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Sethi SM, Zahid S, Nasir N. Predictors of Mortality in Crimean-Congo Hemorrhagic Fever Patients Admitted at a Tertiary Care Hospital in Pakistan over the Last 10 Years: A Case-Control Study. Am J Trop Med Hyg 2024; 111:416-420. [PMID: 38889713 PMCID: PMC11310634 DOI: 10.4269/ajtmh.23-0630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 03/03/2024] [Indexed: 06/20/2024] Open
Abstract
The objective was to identify predictors of mortality in hospitalized patients with Crimean-Congo hemorrhagic fever (CCHF). A case-control study was conducted on patients hospitalized with CCHF from 2012 to 2022. Risk factors for mortality in CCHF patients were analyzed using logistic regression. A total of 86 patients with a median age of 36 years (interquartile range [IQR], 27-36 years) were included, and the majority were males (78, 90.7%). Thirty-one patients (36%) were cases, whereas 55 (64%) were control patients. Based on univariate logistic regression analysis, patients who were in an age group of ≥40 years (odds ratio [OR]: 4.85; 95% CI: 1.8-12.4) or with presence of gum bleeding (OR: 2.66; 95% CI: 1.0-6.8), unit increase in white blood cell count (WBC) (OR: 1.09; 95% CI: 1.00-1.07), serum glutamate-pyruvate transaminase of ≥500 U/L (OR: 3.68; 95% CI: 1.4-9.3), serum glutamic-oxaloacetic transaminase (SGOT) of ≥1,000 U/L (OR: 8.72; 95% CI: 2.6-28.3), prothrombin time (PT) of ≥120 seconds (OR: 9.85; 95% CI: 3.2-29.8), international normalized ratio of ≥5 (OR: 15.8; 95% CI: 2.0-125.3), or acute respiratory distress syndrome (ARDS) (OR: 28.27; 95% CI: 5.84-136.9) were found to be significantly associated with mortality in CCHF. Factors found to be independently associated with mortality on multivariate analysis included ARDS (adjusted OR [aOR]: 27.7; 95% CI: 4.0-190.5), unit increase in WBC (aOR: 1.02; 95% CI: 1.02-1.26), SGOT of ≥1,000 U/L (aOR: 23.6; 95% CI: 2.32-241.7), and PT of ≥120 seconds (OR: 10.2; 95% CI: 2.00-52.4). CCHF is a rare but fatal disease, and patients with ARDS and increased WBC, high SGOT level, and increased PT indicative of liver injury and coagulopathy at the time of hospitalization are at high risk for mortality.
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Affiliation(s)
| | - Soha Zahid
- Aga Khan University Hospital, Karachi, Pakistan
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Arslan M, Comoglu S. Evaluation of epidemiological, clinical, laboratory and treatment characteristics of Crimen Congo hemorrhagic fever patients: Results of a 10-year analysis. North Clin Istanb 2024; 11:177-183. [PMID: 39005753 PMCID: PMC11237834 DOI: 10.14744/nci.2023.09815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/19/2023] [Indexed: 07/16/2024] Open
Abstract
OBJECTIVE Crimean-Congo hemorrhagic fever (CCHF) is a viral zoonosis transmitted by ticks and may have an acute and severe course with fever, bleeding, muscle aches, headache, diarrhea, weakness, and similar non-specific symptoms. This study aimed to determine the distribution of CCHF cases in Amasya province, which is endemic for this disease, according to districts, epidemiological, clinical, laboratory, and treatment characteristics. METHODS The characteristics of 88 CCHF cases over 18 who were admitted to our clinic and treated between January 2013 and January 2023 were evaluated retrospectively. Demographic data such as age, gender, occupation, district of residence, history of tick contact, the incubation period of the disease, period of development of the disease (months, years), length of hospital stay, symptoms, physical examination and laboratory findings, blood product replacement therapies applied, recovery and mortality status of the patients were reached by scanning the patient files. RESULTS The mean age (±standard deviation) of 88 cases was 48±18 years, and 53 (60.2%) were male. Of the patients, 68 (77.3%) were engaged in farming and animal husbandry, and 79 (89.7%) lived in villages and hamlets. Tasova district had the highest frequency of cases, with 29 (32.9%) patients. June was the most common month for the disease, with 31 (35.2%) cases. The most common symptom on admission was fatigue, with a rate of 93%. Other symptoms included myalgia and arthralgia (83.2%), fever (65%), headache (64.4%), nausea-vomiting (43.5%), conjunctival hyperemia (35.2%), and diarrhea (21.7%). In clinical follow-up, bleeding was missed in 15 (17.04%) patients. On admission to the hospital, there were elevated levels of thrombocytopenia (92%), leukopenia (84.1%), aspartate aminotransferase and alanine aminotransferase (86.3%), creatinine phosphokinase (71.6%), and lactate dehydrogenase (76.1%). None of the patients were given ribavirin treatment. Our mortality rate was 3.40% with three patients. CONCLUSION Amasya is an endemic area for CCHF with all its districts. In our province's spring and summer months, tick contact history and the farming-livestock profession should be questioned in patients with fever complaints in clinic admissions, especially emergency services. In the case of the detection of thrombocytopenia in these patients, CCHF should be kept in mind.
