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Ashrafian H. The earliest description of possible viral haemorrhagic fever identified in ancient Greece. J Travel Med 2024; 31:taae016. [PMID: 38263266 DOI: 10.1093/jtm/taae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/11/2024] [Accepted: 01/13/2024] [Indexed: 01/25/2024]
Affiliation(s)
- Hutan Ashrafian
- Institute of Global Health Innovation, Imperial College London, Leeds University Business School and Institute of Civilisation, W2 1NY
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Large outbreak of Crimean-Congo haemorrhagic fever in Iraq, 2022. IJID REGIONS 2023; 6:76-79. [PMID: 36818019 PMCID: PMC9931897 DOI: 10.1016/j.ijregi.2023.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 01/12/2023] [Accepted: 01/12/2023] [Indexed: 01/19/2023]
Abstract
Background Crimean-Congo haemorrhagic fever (CCHF) is reported sporadically in Iraq. The lack of preventive veterinary activities during 2 years of the coronavirus disease 2019 pandemic (2020 and 2021) led to the largest CCHF outbreak in Iraq since 1979. Objective To describe the epidemiological characteristics of CCHF cases that occurred during the first half of 2022 in Iraq in terms of age, sex, residence, history of contact with another case, and history of contact with animals. Materials and methods This descriptive study included laboratory-confirmed cases of CCHF between 1st January 2022 and 26th June 2022. Frequencies and percentages were used to describe the demographic and epidemiologic criteria of the cases. The epidemic curve of the cases was used to describe the timing and duration of the outbreak. Results In total, there were 219 confirmed cases of CCHF from 1st January 2022 to 26th June 2022. The first confirmed case was reported in March 2022, and cases continued to occur through June 2022. The median age of the cases was 34.5 years. The majority of cases were male (n=130, 59.4%), had an unspecified job (n=126, 57.5%) and lived in southern Iraq (n=142, 64.8%). The first case was reported in week 10 of 2022. Case numbers peaked in week 24 (30 cases were reported), and subsequently declined in week 25 (24 cases were reported). The case fatality rate was 16.4%. Conclusion and recommendations The CCHF outbreak in 2022 was the largest in Iraq since the disease was first reported four decades ago. Identification of CCHF strains in Iraq is recommended, together with exploration of the knowledge, attitudes and practices of high-risk groups for CCHF, and a national survey of CCHF vectors in Iraq.
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Ghasemian SO, Fazlalipour M, Hosseini G, Pouryaievali MH, Azad-Manjiri S, Khakifirouz S, Vasmehjani AA, Salehi-Vaziri M. Serosurvey of Crimean-Congo hemorrhagic fever virus in livestock, Kohgiluyeh and Boyer-Ahmad, Iran, 2017. J Vector Borne Dis 2021; 58:70-73. [PMID: 34818866 DOI: 10.4103/0972-9062.313958] [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: 11/04/2022] Open
Abstract
BACKGROUND & OBJECTIVES Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral zoonosis with up to 50% mortality rate in humans. In addition to the role of animals in the transmission of the virus and spread of infected ticks through livestock trade, they can be employed as sentinel hosts for monitoring the infection. Iran is one of the endemic counties for CCHF and the disease has been documented in all provinces. However, in some provinces such as Kohgiluyeh and Boyer-Ahmad, the rate of the disease has been dramatically low. Therefore, this serosurvey was designed to investigate CCHF virus (CCHFV) seroprevalence among livestock in different parts of Kohgiluyeh and Boyer-Ahmad Province. METHODS This study was conducted in 2017, in which, blood samples were collected from 501 sheep and goats from eight different cities of Kohgiluyeh and Boyer-Ahmad Province. CCHFV IgG antibodies were detected in livestock serum samples by specific ELISA assays for detection of ovine and caprine antibodies. RESULTS In total, four sheep serum of out of 501 (0.8%) livestock samples (3 from Gachsaran and 1 from Dena) had CCHFV IgG antibodies. No significant association was found between CCHFV seropositivity and sex or age of animals (P>0.05). INTERPRETATION & CONCLUSION Our findings suggest a minor CCHFV circulation in Kohgiluyeh and Boyer-Ahmad Province, Iran. However, due to the notion that outbreaks of tick-borne infections is hard to predict; steady and comprehensive monitoring programs especially in ticks and animals would be critical for understanding the circulation on the pathogen in a region.
