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Komut S, Çorakyer N, Kaplan G, Baykam N. An Evaluation of the Hitit Index in Differential Diagnosis of Crimean-Congo Hemorrhagic Fever in the Emergency Department. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1796. [PMID: 37893514 PMCID: PMC10608086 DOI: 10.3390/medicina59101796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/25/2023] [Accepted: 09/28/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Crimean-Congo Hemorrhagic Fever (CCHF) is a viral zoonotic infection, which is seen over a wide geographic area. The mortality rate is in inverse proportion to the ability of patients to access healthcare services. Therefore, early identification of patients is extremely important. The aim of this study was to test the sensitivity and specificity of the Hitit Index in the differentiation of CCHF cases at the time of presentation at the Emergency Department and to evaluate the agreement of this index with molecular (CCHFV RNA) and/or serological diagnostic tests (ELISA-CCHF IgM). Materials and Methods: The patients included were those who presented at the Emergency Department (ED) with the complaint of a tick bite or those identified as potential CCHF cases as a result of complaints and/or laboratory findings. For cases that met the study inclusion criteria, the Hitit Index score was calculated automatically from the parameters included in the index formula uploaded to the automation system in the ED at the time of presentation. Through comparisons of the agreement of the Hitit Index with the CCHFV-RNA and/or IgM results the power of the Hitit Index for differentiation of CCHF cases in ED was evaluated. Results: The data of 273 patients were analyzed. There was a history of tick bite in 236 (86%) cases. Of the evaluated cases, 110 (40.2%) were hospitalized; CCHF positivity was determined in 72 (26.4%). The Hitit Index values calculated in ED and at 24 h after hospitalization were determined to be significant in the prediction of the CCHF cases (p < 0.001, AUC = 0.919 (0.887-0.951); p < 0.001, AUC = 0.902 (0.841-0.962). For a cut-off point of 0 of the Hitit Index evaluated in ED, the classification success was found to have a sensitivity of 75% and specificity of 88% (PPV-NPV). For a cut-off point of 0 of the Hitit Index evaluated at 24 h after hospitalization, the classification success was found to have a sensitivity of 79.7% and specificity of 84% (PPV-NPV). Conclusions: The defined form of the Hitit Index can be used in the differentiation of CCHF cases in ED with high sensitivity and specificity levels. Just as evaluation with the Hitit Index prevents unnecessary hospitalization, it can also contribute to reducing mortality rates with the early identification of CCHF cases.
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Affiliation(s)
- Seval Komut
- Department of Emergency Medicine, Faculty of Medicine, Hitit University, 19040 Çorum, Turkey;
| | - Nurullah Çorakyer
- Department of Emergency Medicine, Faculty of Medicine, Hitit University, 19040 Çorum, Turkey;
| | - Gülcan Kaplan
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hitit University, 19040 Çorum, Turkey; (G.K.); (N.B.)
| | - Nurcan Baykam
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Hitit University, 19040 Çorum, Turkey; (G.K.); (N.B.)
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Ozdarendeli A. Crimean-Congo Hemorrhagic Fever Virus: Progress in Vaccine Development. Diagnostics (Basel) 2023; 13:2708. [PMID: 37627967 PMCID: PMC10453274 DOI: 10.3390/diagnostics13162708] [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: 06/27/2023] [Revised: 08/03/2023] [Accepted: 08/04/2023] [Indexed: 08/27/2023] Open
Abstract
Crimean-Congo hemorrhagic fever virus (CCHFV), a member of the Nairoviridae family and Bunyavirales order, is transmitted to humans via tick bites or contact with the blood of infected animals. It can cause severe symptoms, including hemorrhagic fever, with a mortality rate between 5 to 30%. CCHFV is classified as a high-priority pathogen by the World Health Organization (WHO) due to its high fatality rate and the absence of effective medical countermeasures. CCHFV is endemic in several regions across the world, including Africa, Europe, the Middle East, and Asia, and has the potential for global spread. The emergence of the disease in new areas, as well as the presence of the tick vector in countries without reported cases, emphasizes the need for preventive measures to be taken. In the past, the lack of a suitable animal model susceptible to CCHFV infection has been a major obstacle in the development of vaccines and treatments. However, recent advances in biotechnology and the availability of suitable animal models have significantly expedited the development of vaccines against CCHF. These advancements have not only contributed to an enhanced understanding of the pathogenesis of CCHF but have also facilitated the evaluation of potential vaccine candidates. This review outlines the immune response to CCHFV and animal models utilized for the study of CCHFV and highlights the progress made in CCHFV vaccine studies. Despite remarkable advancements in vaccine development for CCHFV, it remains crucial to prioritize continued research, collaboration, and investment in this field.
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Affiliation(s)
- Aykut Ozdarendeli
- Department of Microbiology, Faculty of Medicine, Erciyes University, 38039 Kayseri, Türkiye;
- Vaccine Research, Development and Application Centre (ERAGEM), Erciyes University, 38039 Kayseri, Türkiye
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3
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Frías M, Cuadrado‐Matías R, del Castillo Jarilla‐Fernández M, López‐López P, Casades‐Martí L, Madrigal E, Rivero A, Rivero‐Juárez A, Ruiz‐Fons F. The spatial pattern of human exposure to Crimean-Congo haemorrhagic fever virus is not consistent with red deer-based risk predictions. Transbound Emerg Dis 2022; 69:e3208-e3214. [PMID: 35182451 PMCID: PMC9790474 DOI: 10.1111/tbed.14484] [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: 10/22/2021] [Revised: 01/19/2022] [Accepted: 02/16/2022] [Indexed: 12/30/2022]
Abstract
The objective of this study was to evaluate the spatial risk of exposure to Crimean-Congo haemorrhagic fever virus (CCHFV) infection of healthy blood donors in an enzootic region with a predicted risk gradient based on a virus-animal interaction risk model. We designed a cross-sectional study to test if the exposure pattern of the human population to CCHFV spatially matches the predicted risk. We randomly selected 1384 donors from different risk gradients and analyzed their sera searching for CCHFV antibodies. None of the selected blood donors showed exposure to CCHFV. This study shows that exposure risk spatial patterns, as predicted from animal-tick-virus models, does not necessarily match the pattern of human-infected tick interactions leading to CCHFV infection and CCHF cases, at least in a region of predicted moderate infection risk. The findings suggest that future studies should bear the potential drivers of tick-human encounter rates into account to more accurately predict risks.
