results in this emerging scenario suggest the need to consider that CCHFV may be effectively spreading to Northwest Spain and to urgently understand any possible role of non-Hyalomma spp. ticks in the eco-epidemiological dynamics of CCHFV.

Animal Exposure Model for Mapping Crimean-Congo Hemorrhagic Fever Virus Emergence Risk.

To estimate the determinants of spatial variation in Crimean-Congo hemorrhagic fever virus (CCHFV) transmission and to create a risk map as a preventive public health tool, we designed a survey of small domestic ruminants in Andalusia, Spain. To assess CCHFV exposure spatial distribution, we analyzed serum from 2,440 sheep and goats by using a double-antigen ELISA and modeled exposure probability with environmental predictors by using generalized linear mixed models. CCHFV antibodies detected in 84 samples confirmed low CCHFV prevalence in small domestic ruminants in the region. The best-fitted statistical model indicated that the most significant predictors of virus exposure risk were cattle/horse density and the normalized difference vegetation index. Model validation showed 99.7% specificity and 10.2% sensitivity for identifying CCHFV circulation areas. To map CCHFV exposure risk, we projected the model at a 1 × 1-km spatial resolution. Our study provides insight into CCHFV ecology that is useful for preventing virus transmission.

Crimean-Congo Hemorrhagic Fever Virus Diversity and Reassortment, Pakistan, 2017-2020.

Sporadic cases and outbreaks of Crimean-Congo hemorrhagic fever (CCHF) have been documented across Pakistan since 1976; however, data regarding the diversity of CCHF virus (CCHFV) in Pakistan is sparse. We whole-genome sequenced 36 CCHFV samples collected from persons infected in Pakistan during 2017-2020. Most CCHF cases were from Rawalpindi (n = 10), followed by Peshawar (n = 7) and Islamabad (n = 4). Phylogenetic analysis revealed the Asia-1 genotype was dominant, but 4 reassorted strains were identified. Strains with reassorted medium gene segments clustered with Asia-2 (n = 2) and Africa-2 (n = 1) genotypes; small segment reassortments clustered with the Asia-2 genotype (n = 2). Reassorted viruses showed close identity with isolates from India, Iran, and Tajikistan, suggesting potential crossborder movement of CCHFV. Improved and continuous human, tick, and animal surveillance is needed to define the diversity of circulating CCHFV strains in Pakistan and prevent transmission.

A retrospective study of Crimean-Congo hemorrhagic fever in Iraq

Background: CCHF is transmitted via ticks biting and directly by contact with tissue or blood of infected patients or viremicanimals. This study intends to determine the occurrence of CCHF in Iraq between 2015 and 2019.
 Methods: This study was designed as a retrospective and descriptive cross-sectional study. It was approved the occurrence ofCCHF in Iraq with relation to some epidemiological and demographic data reported in the Iraqi Communicable Diseases ControlCenter (CDC)/zoonotic diseases section between 2015-2019.
 Results: Out of 206 suspected cases, only 17 were diagnosed as CCHF with a total fatality ratio of 52%, 25%, and 80% in 2015and 2018 respectively. However, no mortality was reported during 2016, 2017, and 2019. The mean age of the patients was 33years± 18 SD, in males mainly (76%). Moreover, the risk groups were 29 %, 23 %, 18 % 12 %, and 6 % for butchers, animaldealers, gainers, both housewives and students and children respectively.
 Conclusion: Strict precautions and precise surveillance should be implemented to control the disease and protect the communityby improving the diagnosis and treatment of CCHF. The authors recommend another future study to detect the genotypingand sequencing of CCHFV in Iraq.
 Keywords: Crimean–Congo hemorrhagic fever; Iraq; tick.

Crimean-Congo Hemorrhagic Fever Virus Seroprevalence in Human and Livestock Populations, Northern Tanzania

Crimean-Congo Hemorrhagic Fever Virus Seroprevalence in Human and Livestock Populations, Northern Tanzania

Case Management of Imported Crimean-Congo Hemorrhagic Fever, Senegal, July 2023.

We report an imported Crimean-Congo hemorrhagic fever case in Senegal. The patient received PCR confirmation of virus infection 10 days after symptom onset. We identified 46 patient contacts in Senegal; 87.7% were healthcare professionals. Strengthening border crossing and community surveillance systems can help reduce the risks of infectious disease transmission.

Crimean-Congo haemorrhagic fever virus uses LDLR to bind and enter host cells.