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Affiliation(s)
| | - Mehdi Fazlalipour
- Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran
| | - Ghasem Hosseini
- Agriculture and Natural Research Center, Kohgiluyeh and Boyer-Ahmad Province, Iran
| | - Mohammad Hassan Pouryaievali
- Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran
| | - Sanam Azad-Manjiri
- Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran
| | - Sahar Khakifirouz
- Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran
| | - Abbas Ahmadi Vasmehjani
- Department of Medical Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Salehi-Vaziri
- Research Centre for Emerging and Reemerging Infectious Disease; Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran
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Berber E, Çanakoğlu N, Tonbak Ş, Ozdarendeli A. Development of a protective inactivated vaccine against Crimean-Congo hemorrhagic fever infection. Heliyon 2021; 7:e08161. [PMID: 34703927 PMCID: PMC8526982 DOI: 10.1016/j.heliyon.2021.e08161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 08/09/2021] [Accepted: 10/08/2021] [Indexed: 12/19/2022] Open
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is an emerging zoonotic infectious disease caused by Crimean-Congo hemorrhagic fever virus (CCHFV). The first clinical CCHF infection was described in 1944 in the Crimean Peninsula, exclusively in humans, with case-fatality rates exceeding 30%. The increasing number of cases, high mortality rate, and lack of effective therapy make CCHF a serious threat to public health and a potential bioterrorism agent. The present study evaluated the development, immunogenicity, and immune response durations for cell-culture-derived inactivated vaccine (CCVax) formulations in comparison with those of mouse-brain-derived vaccine (MBVax) formulations. In this study, the Kelkit06 CCHF virus strain was propagated in both suckling mice and Vero E6 cells, and purified with a sucrose gradient. Formalin-inactivated vaccine candidates were formulated at various doses [low dose (LD), 5 μg; medium dose (MD), 10 μg; high dose (HD), 20 μg)] and mixed with an alum adjuvant. BALB/c mice received the same doses of the vaccine formulations three times at 3-week intervals. The humoral endpoint IgG responses were evaluated and compared for the MBVax and CCVax treatments. The duration of the presence of IgG and neutralizing antibody (Ab) titers was evaluated and compared until up to 1 year after immunization. The humoral IgG responses indicated that the CCVax and MBVax candidates enhanced the IgG endpoint titers in a dose-dependent manner, which were induced more strongly in all the CCVax groups than in the MBVax mice. The fold changes in neutralizing Ab levels were also found to be higher in the CCVax groups: between 2- and 7.6-fold after the second week of the last immunization. The neutralization titers peaked 4 months after immunization in all the vaccine-receiving groups, but these were still comparable at the end of the first year. The CCVax formulations induced higher IgG and neutralizing Ab titers at all the measured time points. In this study, we showed that cell-culture-purified and formalin-inactivated vaccine candidates induced strong and robust immunity in vaccinated mice dose-dependently, more so than mouse-brain-derived vaccines.