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Affiliation(s)
- Mustafa Arslan
- Department of Infectious Diseases and Clinical Microbiology, Amasya Sabuncuoglu Serefeddin Training and Research Hospital, Amasya, Turkiye
| | - Senol Comoglu
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkiye
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Mo Q, Feng K, Dai S, Wu Q, Zhang Z, Ali A, Deng F, Wang H, Ning YJ. Transcriptome profiling highlights regulated biological processes and type III interferon antiviral responses upon Crimean-Congo hemorrhagic fever virus infection. Virol Sin 2023; 38:34-46. [PMID: 36075566 PMCID: PMC10006212 DOI: 10.1016/j.virs.2022.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/12/2022] [Indexed: 11/17/2022] Open
Abstract
Crimean-Congo hemorrhagic fever virus (CCHFV) is a biosafety level-4 (BSL-4) pathogen that causes Crimean-Congo hemorrhagic fever (CCHF) characterized by hemorrhagic manifestation, multiple organ failure and high mortality rate, posing great threat to public health. Despite the recently increasing research efforts on CCHFV, host cell responses associated with CCHFV infection remain to be further characterized. Here, to better understand the cellular response to CCHFV infection, we performed a transcriptomic analysis in human kidney HEK293 cells by high-throughput RNA sequencing (RNA-seq) technology. In total, 496 differentially expressed genes (DEGs), including 361 up-regulated and 135 down-regulated genes, were identified in CCHFV-infected cells. These regulated genes were mainly involved in host processes including defense response to virus, response to stress, regulation of viral process, immune response, metabolism, stimulus, apoptosis and protein catabolic process. Therein, a significant up-regulation of type III interferon (IFN) signaling pathway as well as endoplasmic reticulum (ER) stress response was especially remarkable. Subsequently, representative DEGs from these processes were well validated by RT-qPCR, confirming the RNA-seq results and the typical regulation of IFN responses and ER stress by CCHFV. Furthermore, we demonstrate that not only type I but also type III IFNs (even at low dosages) have substantial anti-CCHFV activities. Collectively, the data may provide new and comprehensive insights into the virus-host interactions and particularly highlights the potential role of type III IFNs in restricting CCHFV, which may help inform further mechanistic delineation of the viral infection and development of anti-CCHFV strategies.
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Affiliation(s)
- Qiong Mo
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071/430207, China; University of Chinese Academy of Sciences, Beijing, 101408, China
| | - Kuan Feng
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071/430207, China
| | - Shiyu Dai
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071/430207, China; University of Chinese Academy of Sciences, Beijing, 101408, China
| | - Qiaoli Wu
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071/430207, China
| | - Zhong Zhang
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071/430207, China
| | - Ashaq Ali
- University of Chinese Academy of Sciences, Beijing, 101408, China; Centre of Excellence in Science and Applied Technologies, Islamabad, 45320, Pakistan
| | - Fei Deng
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071/430207, China; Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, 430071/430207, China.
| | - Hualin Wang
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071/430207, China; Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, 430071/430207, China.
| | - Yun-Jia Ning
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071/430207, China; Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, 430071/430207, China.