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Affiliation(s)
- Mario Frías
- Infectious Diseases Unit, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)Hospital Universitario Reina Sofía de Córdoba, Universidad de CórdobaCórdobaSpain,CiberinfecCórdobaSpain
| | - Raúl Cuadrado‐Matías
- Health & Biotechnology (SaBio) GroupInstituto de Investigación en Recursos Cinegéticos IREC (CSIC‐UCLM‐JCCM)Ciudad RealSpain
| | | | - Pedro López‐López
- Infectious Diseases Unit, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)Hospital Universitario Reina Sofía de Córdoba, Universidad de CórdobaCórdobaSpain,CiberinfecCórdobaSpain
| | - Laia Casades‐Martí
- Health & Biotechnology (SaBio) GroupInstituto de Investigación en Recursos Cinegéticos IREC (CSIC‐UCLM‐JCCM)Ciudad RealSpain
| | - Elena Madrigal
- Blood BankHospital General Universitario de Ciudad RealCiudad RealSpain
| | - Antonio Rivero
- Infectious Diseases Unit, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)Hospital Universitario Reina Sofía de Córdoba, Universidad de CórdobaCórdobaSpain,CiberinfecCórdobaSpain
| | - Antonio Rivero‐Juárez
- Infectious Diseases Unit, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC)Hospital Universitario Reina Sofía de Córdoba, Universidad de CórdobaCórdobaSpain,CiberinfecCórdobaSpain
| | - Francisco Ruiz‐Fons
- Health & Biotechnology (SaBio) GroupInstituto de Investigación en Recursos Cinegéticos IREC (CSIC‐UCLM‐JCCM)Ciudad RealSpain
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Bratuleanu B, Anita A, Temmam S, Dascalu A, Crivei L, Cozma A, Pourquier P, Savuta G, Eloit M, Anita D. Seroprevalence of Crimean-Congo Hemorrhagic Fever Among Small Ruminants from Southern Romania. Vector Borne Zoonotic Dis 2022; 22:397-401. [PMID: 35772004 DOI: 10.1089/vbz.2021.0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease that can be contracted by direct contact with viremic animals or humans. Domestic animals are accidental hosts and contribute to the spread and amplification of the virus. The main objective of this study was to provide updated information related to CCHF virus (CCHFV) infection in Southern Romania by assessing the seroprevalence of CCHF in small ruminants (sheep and goats) using a double-antigen sandwich enzyme-linked immunosorbent assay and by detection of CCHFV in engorged ticks and serum samples using real-time RT-PCR. The overall seroprevalence of CCHF in small ruminants was 37.7% (95% CI 31.7 to 43.7). No statistical seroprevalence difference was observed between the two species of ruminants (p = 0.76), but a significant difference was established between the locations (p < 0.01). No CCHFV RNA was detected in tick pools and small ruminant's sera tested by real-time RT-PCR, although the high seroprevalence to CCHFV among ruminants indicates that CCHV or a closely related virus circulates in Southern Romania.
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Affiliation(s)
- Bianca Bratuleanu
- Pathogen Discovery Laboratory, Institut Pasteur, Paris, France.,Regional Center of Advanced Research for Emerging Diseases, Zoonoses and Food Safety (ROVETEMERG), "Ion Ionescu de la Brad" University of Life Sciences, Iasi, Romania
| | - Adriana Anita
- Regional Center of Advanced Research for Emerging Diseases, Zoonoses and Food Safety (ROVETEMERG), "Ion Ionescu de la Brad" University of Life Sciences, Iasi, Romania
| | - Sarah Temmam
- Pathogen Discovery Laboratory, Institut Pasteur, Paris, France.,OIE Collaborating Centre for Detection and Identification in Humans of Emerging Animal Pathogens, Institute Pasteur, Paris, France
| | - Anca Dascalu
- Regional Center of Advanced Research for Emerging Diseases, Zoonoses and Food Safety (ROVETEMERG), "Ion Ionescu de la Brad" University of Life Sciences, Iasi, Romania
| | - Luciana Crivei
- Regional Center of Advanced Research for Emerging Diseases, Zoonoses and Food Safety (ROVETEMERG), "Ion Ionescu de la Brad" University of Life Sciences, Iasi, Romania
| | - Andreea Cozma
- Regional Center of Advanced Research for Emerging Diseases, Zoonoses and Food Safety (ROVETEMERG), "Ion Ionescu de la Brad" University of Life Sciences, Iasi, Romania
| | | | - Gheorghe Savuta
- Regional Center of Advanced Research for Emerging Diseases, Zoonoses and Food Safety (ROVETEMERG), "Ion Ionescu de la Brad" University of Life Sciences, Iasi, Romania
| | - Marc Eloit
- Pathogen Discovery Laboratory, Institut Pasteur, Paris, France.,OIE Collaborating Centre for Detection and Identification in Humans of Emerging Animal Pathogens, Institute Pasteur, Paris, France.,Alfort National Veterinary School, Maisons-Alfort, France
| | - Dragos Anita
- Regional Center of Advanced Research for Emerging Diseases, Zoonoses and Food Safety (ROVETEMERG), "Ion Ionescu de la Brad" University of Life Sciences, Iasi, Romania
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Seroepidemiology of Crimean-Congo Hemorrhagic Fever Virus (CCHFV) in Cattle across Three Livestock Pastoral Regions in Kenya. DAIRY 2021. [DOI: 10.3390/dairy2030034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne zoonotic disease, endemic in Africa, with a high case fatality rate. There is no efficient treatment or licensed vaccine. This study aimed to determine the prevalence of CCHFV in cattle in extensive grazing systems (both pastoralism and ranching) within the Maasai Mara ecosystem, Nanyuki, and the Ol Pejeta Conservancy in Kenya. We conducted a seroepidemiological study of the sera of 148 cattle from 18 households from the three ecosystems in 2014, 2016, and 2019. Sera from 23 sheep and 17 goats were also obtained from the same households during the same period. Sera were analyzed for the presence of antibodies to CCHFV using the commercially available double-antigen ELISA kit. Overall, 31.5% CCHFV seropositivity was observed. The prevalence of CCHF was analyzed using a multiple logistic mixed model with main predictors. Risk factors associated with exposure to CCHFV were age (p = 0.000) and season (p = 0.007). Our findings suggest exposure to CCHFV and point to cattle as likely reservoirs of CCHFV in Kenya. The findings might play a role in providing better insights into disease risk and dynamics where analysis of tick populations in these regions should be further investigated.
