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Negredo A, de la Calle-Prieto F, Palencia-Herrejón E, Mora-Rillo M, Astray-Mochales J, Sánchez-Seco MP, Bermejo Lopez E, Menárguez J, Fernández-Cruz A, Sánchez-Artola B, Keough-Delgado E, Ramírez de Arellano E, Lasala F, Milla J, Fraile JL, Ordobás Gavín M, Martinez de la Gándara A, López Perez L, Diaz-Diaz D, López-García MA, Delgado-Jimenez P, Martín-Quirós A, Trigo E, Figueira JC, Manzanares J, Rodriguez-Baena E, Garcia-Comas L, Rodríguez-Fraga O, García-Arenzana N, Fernández-Díaz MV, Cornejo VM, Emmerich P, Schmidt-Chanasit J, Arribas JR. Autochthonous Crimean-Congo Hemorrhagic Fever in Spain. N Engl J Med 2017; 377:154-161. [PMID: 28700843 DOI: 10.1056/nejmoa1615162] [Citation(s) in RCA: 139] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is a widely distributed, viral, tickborne disease. In Europe, cases have been reported only in the southeastern part of the continent. We report two autochthonous cases in Spain. The index patient acquired the disease through a tick bite in the province of Ávila - 300 km away from the province of Cáceres, where viral RNA from ticks was amplified in 2010. The second patient was a nurse who became infected while caring for the index patient. Both were infected with the African 3 lineage of this virus. (Funded by Red de Investigación Cooperativa en Enfermedades Tropicales [RICET] and Efficient Response to Highly Dangerous and Emerging Pathogens at EU [European Union] Level [EMERGE].).
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Affiliation(s)
- Anabel Negredo
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Fernando de la Calle-Prieto
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Eduardo Palencia-Herrejón
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Marta Mora-Rillo
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Jenaro Astray-Mochales
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - María P Sánchez-Seco
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Esther Bermejo Lopez
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Javier Menárguez
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Ana Fernández-Cruz
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Beatriz Sánchez-Artola
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Elena Keough-Delgado
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Eva Ramírez de Arellano
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Fátima Lasala
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Jakob Milla
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Jose L Fraile
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Maria Ordobás Gavín
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Amalia Martinez de la Gándara
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Lorenzo López Perez
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Domingo Diaz-Diaz
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - M Aurora López-García
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Pilar Delgado-Jimenez
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Alejandro Martín-Quirós
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Elena Trigo
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Juan C Figueira
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Jesús Manzanares
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Elena Rodriguez-Baena
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Luis Garcia-Comas
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Olaia Rodríguez-Fraga
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Nicolás García-Arenzana
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Maria V Fernández-Díaz
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Victor M Cornejo
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Petra Emmerich
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Jonas Schmidt-Chanasit
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
| | - Jose R Arribas
- From the Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III (A.N., M.P.S.-S., E.R.A., F.L.), Red de Investigación Colaborativa en Enfermedades Tropicales (A.N., M.P.S.-S., E.R.A., F.L.), High Level Isolation Unit (F.C.-P., M.M.-R., A.M.-Q., E.T., J.C.F., J. Manzanares, O.R.-F., V.M.C., J.R.A.) and Departments of Preventive Medicine (N.G.-A.) and Occupational Health (M.V.F.-D.), La Paz University Hospital, Intensive Care Unit (E.P.-H., A.M.G., L.L.P., D.D.-D., M.A.L.-G.) and Departments of Internal Medicine (B.S.-A.), Emergency (J.L.F.), and Occupational Health (P.D.-J.), Infanta Leonor University Hospital, Epidemiology Area of the Autonomous Community of Madrid (J.A.-M., M.O.G., E.R.-B., L.G.-C.), Intensive Care Unit (E.B.L., E.K.-D.) and Departments of Pathology (J. Menárguez, J. Milla) and Clinical Microbiology and Infectious Diseases (A.F.-C.), Gregorio Marañón University General Hospital, and Instituto de Investigación Sanitaria Gregorio Marañón, Complutense University (J. Menárguez, J. Milla, A.F.-C.) - all in Madrid; and the World Health Organization Collaborating Center for Arbovirus and Hemorrhagic Fever Reference and Research, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany (P.E., J.S.-C.)
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