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Oluwayelu DO, Moutailler S, Odemuyiwa SO. Editorial: Tick-borne viruses of domestic livestock: Epidemiology, evolutionary trends, biology and climate change impact. Front Vet Sci 2023; 10:1147770. [PMID: 37026097 PMCID: PMC10071661 DOI: 10.3389/fvets.2023.1147770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/08/2023] [Indexed: 04/08/2023] Open
Affiliation(s)
- Daniel O. Oluwayelu
- Department of Veterinary Microbiology, University of Ibadan, Ibadan, Nigeria
- Centre for Control and Prevention of Zoonoses (CCPZ), University of Ibadan, Ibadan, Nigeria
- *Correspondence: Daniel O. Oluwayelu ;
| | - Sara Moutailler
- ANSES, INRAE, Ecole Nationale Vétérinaire d'Alfort, UMR BIPAR, Laboratoire de Santé Animale, Maisons-Alfort, France
| | - Solomon O. Odemuyiwa
- Department of Veterinary Pathobiology, College of Veterinary Medicine, University of Missouri, Columbia, MO, United States
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Bernard C, Holzmuller P, Bah MT, Bastien M, Combes B, Jori F, Grosbois V, Vial L. Systematic Review on Crimean–Congo Hemorrhagic Fever Enzootic Cycle and Factors Favoring Virus Transmission: Special Focus on France, an Apparently Free-Disease Area in Europe. Front Vet Sci 2022; 9:932304. [PMID: 35928117 PMCID: PMC9343853 DOI: 10.3389/fvets.2022.932304] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/15/2022] [Indexed: 12/03/2022] Open
Abstract
Crimean–Congo hemorrhagic fever (CCHF) is a viral zoonotic disease resulting in hemorrhagic syndrome in humans. Its causative agent is naturally transmitted by ticks to non-human vertebrate hosts within an enzootic sylvatic cycle. Ticks are considered biological vectors, as well as reservoirs for CCHF virus (CCHFV), as they are able to maintain the virus for several months or even years and to transmit CCHFV to other ticks. Although animals are not symptomatic, some of them can sufficiently replicate the virus, becoming a source of infection for ticks as well as humans through direct contact with contaminated body fluids. The recent emergence of CCHF in Spain indicates that tick–human interaction rates promoting virus transmission are changing and lead to the emergence of CCHF. In other European countries such as France, the presence of one of its main tick vectors and the detection of antibodies targeting CCHFV in animals, at least in Corsica and in the absence of human cases, suggest that CCHFV could be spreading silently. In this review, we study the CCHFV epidemiological cycle as hypothesized in the French local context and select the most likely parameters that may influence virus transmission among tick vectors and non-human vertebrate hosts. For this, a total of 1,035 articles dating from 1957 to 2021 were selected for data extraction. This study made it possible to identify the tick species that seem to be the best candidate vectors of CCHFV in France, but also to highlight the importance of the abundance and composition of local host communities on vectors' infection prevalence. Regarding the presumed transmission cycle involving Hyalomma marginatum, as it might exist in France, at least in Corsica, it is assumed that tick vectors are still weakly infected and the probability of disease emergence in humans remains low. The likelihood of factors that may modify this equilibrium is discussed.
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Affiliation(s)
- Célia Bernard
- CIRAD, UMR ASTRE, Montpellier, France
- ASTRE, Univ Montpellier, CIRAD, INRAE, Montpellier, France
- French Establishment for Fighting Zoonoses (ELIZ), Malzéville, France
- *Correspondence: Célia Bernard
| | - Philippe Holzmuller
- CIRAD, UMR ASTRE, Montpellier, France
- ASTRE, Univ Montpellier, CIRAD, INRAE, Montpellier, France
| | - Madiou Thierno Bah
- CIRAD, UMR ASTRE, Montpellier, France
- ASTRE, Univ Montpellier, CIRAD, INRAE, Montpellier, France
| | - Matthieu Bastien
- French Establishment for Fighting Zoonoses (ELIZ), Malzéville, France
| | - Benoit Combes
- French Establishment for Fighting Zoonoses (ELIZ), Malzéville, France
| | - Ferran Jori
- CIRAD, UMR ASTRE, Montpellier, France
- ASTRE, Univ Montpellier, CIRAD, INRAE, Montpellier, France
| | - Vladimir Grosbois
- CIRAD, UMR ASTRE, Montpellier, France
- ASTRE, Univ Montpellier, CIRAD, INRAE, Montpellier, France
| | - Laurence Vial
- CIRAD, UMR ASTRE, Montpellier, France
- ASTRE, Univ Montpellier, CIRAD, INRAE, Montpellier, France
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Zhang R, Song H, Chen Q, Wang Y, Wang S, Li Y. Comparison of ARIMA and LSTM for prediction of hemorrhagic fever at different time scales in China. PLoS One 2022; 17:e0262009. [PMID: 35030203 PMCID: PMC8759700 DOI: 10.1371/journal.pone.0262009] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 12/15/2021] [Indexed: 11/29/2022] Open
Abstract
Objectives This study intends to build and compare two kinds of forecasting models at different time scales for hemorrhagic fever incidence in China. Methods Autoregressive Integrated Moving Average (ARIMA) and Long Short-Term Memory Neural Network (LSTM) were adopted to fit monthly, weekly and daily incidence of hemorrhagic fever in China from 2013 to 2018. The two models, combined and uncombined with rolling forecasts, were used to predict the incidence in 2019 to examine their stability and applicability. Results ARIMA (2, 1, 1) (0, 1, 1)12, ARIMA (1, 1, 3) (1, 1, 1)52 and ARIMA (5, 0, 1) were selected as the best fitting ARIMA model for monthly, weekly and daily incidence series, respectively. The LSTM model with 64 neurons and Stochastic Gradient Descent (SGDM) for monthly incidence, 8 neurons and Adaptive Moment Estimation (Adam) for weekly incidence, and 64 neurons and Root Mean Square Prop (RMSprop) for daily incidence were selected as the best fitting LSTM models. The values of root mean square error (RMSE), mean absolute error (MAE) and mean absolute percentage error (MAPE) of the models combined with rolling forecasts in 2019 were lower than those of the direct forecasting models for both ARIMA and LSTM. It was shown from the forecasting performance in 2019 that ARIMA was better than LSTM for monthly and weekly forecasting while the LSTM was better than ARIMA for daily forecasting in rolling forecasting models. Conclusions Both ARIMA and LSTM could be used to build a prediction model for the incidence of hemorrhagic fever. Different models might be more suitable for the incidence prediction at different time scales. The findings can provide a good reference for future selection of prediction models and establishments of early warning systems for hemorrhagic fever.