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Balinandi S, von Brömssen C, Tumusiime A, Kyondo J, Kwon H, Monteil VM, Mirazimi A, Lutwama J, Mugisha L, Malmberg M. Serological and molecular study of Crimean-Congo Hemorrhagic Fever Virus in cattle from selected districts in Uganda. J Virol Methods 2021; 290:114075. [PMID: 33515661 DOI: 10.1016/j.jviromet.2021.114075] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/13/2021] [Accepted: 01/18/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Crimean-Congo Hemorrhagic Fever (CCHF) is a severe tick-borne viral hemorrhagic disease caused by Crimean-Congo Hemorrhagic Fever Virus (CCHFV) that poses serious public health challenges in many parts of Africa, Europe and Asia. METHODS We examined 500 cattle sera samples from five districts for CCHFV antibodies using in-house and commercially available (IDVet) ELISA, Immunofluorescent assay (IFA) and Real-time polymerase chain reaction (RT-PCR). RESULTS 500 cattle (73.8 % females) were analyzed; CCHFV seropositivity was 12.6 % (n = 63) and 75.0 % (n = 375) with the in-house and IDVet ELISAs, respectively. Seropositivity was associated with geographical location, increasing age, being female, and having a higher tick burden. Twenty four out of the 37 (64.8 %) were seropositive for CCHFV using IFA and all were negative for virus on RT-PCR. The IFA results were more comparable to IDVet (κcoefficient = 0.88, p = <0.01) than to in-house (κcoefficient = 0.32, p = 0.02). CONCLUSIONS Our study confirmed the presence and high prevalence of anti-CCHF antibodies in cattle based on three methods from all the five study districts, confirming presence and exposure of CCHFV. Given the zoonotic potential for CCHFV, we recommend a multidisciplinary public health surveillance and epidemiology of CCHFV in both animals and humans throughout the country.
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Affiliation(s)
- Stephen Balinandi
- Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda; College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, P.O. Box 7062, Kampala, Uganda.
| | - Claudia von Brömssen
- Division of Applied Statistics and Mathematics, Department of Engergy and Technology, Swedish University of Agricultural Sciences, Box 7013, Uppsala, 750 07, Sweden.
| | - Alex Tumusiime
- Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda.
| | - Jackson Kyondo
- Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda.
| | - Hyesoo Kwon
- National Veterinary Institute, Uppsala, 751 89, Sweden.
| | - Vanessa M Monteil
- Department of Laboratory Medicine, Karolinska Institute and Karolinska Hospital University, Stockholm, 171 77, Sweden.
| | - Ali Mirazimi
- National Veterinary Institute, Uppsala, 751 89, Sweden; Department of Laboratory Medicine, Karolinska Institute and Karolinska Hospital University, Stockholm, 171 77, Sweden; Public Health Agency of Sweden, Stockholm, 171 82, Sweden.
| | - Julius Lutwama
- Uganda Virus Research Institute, P.O. Box 49, Entebbe, Uganda.
| | - Lawrence Mugisha
- College of Veterinary Medicine, Animal Resources and Biosecurity, Makerere University, P.O. Box 7062, Kampala, Uganda; Ecohealth Research Group, Conservation & Ecosystem Health Alliance (CEHA), Box 34153, Kampala, Uganda.
| | - Maja Malmberg
- Section of Virology, Department of Biomedical Sciences and Veterinary Public Health, Swedish University of Agricultural Sciences, Box 7028, Uppsala, 750 07, Sweden; SLU Global Bioinformatics Centre, Department of Animal Breeding and Genetics, Swedish University of Agricultural Sciences, Box 7023, Uppsala, 750 07, Sweden.
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Discovery and genetic characterization of a novel orthonairovirus in Ixodes ricinus ticks from Danube Delta. INFECTION GENETICS AND EVOLUTION 2021; 88:104704. [PMID: 33418146 DOI: 10.1016/j.meegid.2021.104704] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/16/2020] [Accepted: 01/01/2021] [Indexed: 02/07/2023]
Abstract
Different arthropod species are vectors of a wide array of arboviruses (arthropod-borne viruses) and have likely been central to viral evolution. To better understand the extent of arthropod-borne pathogens, as well as their origin and evolutionary history, it is crucial to uncover the full range of microbial agents, including viruses associated with arthropods. In this study, a collection of ticks obtained in 2016 directly from mammal and bird hosts from several rural and natural sites of Danube Delta was subjected to transcriptome sequencing and amplification assays. Vector surveillance revealed the presence of a novel orthonairovirus species, designated Sulina virus, in Ixodes ricinus ticks. Phylogenetic clustering of each viral protein consistently placed the new virus in the Orthonairovirus genus as a new genogroup closely related to Tamdy orthonairovirus, a genogroup comprising both pathogenic and tick-associated orthonairoviruses. The serological testing of engorged ticks and blood of infected hosts, along with the inoculation of vertebrate cells and mice found no specific antibodies or viral replication, suggesting that Sulina virus is an orthonairovirus associated with the virome of Ixodes ricinus. Finally, the characterization of a novel orthonairovirus identified using high throughput sequencing will advance our knowledge of interactions between viruses and tick vectors, expanding our perspective on fundamental questions regarding orthonairovirus evolution, diversity, ecology and potential of emergence as pathogens.