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Affiliation(s)
- Engin Berber
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, The University of Tennessee, Knoxville, TN, 37996, USA.,Department of Virology, Faculty of Veterinary Medicine, Erciyes University, Kayseri, 38280 Turkey.,Vaccine Research, Development and Application Center, Erciyes University, Kayseri, 38280 Turkey.,Department of Virology, Faculty of Veterinary Medicine, Firat University, Elazığ, 23119, Turkey
| | - Nurettin Çanakoğlu
- Vaccine Research, Development and Application Center, Erciyes University, Kayseri, 38280 Turkey.,Department of Virology, Faculty of Veterinary Medicine, Firat University, Elazığ, 23119, Turkey.,Mugla Sitki Kocman University, Milas Faculty of Veterinary Science, Department of Virology, Muğla, 48200, Turkey.,Department of Microbiology, Medical Faculty, Erciyes University, Kayseri, 38280, Turkey
| | - Şükrü Tonbak
- Department of Virology, Faculty of Veterinary Medicine, Firat University, Elazığ, 23119, Turkey
| | - Aykut Ozdarendeli
- Vaccine Research, Development and Application Center, Erciyes University, Kayseri, 38280 Turkey.,Department of Microbiology, Medical Faculty, Erciyes University, Kayseri, 38280, Turkey
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The impact of climate change and emerging infectious diseases on the blood supply. Transfus Apher Sci 2021; 60:103272. [PMID: 34509385 PMCID: PMC8420088 DOI: 10.1016/j.transci.2021.103272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/03/2021] [Indexed: 11/23/2022]
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Shahhosseini N, Wong G, Babuadze G, Camp JV, Ergonul O, Kobinger GP, Chinikar S, Nowotny N. Crimean-Congo Hemorrhagic Fever Virus in Asia, Africa and Europe. Microorganisms 2021; 9:microorganisms9091907. [PMID: 34576803 PMCID: PMC8471816 DOI: 10.3390/microorganisms9091907] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 08/26/2021] [Accepted: 08/28/2021] [Indexed: 11/16/2022] Open
Abstract
The global spread of ticks and various tick-borne viruses (TBVs) suggests the possibility of new tick-borne diseases emerging. Crimean-Congo hemorrhagic fever virus (CCHFV) is an emerging TBV of the Nairoviridae family that causes serious disease that can be fatal in humans. CCHFV endemic foci can be found in Africa, Asia, the Middle East, and South-Eastern Europe, and has spread to previously unaffected regions and nations, such as Spain, over the last two decades. In this review, we discuss the current situation of CCHFV in Asia, Africa and Europe based on existing knowledge, and we discuss driving factors in the distribution and transmission of the virus, such as the spread of tick vector species and host reservoirs.
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Affiliation(s)
- Nariman Shahhosseini
- Centre for Vector-Borne Diseases, Canadian Food Inspection Agency, Lethbridge, AB T1H 6P7, Canada;
| | - Gary Wong
- Département de Microbiologie-Infectiologie et d’Immunologie, Université Laval, Québec City, QC G1V 0A6, Canada; (G.W.); (G.P.K.)
- Institut Pasteur of Shanghai, Shanghai 200031, China
| | - George Babuadze
- Department of Biological Sciences, Sunnybrook Research Institute, University of Toronto, Toronto, ON M4N 3M5, Canada;
| | - Jeremy V. Camp
- Center for Virology, Medical University of Vienna, 1090 Vienna, Austria;
| | - Onder Ergonul
- Koç University, School of Medicine and Koç University Iş Bank Center for Infectious Diseases, Istanbul 34450, Turkey;
| | - Gary P. Kobinger
- Département de Microbiologie-Infectiologie et d’Immunologie, Université Laval, Québec City, QC G1V 0A6, Canada; (G.W.); (G.P.K.)
- Department of Medical Microbiology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
- Department of Immunology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
- Department of Pathology and Laboratory Medicine, School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Sadegh Chinikar
- Pasteur Institute of Tehran, Tehran 1316943551, Iran
- Institute of Virology, University of Veterinary Medicine Vienna, 1210 Vienna, Austria
- Correspondence: (S.C.); (N.N.)
| | - Norbert Nowotny
- Institute of Virology, University of Veterinary Medicine Vienna, 1210 Vienna, Austria
- Department of Basic Medical Sciences, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 505055, United Arab Emirates
- Correspondence: (S.C.); (N.N.)
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Efstratiou A, Karanis G, Karanis P. Tick-Borne Pathogens and Diseases in Greece. Microorganisms 2021; 9:microorganisms9081732. [PMID: 34442811 PMCID: PMC8399993 DOI: 10.3390/microorganisms9081732] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/06/2021] [Accepted: 08/08/2021] [Indexed: 11/18/2022] Open
Abstract
Tick-borne diseases (TBDs) are recognized as a serious and growing public health epidemic in Europe, and are a cause of major losses in livestock production worldwide. This review is an attempt to present a summary of results from studies conducted over the last century until the end of the year 2020 regarding ticks, tick-borne pathogens, and tick-borne diseases in Greece. We provide an overview of the tick species found in Greece, as well as the most important tick-borne pathogens (viruses, bacteria, protozoa) and corresponding diseases in circulation. We also consider prevalence data, as well as geographic and climatic conditions. Knowledge of past and current situations of TBDs, as well as an awareness of (risk) factors affecting future developments will help to find approaches to integrated tick management as part of the ‘One Health Concept’; it will assist in avoiding the possibility of hotspot disease emergencies and intra- and intercontinental transmission. Increased surveillance in Greece is required to ensure clear and effective policies for TBD control.