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Affiliation(s)
- Rui Zhang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Hejia Song
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qiulan Chen
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yu Wang
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Songwang Wang
- Chinese Center for Disease Control and Prevention, Beijing, China
- * E-mail: (SW); (YL)
| | - Yonghong Li
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
- * E-mail: (SW); (YL)
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Yilmaz R, Karaaslan E, Albayrak SE, Gul A, Kasap T. Analysis of Pediatric Intensive Care Unit Admissions for Crimean–Congo Hemorrhagic Fever in Turkey. J PEDIAT INF DIS-GER 2020. [DOI: 10.1055/s-0040-1713162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Abstract
Objective The aim of this study was to determine the clinical characteristics, course of disease, and outcomes of patients admitted to our pediatric intensive care unit (PICU) for Crimean–Congo hemorrhagic fever (CCHF).
Methods Data of all patients with CCHF who were admitted to PICU during a 3-year period and whose diagnosis was confirmed by serological methods or polymerase chain reaction were retrospectively reviewed. Their presenting characteristics, treatments, and outcomes were extracted from the hospital's electronic database. Disease severity scoring was performed using the severity scoring index and severity grading score system.
Results The data of 22 of 123 patients with suspected CCHF who were admitted to PICU were evaluated. Among them, 68.2% were males and mean age of all patients was 13.4 ± 2.2 years. The average length of stay of 10 patients was >10 days. On average, 3.72 units of platelet suspension per patient was transfused. In the course of the disease, the highest laboratory values were reached on day 3 of admission.
Conclusion Poor CCHF outcome depends on thrombocytopenia severity, prolonged coagulation tests, high-liver enzyme levels, and disseminated intravascular coagulation. Poor outcomes can be avoided by CCHF awareness and preparedness, early diagnosis of the disease, and supportive treatment with appropriate fluid and blood product transfusion. Randomized controlled trials on prophylactic transfusion and ribavirin use are needed.
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Affiliation(s)
- Resul Yilmaz
- Division of Pediatric Critical Care, Department of Pediatrics, Selcuk University School of Medicine, Konya, Turkey
| | - Erhan Karaaslan
- Department of Pediatrics, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | | | - Ali Gul
- Department of Pediatrics, Gaziosmanpasa University School of Medicine, Tokat, Turkey
| | - Tuba Kasap
- Department of Pediatrics, Gaziosmanpasa University School of Medicine, Tokat, Turkey
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Nasirian H. New aspects about Crimean-Congo hemorrhagic fever (CCHF) cases and associated fatality trends: A global systematic review and meta-analysis. Comp Immunol Microbiol Infect Dis 2020; 69:101429. [PMID: 32062190 DOI: 10.1016/j.cimid.2020.101429] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 01/22/2020] [Accepted: 01/24/2020] [Indexed: 02/05/2023]
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is the most popular tick-borne disease causing by Crimean-Congo hemorrhagic fever virus (CCHFV). There are several valuable reviews considering some fields of the CCHF aspects. While there is no a systematic review about means and trends of CCHF cases and fatality rate, means and trends of CCHF cases and fatality rates of human occupations involved in CCHF. Therefore, this meta-analysis review performed to highlight and provide a global detailed of the above CCHF aspects. Among 398 collected papers, 173 papers were become this meta-analysis review. The study results confirm that an apparent increasing CCHF cases occurred through the past decades. The trends of annually and periodically CCHF cases and fatality rates were also increased. The means of annually and periodically CCHF cases and fatality rates were 57 and 432 cases, and 10 cases and 32.2 % and 49 cases and 28.8 %, respectively. The means of annually and periodically CCHF fatality rates are about one-tenth of CCHF human cases. The mean of CCHF fatality rates in Africa (22.0 %) is lower than Asia (33.5 %) and Europe (33.8 %). Among occupations involved in CCHF, agricultural (28.9 %), health-care (19.2 %) and slaughterhouse (16.7 %) workers, and farmers (13.9 %) had the maximum CCHF fatality rates in order. Based on literature review of CCHFV S-segment aspects, several clades and genotypes are reported to distribute in Africa, Asia and Europe regions. There are very wide fields to investigate the epidemiology characteristics of CCHFV clades, genotypes and their distribution in the future.