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Tipih T, Burt FJ. Crimean-Congo Hemorrhagic Fever Virus: Advances in Vaccine Development. Biores Open Access 2020; 9:137-150. [PMID: 32461819 PMCID: PMC7247048 DOI: 10.1089/biores.2019.0057] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2020] [Indexed: 01/12/2023] Open
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is a severe human disease with mortality rates of up to 30%. The disease is widespread in Africa, Asia, the Middle East and Eastern Europe. The last few years have seen disease emergence in Spain for the first time and disease re-emergence in other regions of the world after periods of inactivity. Factors, such as climate change, movement of infected ticks, animals, and changes in human activity, are likely to broaden endemic foci. There are therefore concerns that CCHF might emerge in currently nonendemic regions. The absence of approved vaccines or therapies heightens these concerns; thus Crimean-Congo hemorrhagic fever virus (CCHFV) is listed by the World Health Organization as a priority organism. However, the current sporadic nature of CCHF cases may call for targeted vaccination of risk groups as opposed to mass vaccinations. CCHF vaccine development has accelerated in recent years, partly because of the discovery of CCHF animal models. In this review, we discuss CCHF risk groups who are most likely to benefit from vaccine development, the merits and demerits of available CCHF animal models, and the various approaches which have been explored for CCHF vaccine development. Lastly, we present concluding remarks and research areas which can be further explored to enhance the available CCHFV vaccine data.
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Affiliation(s)
- Thomas Tipih
- Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Felicity Jane Burt
- Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
- National Health Laboratory Service, Bloemfontein, South Africa
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Monsalve-Arteaga L, Alonso-Sardón M, Muñoz Bellido JL, Vicente Santiago MB, Vieira Lista MC, López Abán J, Muro A, Belhassen-García M. Seroprevalence of Crimean-Congo hemorrhagic fever in humans in the World Health Organization European region: A systematic review. PLoS Negl Trop Dis 2020; 14:e0008094. [PMID: 32119682 PMCID: PMC7067482 DOI: 10.1371/journal.pntd.0008094] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 03/12/2020] [Accepted: 01/27/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Crimean-Congo hemorrhagic fever (CCHF) is an emerging infectious disease caused by a Nairovirus. CCHF is a tick-borne disease that is predominantly associated with Hyalomma ticks and have a widespread distribution in Africa, Asia and Europe. CCHF usually presents as a subclinical disease, but in some cases, it may present as a hemorrhagic fever with a high mortality rate. This systematic review of the literature was performed to identify the available evidence on the prevalence of CCHF in the European Region of the World Health Organization, based on seroprevalence (IgG antibodies). METHODOLOGY A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement protocol. PubMed, Embase, and the Web of Science were used for the search (up to January 31, 2019), combining the following MeSH terms: ["Crimean-Congo haemorrhagic fever" OR "Crimean-Congo hemorrhagic fever virus" OR "Congo-Crimea" OR "Crimea-Congo"] AND ["Europe"] AND ["epidemiology" OR "seroprevalence"]. The abstracts were screened. Subsequently, full-text articles were selected and reviewed based on the PICOS (Population-Intervention-Comparison-Outcomes-Study type) criteria by two independent reviewers for inclusion in the final analysis. The data were qualitatively synthesized without quantitative pooling due to the heterogeneity in the study populations and methodologies. PRINCIPAL FINDINGS Thirty articles (9 from western Europe, 18 from central Europe and 3 from eastern Europe) were included in the analysis. All articles were cross-sectional studies (descriptive studies). CONCLUSIONS The highest seroprevalence of CCHF is found in central and eastern European countries. Southern and western Europe countries, such as Greece and Spain, have low levels of endemicity, but the spread of the infection, which is associated with climate change, is a possibility that we should keep in mind. Further studies, especially larger seroprevalence studies in humans and animals, are needed to establish the current status of the CCHF epidemiology and to generate standardized guidelines for action in the region.