Climate change and population densities accelerated transmission of highly pathogenic viruses to humans, including the Crimean-Congo haemorrhagic fever virus (CCHFV). Here we report that the Low Density Lipoprotein Receptor (LDLR) is a critical receptor for CCHFV cell entry, playing a vital role in CCHFV infection in cell culture and blood vessel organoids. The interaction between CCHFV and LDLR is highly specific, with other members of the LDLR protein family failing to bind to or neutralize the virus. Biosensor experiments demonstrate that LDLR specifically binds the surface glycoproteins of CCHFV. Importantly, mice lacking LDLR exhibit a delay in CCHFV-induced disease. Furthermore, we identified the presence of Apolipoprotein E (ApoE) on CCHFV particles. Our findings highlight the essential role of LDLR in CCHFV infection, irrespective of ApoE presence, when the virus is produced in tick cells. This discovery holds profound implications for the development of future therapies against CCHFV.

Crimean-Congo Hemorrhagic Fever in the World. Epidemiological and Epizootiological Situation in the Russian Federation in 2023 and Forecast for 2024

The review features the situation on Crimean-Congo hemorrhagic fever (CCHF) in the world and the analysis of the epidemiological and epizootiological situation in the Russian Federation in 2023. The number of CCHF cases (26) in Russia was 2.3 times less than in 2022, and 71.6 % lower than the long-term average (in 2013–2022 – an average of 88.8 cases per year, mortality (8 %) is 2.4 times higher than the long-term average (3.3 %). The epidemically significant indicator of the abundance of the main vector of the CCHF virus, ticks Hyalomma marginatum, was 5 times higher than the threshold value (abundance index for cattle – 15.5) at long-term observation points in April. For the first time, one case of CCHF disease was registered in a new epidemically active territory – in the Botlikh and Novolaksky districts of the Republic of Dagestan. For the first time in the Zaporozhye Region, RNA of the CCHF virus was detected in ticks H. marginatum and Rhipicephalus rossicus. Markers of CCHF virus were found in 0.67–18.27 % of samples, CCHF virus variants of the genetic line Europe 1 were circulating on the territory of Russia in 2023. According to the forecast of the epidemic situation for 2024, CCHF morbidity is likely to increase in the south of the European part of Russia. The recommendations for undertaking preventive measures have been provided.

Crimean-Congo hemorrhagic fever virus prevalence in livestock of Jabalpur, Madhya Pradesh, Central India and its implications for public health

The rise of Crimean-Congo Hemorrhagic Fever (CCHF), poses a significant global health challenge, urging immediate action and continuous surveillance. With no available vaccines, monitoring pathogen presence is critical to identify at-risk areas promptly. A study was designed to assess the incidence of CCHF virus in goats and cattle using commercial ELISA IgG kits in tribal-dominated regions. Overall, 16% of the samples (n = 63/393) were positive for CCHF virus-specific IgG antibodies, whereas sero-prevalence detected in cattle 11.6% [95% CI:7–17.7] and in goats 18.9% [95% CI: 13.76–24.01], respectively. Statistically, Animal gender and age didn't significantly affect prevalence (p-value >0.05). Our finding indicates unnoticed CCHF virus circulation. Notably, lack of public awareness about zoonotic diseases in the study region was recorded. To combat this emerging tick-borne disease effectively, it's crucial to screen individuals with hemorrhagic manifestations in healthcare settings and active surveillance of ticks to prevent unwarranted public health outbreaks and design preventive interventions.

Addressing the Crimean-Congo Hemorrhagic Fever Crisis in Pakistan's Healthcare System: An Urgent Call for Holistic Action

Addressing the Crimean-Congo Hemorrhagic Fever Crisis in Pakistan's Healthcare System: An Urgent Call for Holistic Action

Establishment of a lethal mouse model of emerging tick-borne orthonairovirus infections.

Emerging and reemerging tick-borne virus infections caused by orthonairoviruses (family Nairoviridae), which are genetically distinct from Crimean-Congo hemorrhagic fever virus, have been recently reported in East Asia. Here, we have established a mouse infection model using type-I/II interferon receptor-knockout mice (AG129 mice) both for a better understanding of the pathogenesis of these infections and validation of antiviral agents using Yezo virus (YEZV), a novel orthonairovirus causing febrile illnesses associated with tick bites in Japan and China. YEZV-inoculated AG129 mice developed hepatitis with body weight loss and died by 6 days post infection. Blood biochemistry tests showed elevated liver enzyme levels, similar to YEZV-infected human patients. AG129 mice treated with favipiravir survived lethal YEZV infection, demonstrating the anti-YEZV effect of this drug. The present mouse model will help us better understand the pathogenicity of the emerging tick-borne orthonairoviruses and the development of specific antiviral agents for their treatment.