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Affiliation(s)
- Hassan Nasirian
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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Nasirian H. Crimean-Congo hemorrhagic fever (CCHF) seroprevalence: A systematic review and meta-analysis. Acta Trop 2019; 196:102-120. [PMID: 31108083 DOI: 10.1016/j.actatropica.2019.05.019] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 04/07/2019] [Accepted: 05/15/2019] [Indexed: 12/13/2022]
Abstract
Crimean-Congo haemorrhagic fever (CCHF) is the most widespread, tick-borne viral disease affecting humans and therefore this paper performed a meta-analysis to highlight seroprevalence features of CCHF in a global context. After a preliminary review of the 396 papers representing areas throughout the world, 206 were selected for detailed meta-analysis. In general the total means of CCHF seroprevalence were, respectively 4.7 and 24.6% for humans and animals; and 17.1, 18.9, 24.3, 29.3 and 27.1% for camels, cattle, goats, sheep and livestock. Statistical analysis revealed a significant difference in seroprevalence between humans and camels (P = 0.043), cattle (P = 0.010), goats (P = 0.015), sheep (P = 0.005) and livestock (P = 0.017). Regionally, there also was a difference between humans, and goats (P = 0.0001), sheep (P = 0.007) and livestock (P = 0.002). Globally, CCHF seroprevalence in at-risk professionals was 7.5 fold greater than in normal humans, while CCHF seroprevalence was 5 fold greater in animals, camels, cattle, goats, sheep and livestock than normal humans. Animal contact, animal husbandry, farming, tick bite history and secretion exposure were the most frequently reported CCHF seropositivity risk factors. This study serves as an important resource for epidemiological discussions related to CCHF and CCHF seroprevalence features, providing specific information in understanding human and animal mean and trend CCHF seroprevalence for different regions of the world and on an aggregate global scale; seroprevalence in at-risk professionals; and total mean and trend CCHF seropositivity involving risk factors.
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Affiliation(s)
- Hassan Nasirian
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Enqelab Square, Zip code 1346689151, Tehran, Iran.
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Jeeva S, Mir S, Velasquez A, Ragan J, Leka A, Wu S, Sevarany AT, Royster AD, Almeida NA, Chan F, O'Brien L, Mir MA. Crimean-Congo hemorrhagic fever virus nucleocapsid protein harbors distinct RNA-binding sites in the stalk and head domains. J Biol Chem 2019; 294:5023-5037. [PMID: 30723154 DOI: 10.1074/jbc.ra118.004976] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 01/17/2019] [Indexed: 11/06/2022] Open
Abstract
Crimean-Congo hemorrhagic fever virus (CCHFV) is a tick-borne Nairovirus that causes severe hemorrhagic fever with a mortality rate of up to 30% in certain outbreaks worldwide. The virus has wide endemic distribution. There is no effective antiviral therapeutic or FDA approved vaccine for this zoonotic viral illness. The multifunctional CCHFV nucleocapsid protein (N protein) plays a crucial role in the establishment of viral infection and is an important structural component of the virion. Here we show that CCHFV N protein has a distant RNA-binding site in the stalk domain that specifically recognizes the vRNA panhandle, formed by the base pairing of complementary nucleotides at the 5' and 3' termini of the vRNA genome. Using multiple approaches, including filter-bonding analysis, GFP reporter assay, and biolayer interferometry we observed an N protein-panhandle interaction both in vitro and in vivo The purified WT CCHFV N protein and the stalk domain also recognize the vRNA panhandle of hazara virus, another Nairovirus in the family Bunyaviridae, demonstrating the genus-specific nature of N protein-panhandle interaction. Another RNA-binding site was identified at the head domain of CCHFV N protein that nonspecifically recognizes the single strand RNA (ssRNA) of viral or nonviral origin. Expression of CCHFV N protein stalk domain active in panhandle binding, dramatically inhibited the hazara virus replication in cell culture, illustrating the role of N protein-panhandle interaction in Nairovirus replication. Our findings reveal the stalk domain of N protein as a potential target in therapeutic interventions to manage CCHFV disease.