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Affiliation(s)
- Lía Monsalve-Arteaga
- Laboratorio de Inmunología Parasitaria y Molecular, Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
| | - Montserrat Alonso-Sardón
- Área de Medicina Preventiva y Salud Pública, CIETUS, IBSAL, Facultad de Medicina, Universidad de Salamanca, Salamanca, Spain
| | - Juan Luis Muñoz Bellido
- Servicio de Microbiología y Parasitología, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
- Departamento de Ciencias Biomédicas y del Diagnóstico, Universidad de Salamanca, Salamanca, Spain
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Universidad de Salamanca, CSIC, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - María Belén Vicente Santiago
- Laboratorio de Inmunología Parasitaria y Molecular, Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
| | - María Carmen Vieira Lista
- Laboratorio de Inmunología Parasitaria y Molecular, Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
| | - Julio López Abán
- Laboratorio de Inmunología Parasitaria y Molecular, Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
| | - Antonio Muro
- Laboratorio de Inmunología Parasitaria y Molecular, Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
| | - Moncef Belhassen-García
- Laboratorio de Inmunología Parasitaria y Molecular, Centro de Investigación de Enfermedades Tropicales de la Universidad de Salamanca (CIETUS), Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Farmacia, Universidad de Salamanca, Salamanca, Spain
- Servicio de Medicina Interna. Sección de Enfermedades Infecciosas. CAUSA. CIETUS. IBSAL. Universidad de Salamanca, Salamanca, Spain
- * E-mail:
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10
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Crimean-Congo hemorrhagic fever: An update. Med Mal Infect 2019; 49:574-585. [PMID: 31607406 DOI: 10.1016/j.medmal.2019.09.005] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/22/2018] [Accepted: 09/03/2019] [Indexed: 11/23/2022]
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is a severe form of hemorrhagic fever caused by a virus of the genus Nairovirus. The amplifying hosts are various mammal species that remain asymptomatic. Humans are infected by tick bites or contact with animal blood. CCHF has a broad geographic distribution and is endemic in Africa, Asia (in particular the Middle East) and South East Europe. This area has expanded in recent years with two indigenous cases reported in Spain in 2016 and 2018. The incubation period is short with the onset of symptoms in generally less than a week. The initial symptoms are common to other infectious syndromes with fever, headache, myalgia and gastrointestinal symptoms. The hemorrhagic syndrome occurs during a second phase with sometimes major bleeding in and from the mucous membranes and the skin. Strict barrier precautionary measures are required to prevent secondary and nosocomial spread. CCHF may be documented by PCR detection of the virus genome during the first days after the onset of illness, and then by serological testing for IgM antibodies as from the 2nd week after infection. Patient management is mainly based on supportive care. Despite a few encouraging retrospective reports, there is no confirmed evidence that supports the use of ribavirin for curative treatment. Nevertheless, the World Health Organization continues to recommend the use of ribavirin to treat CCHF, considering the limited medical risk related to short-term treatment. The prescription of ribavirin should however be encouraged post-exposure for medical professionals, to prevent secondary infection.
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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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Földes F, Madai M, Németh V, Zana B, Papp H, Kemenesi G, Bock-Marquette I, Horváth G, Herczeg R, Jakab F. Serologic survey of the Crimean-Congo haemorrhagic fever virus infection among wild rodents in Hungary. Ticks Tick Borne Dis 2019; 10:101258. [PMID: 31302067 DOI: 10.1016/j.ttbdis.2019.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 06/17/2019] [Accepted: 07/05/2019] [Indexed: 10/26/2022]
Abstract
Crimean-Congo haemorrhagic fever virus (CCHFV) is a tick-borne pathogen, which causes an increasing number of severe infections in many parts of Africa, Asia and in Europe. The virus is primarily transmitted by ticks, however, the spectrum of natural hosts regarding CCHFV includes a wide variety of domestic and wild animals. Although the presence of CCHFV was hypothesized in Hungary, data in support of CCHFV prevalence has thus far, proven insufficient. In the present study, rodents belonging to four species, the yellow-necked mouse (Apodemus flavicollis), the striped field mouse (A. agrarius), the wood mouse (A. sylvaticus) and the bank vole (Myodes glareolus), were all systematically trapped in the Mecsek Mountain region (Southwest Hungary), from 2011 through 2013. Rodent sera were collected and screened for CCHFV antibodies with dot-blot pre-screening and immunofluorescence assay. Among the 2085 tested rodents, 20 (0.96%) were positive for IgG antibody against CCHFV. Seroprevalence was the highest (1.25%) in A. flavicollis serum samples. Distinctly, we now provide the first data regarding CCHFV occurrence and seroprevalence among wild rodents in Hungary. This observation represents a need for large-scale surveillance to effectively assess the enzootic background and the potential public health risk of CCHFV in Hungary.
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Affiliation(s)
- Fanni Földes
- Virological Research Group, BSL-4 Laboratory, Szentágothai Research Centre, University of Pécs, Pécs, Hungary; Institute of Biology, Faculty of Sciences, University of Pécs, Pécs, Hungary
| | - Mónika Madai
- Virological Research Group, BSL-4 Laboratory, Szentágothai Research Centre, University of Pécs, Pécs, Hungary; Institute of Biology, Faculty of Sciences, University of Pécs, Pécs, Hungary
| | - Viktória Németh
- Department of Dermatology, Venereology and Oncodermatology, University of Pécs, Pécs, Hungary
| | - Brigitta Zana
- Virological Research Group, BSL-4 Laboratory, Szentágothai Research Centre, University of Pécs, Pécs, Hungary; Institute of Biology, Faculty of Sciences, University of Pécs, Pécs, Hungary
| | - Henrietta Papp
- Virological Research Group, BSL-4 Laboratory, Szentágothai Research Centre, University of Pécs, Pécs, Hungary; Institute of Biology, Faculty of Sciences, University of Pécs, Pécs, Hungary
| | - Gábor Kemenesi
- Virological Research Group, BSL-4 Laboratory, Szentágothai Research Centre, University of Pécs, Pécs, Hungary; Institute of Biology, Faculty of Sciences, University of Pécs, Pécs, Hungary
| | - Ildikó Bock-Marquette
- Genomics and Experimental Cardiology Research Group, Szentágothai Research Centre, University of Pécs, Pécs, Hungary
| | - Győző Horváth
- Institute of Biology, Faculty of Sciences, University of Pécs, Pécs, Hungary
| | - Róbert Herczeg
- Bioinformatics Research Group, Szentágothai Research Centre, University of Pécs, Pécs, Hungary
| | - Ferenc Jakab
- Virological Research Group, BSL-4 Laboratory, Szentágothai Research Centre, University of Pécs, Pécs, Hungary; Institute of Biology, Faculty of Sciences, University of Pécs, Pécs, Hungary.