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Affiliation(s)
- Artemis Efstratiou
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro 080-8555, Japan;
| | - Gabriele Karanis
- Orthopädische Rehabilitationsklinik, Eisenmoorbad Bad Schmiedeberg Kur GmbH, 06905 Bad Schmiedeberg, Germany;
| | - Panagiotis Karanis
- Medical Faculty and University Hospital, The University of Cologne, 50923 Cologne, Germany
- Department of Basic and Clinical Sciences, University of Nicosia Medical School, 21 Ilia Papakyriakou, 2414 Engomi. P.O. Box 24005, Nicosia CY-1700, Cyprus
- Correspondence:
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Tahir Ul Qamar M, Ismail S, Ahmad S, Mirza MU, Abbasi SW, Ashfaq UA, Chen LL. Development of a Novel Multi-Epitope Vaccine Against Crimean-Congo Hemorrhagic Fever Virus: An Integrated Reverse Vaccinology, Vaccine Informatics and Biophysics Approach. Front Immunol 2021; 12:669812. [PMID: 34220816 PMCID: PMC8242340 DOI: 10.3389/fimmu.2021.669812] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 05/28/2021] [Indexed: 12/22/2022] Open
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is a highly severe and virulent viral disease of zoonotic origin, caused by a tick-born CCHF virus (CCHFV). The virus is endemic in many countries and has a mortality rate between 10% and 40%. As there is no licensed vaccine or therapeutic options available to treat CCHF, the present study was designed to focus on application of modern computational approaches to propose a multi-epitope vaccine (MEV) expressing antigenic determinants prioritized from the CCHFV genome. Integrated computational analyses revealed the presence of 9 immunodominant epitopes from Nucleoprotein (N), RNA dependent RNA polymerase (RdRp), Glycoprotein N (Gn/G2), and Glycoprotein C (Gc/G1). Together these epitopes were observed to cover 99.74% of the world populations. The epitopes demonstrated excellent binding affinity for the B- and T-cell reference set of alleles, the high antigenic potential, non-allergenic nature, excellent solubility, zero percent toxicity and interferon-gamma induction potential. The epitopes were engineered into an MEV through suitable linkers and adjuvating with an appropriate adjuvant molecule. The recombinant vaccine sequence revealed all favorable physicochemical properties allowing the ease of experimental analysis in vivo and in vitro. The vaccine 3D structure was established ab initio. Furthermore, the vaccine displayed excellent binding affinity for critical innate immune receptors: TLR2 (-14.33 kcal/mol) and TLR3 (-6.95 kcal/mol). Vaccine binding with these receptors was dynamically analyzed in terms of complex stability and interaction energetics. Finally, we speculate the vaccine sequence reported here has excellent potential to evoke protective and specific immune responses subject to evaluation of downstream experimental analysis.