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Affiliation(s)
- Subbiah Jeeva
- From the Western University of Health Sciences, Pomona, California 91766
| | - Sheema Mir
- Applied BioCode, Santa Fe Springs, California 90670, and
| | - Adrain Velasquez
- the College of Science, California State Polytechnic University, Pomona, California 91766
| | - Jacquelyn Ragan
- From the Western University of Health Sciences, Pomona, California 91766
| | - Aljona Leka
- the College of Science, California State Polytechnic University, Pomona, California 91766
| | - Sharon Wu
- the College of Science, California State Polytechnic University, Pomona, California 91766
| | | | - Austin D Royster
- the College of Science, California State Polytechnic University, Pomona, California 91766
| | - Nicholas A Almeida
- the College of Science, California State Polytechnic University, Pomona, California 91766
| | - Fion Chan
- the College of Science, California State Polytechnic University, Pomona, California 91766
| | - Lea O'Brien
- the College of Science, California State Polytechnic University, Pomona, California 91766
| | - Mohammad Ayoub Mir
- From the Western University of Health Sciences, Pomona, California 91766,
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11
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An Outbreak of Crimean-Congo Hemorrhagic Fever in the South West of Iran. Jundishapur J Microbiol 2016. [DOI: 10.5812/jjm.41735] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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12
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Dórea FC, Elbers AR, Hendrikx P, Enoe C, Kirkeby C, Hoinville L, Lindberg A. Vector-borne disease surveillance in livestock populations: A critical review of literature recommendations and implemented surveillance (BTV-8) in five European countries. Prev Vet Med 2016; 125:1-9. [DOI: 10.1016/j.prevetmed.2016.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 11/27/2015] [Accepted: 01/02/2016] [Indexed: 10/22/2022]
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13
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Cikman A, Aydin M, Gulhan B, Karakecili F, Kesik OA, Ozcicek A, Akin H, Kara M. Seroprevalence of Crimean-Congo Hemorrhagic Fever Virus in Erzincan Province, Turkey, Relationship with Geographic Features and Risk Factors. Vector Borne Zoonotic Dis 2016; 16:199-204. [PMID: 26808904 DOI: 10.1089/vbz.2015.1879] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To determine the seroprevalence and risk factors associated with Crimean-Congo hemorrhagic fever virus (CCHFV) in residents of Erzincan, Turkey. Although CCHFV is endemic in Erzincan, this is the first study to evaluate its seroprevalence in this region. This study included a total of 372 subjects, 174 of whom had been exposed to or bitten by ticks, 145 of whom worked with livestock, and 53 of whom resided in the city and did not have exposure to livestock. Data on CCHFV IgG and IgM antibodies were extracted from serum samples collected from all subjects using an ELISA. All samples were tested for CCHFV IgG and CCHFV IgM. Only IgM-positive samples were processed for detection of viral RNA through RT-PCR. Using seropositive cases only, we performed spatial analyses to evaluate correlations between seroprevalence and geographic location (i.e., proximity to rivers, altitude, and slope angle of land). In this study, 14.0% (52/322) of the total subjects were positive for CCHFV IgG. Seven of the individuals were positive both for CCHFV IgG and CCHFV IgM. Of these seven, only one sample tested positive for CCHFV RNA. Individuals who worked with livestock in the rural areas and had a history of tick exposure were statistically more likely to test positive for CCHFV IgG than individuals from the city and not exposed to ticks (p < 0.05). Seroprevalence was affected by geographic characteristics, including distance to rivers, altitude, and slope angle of land. We observed a high seroprevalence of CCHFV in Erzincan, which is similar to that observed in other endemic regions of Turkey. CCHFV seroprevalence rates are found to be quite high in the people who live in the sloping fields at certain heights and where there are a lot of rivers and streams.