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Maiga O, Sas MA, Rosenke K, Kamissoko B, Mertens M, Sogoba N, Traore A, Sangare M, Niang M, Schwan TG, Maiga HM, Traore SF, Feldmann H, Safronetz D, Groschup MH. Serosurvey of Crimean-Congo Hemorrhagic Fever Virus in Cattle, Mali, West Africa. Am J Trop Med Hyg 2017; 96:1341-1345. [PMID: 28719259 DOI: 10.4269/ajtmh.16-0818] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AbstractCrimean-Congo hemorrhagic fever is a tick-borne disease caused by the arbovirus Crimean-Congo hemorrhagic fever virus (CCHFV, family Bunyaviridae, genus Nairovirus). CCHFV can cause a severe hemorrhagic fever with high-case fatality rates in humans. CCHFV has a wide geographic range and has been described in around 30 countries in the Middle East, Asia, Europe, and Africa including Mali and neighboring countries. To date, little is known about the prevalence rates of CCHFV in Mali. Here, using banked bovine serum samples from across the country, we describe the results of a seroepidemiological study for CCHFV aimed at identifying regions of circulation in Mali. In total, 1,074 serum samples were tested by a modified in-house CCHFV-IgG-enzyme-linked immunosorbent assay (ELISA) with confirmatory testing by commercial ELISA and immunofluorescence assay. Overall, 66% of samples tested were positive for CCHFV-specific IgG antibodies. Regional seroprevalence rates ranged from 15% to 95% and seemed to correlate with cattle density. Our results demonstrate that CCHFV prevalence is high in many regions in Mali and suggest that CCHFV surveillance should be established.
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Affiliation(s)
- Ousmane Maiga
- International Center for Excellence in Research, Malaria Research and Training Center, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Miriam Andrada Sas
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Isle of Riems-Greifswald, Germany
| | - Kyle Rosenke
- Laboratory of Virology, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana
| | | | - Marc Mertens
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Isle of Riems-Greifswald, Germany
| | - Nafomon Sogoba
- International Center for Excellence in Research, Malaria Research and Training Center, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Modibo Sangare
- Faculty of Sciences and Techniques, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | | | - Tom G Schwan
- Laboratory of Zoonotic Pathogens, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana
| | - Hamidou Moussa Maiga
- Faculty of Sciences and Techniques, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Sekou F Traore
- International Center for Excellence in Research, Malaria Research and Training Center, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako, Mali
| | - Heinz Feldmann
- Laboratory of Virology, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, Montana.,Deptartment of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - David Safronetz
- Deptartment of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada.,Division of Zoonotic Diseases and Special Pathogens, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Martin H Groschup
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Isle of Riems-Greifswald, Germany
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Wasfi F, Dowall S, Ghabbari T, Bosworth A, Chakroun M, Varghese A, Tiouiri H, Ben Jemaa M, Znazen A, Hewson R, Zhioua E, Letaief A. Sero-epidemiological survey of Crimean-Congo hemorrhagic fever virus in Tunisia. ACTA ACUST UNITED AC 2016; 23:10. [PMID: 26956221 PMCID: PMC4783585 DOI: 10.1051/parasite/2016010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 02/23/2016] [Indexed: 11/18/2022]
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease associated with a high case fatality rate and transmitted mainly by Hyalomma marginatum. The geographical distribution of H. marginatum covers most of the Western Mediterranean basin. We aimed to investigate whether CCHF virus (CCHFv) is circulating in Tunisia. Samples from unexplained acute febrile patients (n = 181) and a high risk group of humans, mainly slaughter workers (n = 38), were collected in the summer of 2014 and analyzed for exposure to CCHFv using serological tests and real-time RT-PCR. Ticks were collected from Northern and Southern Tunisia during May–June 2014 and examined for the presence of CCHFv by real-time RT-PCR. Of the 181 febrile patients, 5 showed only high titers of IgM suggesting a recent exposure to CCHFv. Among 38 slaughter workers, 2 had IgG anti-CCHFv responses yielding a seroprevalence of 5.2%. No CCHFv was detected in ticks and sera. Our results provide evidence of human exposure to CCHFv in Tunisia.
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Affiliation(s)
- Fares Wasfi
- Institut Pasteur de Tunis, Laboratory of Vector Ecology, 13 Place Pasteur, 1002 Tunis, Tunisia
| | - Stuart Dowall
- Public Health England, Porton Down, Salisbury, Wiltshire SP4 0JG, UK
| | - Tayssir Ghabbari
- Infectious Diseases Department, Farhat Hached University Hospital, 4004 Sousse, Tunisia
| | - Andrew Bosworth
- Public Health England, Porton Down, Salisbury, Wiltshire SP4 0JG, UK
| | - Mohamed Chakroun
- Infectious Diseases Department, Fatouma Bourguiba University Hospital, 5000 Monastir, Tunisia
| | - Anitha Varghese
- Public Health England, Porton Down, Salisbury, Wiltshire SP4 0JG, UK
| | | | | | - Abir Znazen
- Laboratory of Microbiology, 3000 Sfax, Tunisia
| | - Roger Hewson
- Public Health England, Porton Down, Salisbury, Wiltshire SP4 0JG, UK - National Institute of Health Research, Health Protection Research Unit in Emerging and Zoonotic Infections, L3 5RF Liverpool, UK
| | - Elyes Zhioua
- Institut Pasteur de Tunis, Laboratory of Vector Ecology, 13 Place Pasteur, 1002 Tunis, Tunisia
| | - Amel Letaief
- Infectious Diseases Department, Farhat Hached University Hospital, 4004 Sousse, Tunisia
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15
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Seroepidemiological Studies of Crimean-Congo Hemorrhagic Fever Virus in Domestic and Wild Animals. PLoS Negl Trop Dis 2016; 10:e0004210. [PMID: 26741652 PMCID: PMC4704823 DOI: 10.1371/journal.pntd.0004210] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is a widely distributed, tick-borne viral disease. Humans are the only species known to develop illness after CCHF virus (CCHFV) infection, characterized by a nonspecific febrile illness that can progress to severe, often fatal, hemorrhagic disease. A variety of animals may serve as asymptomatic reservoirs of CCHFV in an endemic cycle of transmission. Seroepidemiological studies have been instrumental in elucidating CCHFV reservoirs and in determining endemic foci of viral transmission. Herein, we review over 50 years of CCHFV seroepidemiological studies in domestic and wild animals. This review highlights the role of livestock in the maintenance and transmission of CCHFV, and provides a detailed summary of seroepidemiological studies of wild animal species, reflecting their relative roles in CCHFV ecology.