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MESH Headings
- Animals
- Antigens, Viral/genetics
- Antigens, Viral/immunology
- Antigens, Viral/metabolism
- Antigens, Viral/pharmacology
- Computational Biology
- Computer-Aided Design
- Drug Development
- Hemorrhagic Fever Virus, Crimean-Congo/genetics
- Hemorrhagic Fever Virus, Crimean-Congo/immunology
- Hemorrhagic Fever, Crimean/immunology
- Hemorrhagic Fever, Crimean/prevention & control
- Hemorrhagic Fever, Crimean/virology
- Immunodominant Epitopes
- Immunogenicity, Vaccine
- Molecular Docking Simulation
- Molecular Dynamics Simulation
- Ticks/virology
- Toll-Like Receptor 2/metabolism
- Toll-Like Receptor 3/metabolism
- Vaccines, DNA/genetics
- Vaccines, DNA/immunology
- Vaccines, DNA/metabolism
- Vaccines, DNA/pharmacology
- Vaccinology
- Viral Vaccines/genetics
- Viral Vaccines/immunology
- Viral Vaccines/metabolism
- Viral Vaccines/pharmacology
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Affiliation(s)
| | - Saba Ismail
- NUMS Department of Biological Sciences, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Sajjad Ahmad
- Department of Microbiology and Pharmacy, Abasyn University, Peshawar, Pakistan
| | - Muhammad Usman Mirza
- Department of Chemistry and Biochemistry, University of Windsor, Windsor, ON, Canada
| | - Sumra Wajid Abbasi
- NUMS Department of Biological Sciences, National University of Medical Sciences, Rawalpindi, Pakistan
| | - Usman Ali Ashfaq
- Department of Bioinformatics and Biotechnology, Government College University Faisalabad, Faisalabad, Pakistan
| | - Ling-Ling Chen
- College of Life Science and Technology, Guangxi University, Nanning, China
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An Epidemiological Survey Regarding Ticks and Tick-Borne Diseases among Livestock Owners in Punjab, Pakistan: A One Health Context. Pathogens 2021; 10:pathogens10030361. [PMID: 33803649 PMCID: PMC8003106 DOI: 10.3390/pathogens10030361] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 03/14/2021] [Accepted: 03/16/2021] [Indexed: 12/30/2022] Open
Abstract
Recent global changes have led to an increase in the spread of ticks and tick-borne diseases (TBDs) affecting domestic ruminants and humans, with an annual loss of US $13.9–$18.7 billion. The current study determined the perception and practices of livestock farmers regarding tick infestation. A total of 112 livestock farms were surveyed in Punjab, Pakistan, among which animals from 42 (37.5%) farms were infested with ticks. Only 28.6% (n = 32) of the dairy farmers were consulting veterinarians for ticks control, while 86.7% (n = 97) of the respondents did not consider biosecurity measures in the control of tick transmission. Most of the respondents, 71.4% (n = 80), did not consider manual tick removal from their animals (i.e., by hand, followed by physically crushing) as a risky practice for spreading zoonotic diseases. Improper disposal of bottles of acaricides in the farm drainage was also observed, putting the environment and aquatic life at risk. These wrong practices may contribute to high disease burdens and economic losses, increasing the possibility of transmission of zoonotic TBDs and pollution of the environment. Therefore, an integrated One Health approach is required for the control of TBDs through environmentally friendly approaches.
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Buczek A, Pilch J, Buczek W. Tick Preventive Behaviors and Practices Adopted by Medical Students from Poland, Germany, and Thailand in Relation to Socio-Demographic Conditions and Their Knowledge of Ticks and Tick-Borne Diseases. INSECTS 2020; 11:insects11120863. [PMID: 33287425 PMCID: PMC7761883 DOI: 10.3390/insects11120863] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 12/30/2022]
Abstract
Given the high medical importance of ticks, we analyzed the most common preventive behaviors and practices adopted by medical students from Poland, Germany, and Thailand, and the level of their knowledge of ticks and tick-borne diseases. A survey consisting of 19 questions was conducted among 636 randomly selected students. The study showed that the Polish and German students preferred inspection of the body on their return home (86.9% and 63.5%, respectively) and wearing protective clothes (79.8% and 32.3%, respectively) as part of prophylaxis. The Thai students most often chose wearing protective clothes (54.7%) and preventive behavior in tick habitats (42.7%). Approximately 7% of the Polish medical students and as many as 22% of the German and Thai respondents did not use any means of prevention. Our analyses suggest that the use of preventive methods and respondents' behaviors depend on socio-demographic factors and the level of health education. The insufficient practical implementation of tick prevention measures by the medical students suggests a need for verification of health education programs in schools as well as effective popularization and educational activities. It is also necessary to develop a public health protection strategy against the effects of tick bites.