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Affiliation(s)
- Aytekin Cikman
- 1 Department of Medical Microbiology, Erzincan University , Erzincan, Turkey
| | - Merve Aydin
- 1 Department of Medical Microbiology, Erzincan University , Erzincan, Turkey
| | - Baris Gulhan
- 1 Department of Medical Microbiology, Erzincan University , Erzincan, Turkey
| | - Faruk Karakecili
- 2 Department of Infectious Diseases, Faculty of Medicine, Erzincan University , Erzincan, Turkey
| | - Ozan Arif Kesik
- 3 Department of Geography, Faculty of Arts and Sciences, Erzincan University , Erzincan, Turkey
| | - Adalet Ozcicek
- 4 Department of Internal Medicine, Faculty of Medicine, Erzincan University , Erzincan, Turkey
| | - Hicran Akin
- 2 Department of Infectious Diseases, Faculty of Medicine, Erzincan University , Erzincan, Turkey
| | - Murat Kara
- 1 Department of Medical Microbiology, Erzincan University , Erzincan, Turkey
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Switkes J, Nannyonga B, Mugisha JYT, Nakakawa J. A mathematical model for Crimean-Congo haemorrhagic fever: tick-borne dynamics with conferred host immunity. JOURNAL OF BIOLOGICAL DYNAMICS 2016; 10:59-70. [PMID: 26550705 DOI: 10.1080/17513758.2015.1102976] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Crimean-Congo haemorrhagic fever (CCHF) is a highly contagious tick-borne disease that impacts many countries in parts of Africa, Europe, Asia, and the Middle East. Outbreaks are episodic, but deadly. Due to the highly contagious nature of this disease, suspected cases are taken extremely serious, with very strong control measures implemented almost immediately. It is primarily those living on farms, livestock workers, and medical workers who are at risk. The virus responsible for CCHF is transmitted asymptomatically and transiently to livestock, and symptomatically to humans. The fatality rate in human cases can be very high. The number of methods and directions of viral transmission is large, including tick-to-tick, tick-to-livestock, tick-to-human, livestock-to-tick, livestock-to-human, and human-to-human. We model CCHF using a deterministic system of nonlinear differential equations. This compartment model allows us to analyse threshold parameters and equilibria describing the magnitude and progression of cases of the disease in a hypothetical outbreak.
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Affiliation(s)
- J Switkes
- a Department of Mathematics and Statistics , California State Polytechnic University , Pomona , CA , USA
| | - B Nannyonga
- b Department of Mathematics , School of Physical Sciences, College of Natural Sciences, Makerere University , Kampala , Uganda
| | - J Y T Mugisha
- b Department of Mathematics , School of Physical Sciences, College of Natural Sciences, Makerere University , Kampala , Uganda
| | - J Nakakawa
- b Department of Mathematics , School of Physical Sciences, College of Natural Sciences, Makerere University , Kampala , Uganda
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15
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Aslam S, Latif MS, Daud M, Rahman ZU, Tabassum B, Riaz MS, Khan A, Tariq M, Husnain T. Crimean-Congo hemorrhagic fever: Risk factors and control measures for the infection abatement. Biomed Rep 2015; 4:15-20. [PMID: 26870327 DOI: 10.3892/br.2015.545] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 09/18/2015] [Indexed: 11/06/2022] Open
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is a vector-borne viral disease, widely distributed in different regions of the world. The fever is caused by the CCHF virus (CCHFV), which belongs to the Nairovirus genus and Bunyaviridae family. The virus is clustered in seven genotypes, which are Africa-1, Africa-2, Africa-3, Europe-1, Europe-2, Asia-1 and Asia-2. The virus is highly pathogenic in nature, easily transmissible and has a high case fatality rate of 10-40%. The reservoir and vector of CCHFV are the ticks of the Hyalomma genus. Therefore, the circulation of this virus depends upon the distribution of the ticks. The virus can be transmitted from tick to animal, animal to human and human to human. The major symptoms include headache, high fever, abdominal pain, myalgia, hypotension and flushed face. As the disease progresses, severe symptoms start appearing, which include petechiae, ecchymosis, epistaxis, bleeding gums and emesis. Enzyme-linked immunosorbent assay, quantitative polymerase chain reaction, antigen detection, serum neutralization and isolation of the virus by cell culture are the diagnostic techniques used for this viral infection. There is no specific antiviral therapy available thus far. However, ribavirin has been approved by the World Health Organization for the treatment of CCHFV infection. Awareness campaigns regarding the risk factors and control measures can aid in reducing the spread of this disease to a greater extent, particularly in developing countries.