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Fernandez-Garcia MD, Negredo A, Papa A, Donoso-Mantke O, Niedrig M, Zeller H, Tenorio A, Franco L. European survey on laboratory preparedness, response and diagnostic capacity for Crimean-Congo haemorrhagic fever, 2012. ACTA ACUST UNITED AC 2014; 19. [PMID: 25011064 DOI: 10.2807/1560-7917.es2014.19.26.20844] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Crimean-Congo haemorrhagic fever (CCHF) is an infectious viral disease that has (re-)emerged in the last decade in south-eastern Europe, and there is a risk for further geographical expansion to western Europe. Here we report the results of a survey covering 28 countries, conducted in 2012 among the member laboratories of the European Network for Diagnostics of 'Imported' Viral Diseases (ENIVD) to assess laboratory preparedness and response capacities for CCHF. The answers of 31 laboratories of the European region regarding CCHF case definition, training necessity, biosafety, quality assurance and diagnostic tests are presented. In addition, we identified the lack of a Regional Reference Expert Laboratory in or near endemic areas. Moreover, a comprehensive review of the biosafety level suitable to the reality of endemic areas is needed. These issues are challenges that should be addressed by European public health authorities. However, all respondent laboratories have suitable diagnostic capacities for the current situation.
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Sándor AD, Dumitrache MO, D'Amico G, Kiss BJ, Mihalca AD. Rhipicephalus rossicus and not R. sanguineus is the dominant tick species of dogs in the wetlands of the Danube Delta, Romania. Vet Parasitol 2014; 204:430-2. [PMID: 24893695 DOI: 10.1016/j.vetpar.2014.05.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 05/07/2014] [Accepted: 05/08/2014] [Indexed: 11/29/2022]
Abstract
Changes in the distribution of tick species are among the major causes for the increase in prevalence of zoonotic diseases worldwide, with tick-borne diseases' prevalence showing an emerging pattern. One of these ticks, Rhipicephalus rossicus, which is reported occasionally from humans, seems to be particularly interesting because of its demonstrated vectorial role for zoonotic pathogens like Francisella tularensis, Coxiella burnetii, or CCHF and West Nile viruses. Here we report a case of dominant occurrence of R. rossicus on household dogs in the wetlands of Eastern Europe (Romania). Ticks were collected from dogs in 5 distinct locations, with 1068 ticks of 6 species found. R. rossicus had a dominant occurrence in dogs in all but one location, accounting for 87.1% of all ticks (32.3-95.3% in different locations). Until this study, Rhipicephalus sanguineus was considered as the only important tick species on dogs in south-temperate regions of Europe, as well in Romania. The dominant presence of R. rossicus in dogs, its vectorial competence and broad host spectrum (including humans), make this tick species an important candidate for further analysis and highlight the paucity of our knowledge on disease vectors in this region of Europe.
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Affiliation(s)
- Attila D Sándor
- University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Faculty of Veterinary Medicine, Department of Parasitology and Parasitic Diseases, Calea Mănăştur 3-5, Cluj-Napoca 400372, Romania
| | - Mirabela O Dumitrache
- University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Faculty of Veterinary Medicine, Department of Parasitology and Parasitic Diseases, Calea Mănăştur 3-5, Cluj-Napoca 400372, Romania.
| | - Gianluca D'Amico
- University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Faculty of Veterinary Medicine, Department of Parasitology and Parasitic Diseases, Calea Mănăştur 3-5, Cluj-Napoca 400372, Romania
| | - Botond J Kiss
- Danube Delta National Institute for Research and Development, Str. Babadag 165, Tulcea 820112, Romania
| | - Andrei D Mihalca
- University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca, Faculty of Veterinary Medicine, Department of Parasitology and Parasitic Diseases, Calea Mănăştur 3-5, Cluj-Napoca 400372, Romania
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Dumitrache MO, Kiss B, Dantas-Torres F, Latrofa MS, D'Amico G, Sándor AD, Mihalca AD. Seasonal dynamics of Rhipicephalus rossicus attacking domestic dogs from the steppic region of southeastern Romania. Parasit Vectors 2014; 7:97. [PMID: 24612483 PMCID: PMC3975290 DOI: 10.1186/1756-3305-7-97] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 03/03/2014] [Indexed: 11/25/2022] Open
Abstract
Background Danube Delta Biosphere Reserve is one of the most interesting regions in Europe from an epidemiological point of view due to its great biodiversity, local climatic conditions and various types of habitats. Moreover, there is no data regarding the ectoparasite communities of dogs from this area. In this frame, the aims of our study were to establish the tick communities parasitizing dogs and to provide new data regarding seasonal dynamics of a neglected tick species, Rhipicephalus rossicus. Methods A survey was carried out in order to gather information regarding tick species attaching to domestic dogs from a steppic region of southeastern Romania and to establish their seasonal dynamics. The research was conducted from 1 December 2012 to 30 November 2013, on 8 dogs from Iazurile, a locality from the west-central part of the Danube Delta Biosphere Reserve. In total, 384 examinations were made, each dog being checked for tick infestation 4 times per month, for one year. Results The 893 ticks found belonged to six species: R. rossicus (95.6%), Dermacentor reticulatus (3.2%), Ixodes ricinus (0.5%), Hyalomma marginatum (0.3%), Rhipicephalus sanguineus sensu lato (s.l.) (0.2%) and Ixodes crenulatus (0.1%). From the 91 positive examinations, R. rossicus was found in 80 (87.9%). Single species infestation occurred in 84 examinations. In 7 out of 91 positive examinations mixed infestation were found. No ticks were found in December, January and September. Conclusions For R. rossicus, high frequency and intensity were observed in May, June and July. The activity peaks for D. reticulatus were in spring and autumn. Our results highlight that within the range of R. sanguineus s.l., the most common dog tick worldwide, selected dog populations may be predominantly infested by closely related species, like in our case, R. rossicus.