Lactate/Albumin Ratio as a Predictor of Mortality in Patients with Crimean-Congo Hemorrhagic Fever

Objective:This study aimed to determine the relationship of lactate/albumin (L/A) ratio with prognosis and fatality in CCHF patients. Materials and Methods: A total of 260 patients diagnosed with CCHF between January 2019 and December 2022, 36 of whom were deceased and 224 of whom were alive, were retrospectively included in the study. The findings of survivor and non-survivor patients were compared. Results: There was no significant difference between the groups in terms of age and gender. While albumin, glucose and platelet levels were quite low in the patient group who died due to CCHF (p

Assessing One Health capacities for transboundary zoonotic diseases at the Libya-Tunisia border

BackgroundThe dynamic nature of zoonotic emergence, spillover and spread necessitates multisectoral coordination beyond national borders to encompass cross-boundary and regional cooperation. Designated points of entry (POEs), specifically ground crossings, serve as critical locales for establishing and maintaining robust prevention, detection, notification, coordination, and response mechanisms to transboundary emerging and re-emerging disease threats. In order to better assess One Health capacities for transboundary zoonotic diseases (TZD) prevention, detection and response we adapted an existing tool, One Health Systems Assessment for Priority Zoonoses (OHSAPZ), for a cross-border, POE setting in North Africa.MethodsThe One Health Transboundary Assessment for Priority Zoonoses (OHTAPZ) tool was used to support prioritization of transboundary zoonoses and analyze operational capacities between national and subnational-level human and animal health stakeholders from Libya and Tunisia. Country partners jointly identified and prioritized five TZDs of concern. Case study scenarios for each priority pathogen were used to elicit current disease operations, as well as multisectoral and bilateral engagement networks. Finally, a gap analysis was performed to determine bilateral strengths and weaknesses to TZDs.ResultsThe five priority TZDs jointly confirmed to undergo One Health assessment were avian influenza (low and high pathogenic strains); brucellosis; Rift Valley fever; Crimean-Congo hemorrhagic fever; and rabies. Using the qualitative information collected, a transboundary systems map schematic was developed outlining the movement of human patients, animals, diagnostic samples, and routes of communication and coordination both within and between countries for zoonotic diseases.ConclusionsAnalysis of current operations (prevention, detection, surveillance, laboratory capacity, quarantine/isolation, and response) and the resulting transboundary systems map schematic helped identify existing capacity strengths for certain priority pathogens, as well as challenges to timely information-sharing and coordination. We developed targeted recommendations to address these limitations for joint action planning between Libya and Tunisia.

The Risk of Crimean Congo Haemorrhagic Fever in India as a Growing Health Concern.

Every year witnesses an outbreak of some or the other zoonotic disease that causes the unparalled loss of human life. The year 2022 presented the outbreak of Crimean Congo haemorrhagic fever (CCHF), which brought unprecedented challenges to individuals as well as to the healthcare system all around the world, making it a serious health concern. Rising health concerns have highlighted the importance of managing and decreasing the further transmission of the CCHF virus. CCHF is one of tick-borne viral diseases, which spreads due to various reasons like changes in global warming, environmental influences, and other ecological factors. All these factors somehow impact the disease prevalence. This disease has a negative impact on both humans and livestock. The diverse climate and significant livestock population of India make it susceptible to the prevalence of CCHF. Therefore, it is the need of the hour to develop some strategies in order to tackle the challenges posed by CCHF. This article includes all the cases of CCHF that have occurred in India from the year 2011, along with the fatality rates associated with this disease. Also this study discusses the need to explore some specific drugs for the management and prevention of such diseases. In addition, the pathogenesis of the disease progression, along with some protective measures suggested by the government has been described for prevention of CCHF. Subsequently, this article attempted to draw attention towards the risk that may be posed by CCHF in the coming scenario, emphasizing the importance of taking proactive measures in anticipation of such risks.

Epidemic survey of Crimean-Congo hemorrhagic fever infections in the Iraqi population during 2022

The primary cause of the Crimean-Congo hemorrhagic fever (CCHF) is a virus spread by ticks. The rate of frequency of case mortality is 10–40%, which is spurred on by the CCHF virus, which also produces severe viral hemorrhagic fever outbreaks. The current study can be viewed as an epidemiological survey of CCHF infections in Iraq, with the goal of better understanding block virus transmission and preventing the risk of contracting the disease. Approximately 1370 blood samples from suspect patients were taken and separated; then, the serum was processed to remove viral RNA and tested for CCHF infection using specialized kits. Results revealed 382 (27.9%) positive cases, including 76 (19.9%) positive patients with dying compared to 306 (80.1%) who experienced cures. Findings showed a significant incidence of more than 50% of the positive cases having contact with animals and raw meat, 33% slaughtering, and 36% tick bites. Furthermore, 125 (32.7%) homemakers and 64 (16.8%) butchers had the most significant infection percentage. With 42.4% of all infections, Thiqar province had the most infected patients, followed by Misan with 9.7%, then Wasit and Babil. With 27.2% of all infections, May had the most CCHF-positive infections, followed by June and July. In conclusion, in response to the initial wave counterattack in southern Iraq, public health interventions on the veterinarian side should be implemented; these should eliminate, or at least decrease, the impact of a second wave. Illegal trading practices must be controlled if zoonotic diseases like CCHF are to stop spreading. Keywords: CCHF, Iraqi provinces, RT-PCR, tick bites, zoonotic disease.