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Affiliation(s)
- Saadia Aslam
- National Centre of Excellence in Molecular Biology, University of the Punjab, Thokar Niaz Baig, Lahore 53700, Pakistan
| | - Muhammad Shahzad Latif
- National Centre of Excellence in Molecular Biology, University of the Punjab, Thokar Niaz Baig, Lahore 53700, Pakistan
| | - Muhammad Daud
- National Centre of Excellence in Molecular Biology, University of the Punjab, Thokar Niaz Baig, Lahore 53700, Pakistan
| | - Zia Ur Rahman
- National Centre of Excellence in Molecular Biology, University of the Punjab, Thokar Niaz Baig, Lahore 53700, Pakistan
| | - Bushra Tabassum
- National Centre of Excellence in Molecular Biology, University of the Punjab, Thokar Niaz Baig, Lahore 53700, Pakistan
| | | | - Anwar Khan
- National Centre of Excellence in Molecular Biology, University of the Punjab, Thokar Niaz Baig, Lahore 53700, Pakistan
| | - Muhammad Tariq
- National Centre of Excellence in Molecular Biology, University of the Punjab, Thokar Niaz Baig, Lahore 53700, Pakistan
| | - Tayyab Husnain
- National Centre of Excellence in Molecular Biology, University of the Punjab, Thokar Niaz Baig, Lahore 53700, Pakistan
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16
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Clinical significance of neutrophil gelatinase-associated lipocalin in Crimean-Congo hemorrhagic Fever. BIOMED RESEARCH INTERNATIONAL 2015. [PMID: 25685783 DOI: 10.1155/2015/374010.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Neutrophil gelatinase-associated lipocalin (NGAL), which is an important prognostic marker for sepsis and inflammatory diseases, is mostly released from neutrophils. Crimean-Congo hemorrhagic fever (CCHF) patients are generally neutropenic. We aimed to investigate whether there is a change in serum NGAL level and to investigate its effect on the recovery time (RT) during the course of CCHF. A total of 40 CCHF patients (19 females and 21 males) and 34 healthy controls (17 females and 17 males) were included in the study. The serum NGAL level and biochemical and hematological parameters were checked. The NGAL level of CCHF patients was significantly higher than that of the healthy controls (P < 0.001). A multivariate analysis showed that the independent prognostic factor for the prediction of the RT is the NGAL level (odds ratio [OR] 0.3, 95% confidence interval [Cl] 0.1-0.4, P < 0.001). An elevated NGAL level was found to be associated with an increased RT in CCHF patients. The NGAL levels of CHHF patients might be elevated due to increased cytokine release, the presence of a tissue injury, and the release of immature neutrophils from the bone marrow into the peripheral stream. This may be a good prognostic factor in CHHF patients.
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Erturk A, Cure E, Parlak E, Cumhur Cure M, Baydur Sahin S, Yuce S. Clinical significance of neutrophil gelatinase-associated lipocalin in Crimean-Congo hemorrhagic Fever. BIOMED RESEARCH INTERNATIONAL 2015; 2015:374010. [PMID: 25685783 PMCID: PMC4317576 DOI: 10.1155/2015/374010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 09/13/2014] [Accepted: 09/30/2014] [Indexed: 02/07/2023]
Abstract
Neutrophil gelatinase-associated lipocalin (NGAL), which is an important prognostic marker for sepsis and inflammatory diseases, is mostly released from neutrophils. Crimean-Congo hemorrhagic fever (CCHF) patients are generally neutropenic. We aimed to investigate whether there is a change in serum NGAL level and to investigate its effect on the recovery time (RT) during the course of CCHF. A total of 40 CCHF patients (19 females and 21 males) and 34 healthy controls (17 females and 17 males) were included in the study. The serum NGAL level and biochemical and hematological parameters were checked. The NGAL level of CCHF patients was significantly higher than that of the healthy controls (P < 0.001). A multivariate analysis showed that the independent prognostic factor for the prediction of the RT is the NGAL level (odds ratio [OR] 0.3, 95% confidence interval [Cl] 0.1-0.4, P < 0.001). An elevated NGAL level was found to be associated with an increased RT in CCHF patients. The NGAL levels of CHHF patients might be elevated due to increased cytokine release, the presence of a tissue injury, and the release of immature neutrophils from the bone marrow into the peripheral stream. This may be a good prognostic factor in CHHF patients.
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Affiliation(s)
- Ayse Erturk
- 1Department of Infectious Disease, School of Medicine, Recep Tayyip Erdogan University, Islampasa Mahallesi, 53100 Rize, Turkey
- *Ayse Erturk:
| | - Erkan Cure
- 2Department of Internal Medicine, School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Emine Parlak
- 3Department of Infectious Disease, School of Medicine, Ataturk University, Erzurum, Turkey
| | - Medine Cumhur Cure
- 4Department of Biochemistry, School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Serap Baydur Sahin
- 5Department of Endocrinology, School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Suleyman Yuce
- 2Department of Internal Medicine, School of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
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Abstract
Plant-made or "biofarmed" viral vaccines are some of the earliest products of the technology of plant molecular farming, and remain some of the brightest prospects for the success of this field. Proofs of principle and of efficacy exist for many candidate viral veterinary vaccines; the use of plant-made viral antigens and of monoclonal antibodies for therapy of animal and even human viral disease is also well established. This review explores some of the more prominent recent advances in the biofarming of viral vaccines and therapies, including the recent use of ZMapp for Ebolavirus infection, and explores some possible future applications of the technology.
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Affiliation(s)
- Edward P Rybicki
- Biopharming Research Unit, Department of Molecular & Cell Biology and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Private Bag X3, Rondebosch, 7701, Cape Town, South Africa.
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