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Affiliation(s)
| | | | | | | | | | | | - Andrei Daniel Mihalca
- Department of Parasitology and Parasitic Diseases, University of Agricultural Sciences and Veterinary Medicine Cluj-Napoca, Calea Mănăştur 3-5, Cluj-Napoca 400372, Romania.
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Do the ticks of birds at an important migratory hotspot reflect the seasonal dynamics of Ixodes ricinus at the migration initiation site? A case study in the Danube Delta. PLoS One 2014; 9:e89378. [PMID: 24586732 PMCID: PMC3929702 DOI: 10.1371/journal.pone.0089378] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 01/20/2014] [Indexed: 12/30/2022] Open
Abstract
Migratory birds play important roles as distributors of ticks within and between continents. In the Old World, the most important migratory route of birds links Asia, Europe and Africa. During their migration, birds use various stopover sites, where they feed and rest and where ticks may attach or detach, creating new natural foci for vector-borne diseases. Danube Delta is one of the most important migration hotspots and so far no studies were focused on ticks of migratory birds herein. The aim of the present study was to assess the species diversity and seasonal dynamics of ticks parasitizing migratory birds in Danube Delta Biosphere Reserve. Migratory birds were trapped on Grindul Lupilor (44°41′N; 28°56′E) using mist nets during 4 migratory seasons (2 spring and 2 autumn) in 2011 and 2012. From each bird, all the ticks were collected and identified based on morphological features. Epidemiological parameters (prevalence, mean abundance, mean intensity) were calculated and all data were analysed statistically based on the season (spring and autumn), regional status of birds (migrants and breeding) and foraging behaviour (ground feeders, reed-bed feeders, foliage feeders). A total of 1434 birds (46 species) were captured. Ticks were found on 94 birds (10 species). Significantly more migratory birds hosted ticks, compared to resident birds. The 400 collected ticks belonged to four species: Ixodes ricinus (92.25%), I. arboricola (6.25%), I. redikorzevi (1.00%) and Haemaphysalis punctata (0.50%). A higher prevalence was found for I. ricinus in spring, with higher prevalence of nymphs in this season, while larvae occurred with the same prevalence in both seasons. Larval intensity was higher during spring and nymphs were more abundant during autumn. The seasonal differences in our study may be related not to the local seasonal dynamics of ticks, but on the seasonal dynamics at the site of migration initiation.
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Sargianou M, Papa A. Epidemiological and behavioral factors associated with Crimean-Congo hemorrhagic fever virus infections in humans. Expert Rev Anti Infect Ther 2013; 11:897-908. [PMID: 24053271 DOI: 10.1586/14787210.2013.827890] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Crimean-Congo hemorrhagic fever (CCHF), a viral disease with high fatality rate, is endemic in many countries in Europe, the Middle East, Asia and Africa. It is transmitted to humans either by tick bite or by direct contact with blood or tissues of viremic patients or livestock. Aim of the present study was to review the main epidemiological characteristics of the disease worldwide, with special attempt to show the epidemiological and behavioral factors that play a role in acquisition of the infection. It is obvious that these factors differ among countries, and the knowledge and understanding of the transmission routes in each region facilitates the implementation of proper control measures, the awareness enhancement and the prevention of the disease.
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Affiliation(s)
- Maria Sargianou
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Bente DA, Forrester NL, Watts DM, McAuley AJ, Whitehouse CA, Bray M. Crimean-Congo hemorrhagic fever: history, epidemiology, pathogenesis, clinical syndrome and genetic diversity. Antiviral Res 2013; 100:159-89. [PMID: 23906741 DOI: 10.1016/j.antiviral.2013.07.006] [Citation(s) in RCA: 509] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 07/05/2013] [Accepted: 07/09/2013] [Indexed: 11/26/2022]
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is the most important tick-borne viral disease of humans, causing sporadic cases or outbreaks of severe illness across a huge geographic area, from western China to the Middle East and southeastern Europe and throughout most of Africa. CCHFV is maintained in vertical and horizontal transmission cycles involving ixodid ticks and a variety of wild and domestic vertebrates, which do not show signs of illness. The virus circulates in a number of tick genera, but Hyalomma ticks are the principal source of human infection, probably because both immature and adult forms actively seek hosts for the blood meals required at each stage of maturation. CCHF occurs most frequently among agricultural workers following the bite of an infected tick, and to a lesser extent among slaughterhouse workers exposed to the blood and tissues of infected livestock and medical personnel through contact with the body fluids of infected patients. CCHFV is the most genetically diverse of the arboviruses, with nucleotide sequence differences among isolates ranging from 20% for the viral S segment to 31% for the M segment. Viruses with diverse sequences can be found within the same geographic area, while closely related viruses have been isolated in far distant regions, suggesting that widespread dispersion of CCHFV has occurred at times in the past, possibly by ticks carried on migratory birds or through the international livestock trade. Reassortment among genome segments during co-infection of ticks or vertebrates appears to have played an important role in generating diversity, and represents a potential future source of novel viruses. In this article, we first review current knowledge of CCHFV, summarizing its molecular biology, maintenance and transmission, epidemiology and geographic range. We also include an extensive discussion of CCHFV genetic diversity, including maps of the range of the virus with superimposed phylogenetic trees. We then review the features of CCHF, including the clinical syndrome, diagnosis, treatment, pathogenesis, vaccine development and laboratory animal models of CCHF. The paper ends with a discussion of the possible future geographic range of the virus. For the benefit of researchers, we include a Supplementary Table listing all published reports of CCHF cases and outbreaks in the English-language literature, plus some principal articles in other languages, with total case numbers, case fatality rates and all CCHFV strains on GenBank.
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Affiliation(s)
- Dennis A Bente
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, TX 77555, United States.
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