Crimean-Congo Hemorrhagic Fever: A Systematic Review

Crimean-Congo hemorrhagic fever is an predominatingly lethal viral contagion qualified in around thirty countries, and it has the roughly inclusive geographic allocation of the medically significant tick borne viral infections. Human become infected by tick bites, through pulverize infected ticks, next to contact with a case of Crimean-Congo hemorrhagic fever pending the acute stage of infection, or through handle with tissues or blood from viremic kine. Clinical features mostly display a spectacular progression recognized by myalgia, fever and bleeding. The best method used for diagnosis of Crimean-Congo hemorrhagic fever virus by real time polymerase chain reaction.

Knowledge and risky behaviors of Kabul city butchers regarding Crimean-Congo hemorrhagic fever

Abstract Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne zoonotic disease with high morbidity and case fatality rates (CFR) in humans, especially among the high-risk groups, including butchers. Therefore, a cross-sectional study was conducted in Kabul City to determine the knowledge gaps and risky behaviors of Kabul City’s butchers about CCHF. Data were collected from 123 butchers by structured interview using a pre-designed questionnaire. The finding of the present study revealed that of the total CCHF cases in the butchers, their family members, and co-workers, 37.9% died. Nearly half of the butchers (45.0%) experienced splashing of animal blood on their faces, while 70.1% of them had cut their hands with a knife during their occupation life. In addition, 27.0% of the respondents held the knife in their mouth while dressing the animal carcasses, and 27.3% of the butchers consumed raw liver. Hand washing and PPE application were practiced by 94.3% and 22.8% of the respondents, respectively. About 92% of the respondents had heard about CCHF, and 67.4% of the participants had good knowledge about CCHF. The knowledge level of the respondents (poor or good) was statistically related to their age, history of blood splash in the face and eyes of the butchers, holding work knives in the mouth, blowing the skin of animals, hand washing with soap and water, and slaughter places ( p < 0.05). A medium correlation between education and total knowledge of the butchers was observed (r = 0.3; p < 0.05). It is necessary to change such high-risk behaviors by continually coordinating awareness campaigns through mass media, workshops, and informative leaflet distribution to improve knowledge. One Health impact statement CCHF is a multifaceted zoonotic disease where tick bites, direct contact with the tissue, secretions, and body fluids of the infected animals and humans, and consumption of raw milk, meat, and liver of infected animals are the main transmission methods of the disease to humans. Although livestock including cattle, sheep, goats, camels, and ostrich are the main reservoirs of the virus, they are infected in subclinical form, and humans are the only hosts where fatal clinical disease develops. Since the CCHF virus circulates in nature between tick-vertebrates-ticks, the only method that can effectively control and prevent the disease in humans is by using a targeted One Health approach between the human, veterinary, and environmental health sectors. Meanwhile, it has been proven that public awareness campaigns through the use of mass media, community leaders, and integrated workshops are the most effective tools to prevent the transmission of the CCHF virus from infected animals and ticks to humans.

Approaching the complexity of Crimean-Congo hemorrhagic fever virus serology: A study in swine

Crimean-Congo hemorrhagic fever virus (CCHFV) is a tick-borne zoonotic orthonairovirus of public health concern and widespread geographic distribution. Several animal species are known to seroconvert after infection with CCHFV without showing clinical symptoms. The commercial availability of a multi-species ELISA has led to an increase in recent serosurveillance studies as well as in the range of species reported to be exposed to CCHFV in the field, including wild boar (Sus scrofa). However, development and validation of confirmatory serological tests for swine based on different CCHFV antigens or test principles are hampered by the lack of defined control sera from infected and non-infected animals. For the detection of anti-CCHFV antibodies in swine, we established a swine-specific in-house ELISA using a panel of swine sera from CCHFV-free regions and regions with reported CCHFV circulation. We initially screened more than 700 serum samples from wild boar and domestic pigs and observed a correlation of ≃67% between the commercial and the in-house test. From these sera, we selected a panel of 60 samples that were further analyzed in a newly established indirect immunofluorescence assay (iIFA) and virus neutralization test. ELISA-non-reactive samples tested negative. Interestingly, only a subset of samples reactive in both ELISA and iIFA displayed CCHFV-neutralizing antibodies. The observed partial discrepancy between the tests may be explained by different test sensitivities, antibody cross-reactivities or suggests that the immune response to CCHFV in swine is not necessarily associated with eliciting neutralizing antibodies. Overall, this study highlights that meaningful CCHFV serology in swine, and possibly other species, should involve the performance of multiple tests and careful interpretation of the results.