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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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12
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Garrison AR, Smith DR, Golden JW. Animal Models for Crimean-Congo Hemorrhagic Fever Human Disease. Viruses 2019; 11:E590. [PMID: 31261754 PMCID: PMC6669593 DOI: 10.3390/v11070590] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 06/21/2019] [Accepted: 06/25/2019] [Indexed: 12/18/2022] Open
Abstract
Crimean-Congo hemorrhagic fever virus (CCHFV) is an important tick-borne human pathogen endemic throughout Asia, Africa and Europe. CCHFV is also an emerging virus, with recent outbreaks in Western Europe. CCHFV can infect a large number of wild and domesticated mammalian species and some avian species, however the virus does not cause severe disease in these animals, but can produce viremia. In humans, CCHFV infection can lead to a severe, life-threating disease characterized by hemodynamic instability, hepatic injury and neurological disorders, with a worldwide lethality rate of ~20-30%. The pathogenic mechanisms of CCHF are poorly understood, largely due to the dearth of animal models. However, several important animal models have been recently described, including novel murine models and a non-human primate model. In this review, we examine the current knowledge of CCHF-mediated pathogenesis and describe how animal models are helping elucidate the molecular and cellular determinants of disease. This information should serve as a reference for those interested in CCHFV animal models and their utility for evaluation of medical countermeasures (MCMs) and in the study of pathogenesis.
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Affiliation(s)
- Aura R Garrison
- Virology Division, United States Army Medical Research Institute of Infectious Diseases, 1425 Porter Street, Fort Detrick, MD 21702, USA.
- Mailing address: Virology Division, USAMRIID, 1425 Porter Street, Fort Detrick, MD 21702, USA.
| | - Darci R Smith
- Virology Division, United States Army Medical Research Institute of Infectious Diseases, 1425 Porter Street, Fort Detrick, MD 21702, USA.
- Mailing address: Virology Division, USAMRIID, 1425 Porter Street, Fort Detrick, MD 21702, USA.
| | - Joseph W Golden
- Virology Division, United States Army Medical Research Institute of Infectious Diseases, 1425 Porter Street, Fort Detrick, MD 21702, USA.
- Mailing address: Virology Division, USAMRIID, 1425 Porter Street, Fort Detrick, MD 21702, USA.
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13
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Maltezou HC, Papa A, Ventouri S, Tseki C, Pervanidou D, Pavli A, Panagopoulos P, Markatou P, Gavana E, Maltezos E. A case of Crimean-Congo haemorrhagic fever imported in Greece: Contact tracing and management of exposed healthcare workers. J Infect Prev 2019; 20:171-178. [PMID: 31428197 DOI: 10.1177/1757177419852666] [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: 09/23/2018] [Accepted: 04/14/2019] [Indexed: 11/16/2022] Open
Abstract
Background Nosocomial transmission is a major mode of infection of Crimean-Congo haemorrhagic fever (CCHF). In May 2018, a patient with CCHF was hospitalised in Greece. Objective Our aim was to present the management of healthcare workers (HCWs) to the CCHF case. Methods Contact tracing, risk assessment and follow-up of exposed HCWs were performed. Testing (RT-PCR and/or serology) was offered to contacts. Post-exposure prophylaxis (PEP) with ribavirin was considered for high-risk exposures. Results Ninety-one HCWs were exposed to the case. Sixty-six HCWs were grouped as high-risk exposures. Ribavirin PEP was offered to 29 HCWs; seven agreed to receive prophylaxis. Forty-one HCWs were tested for CCHF infection; none was found positive. Gaps in infection control occurred. Discussion CCHF should be considered in patients with compatible travel history and clinical and laboratory findings. Early clinical suspicion and laboratory confirmation are imperative for the implementation of appropriate infection control measures. Ribavirin should be considered for high-risk exposures. Infection control capacity for highly pathogenic agents should increase.
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Affiliation(s)
- Helena C Maltezou
- Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, Athens, Greece
| | - Anna Papa
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Sarantoula Ventouri
- Department of Infection Control, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Charikleia Tseki
- Department of Infection Control, General Hospital of Xanthi, Xanthi, Greece
| | - Danai Pervanidou
- Department for Epidemiological Surveillance and Intervention, Hellenic Center for Disease Control and Prevention, Athens, Greece
| | - Androula Pavli
- Department for Interventions in Health-Care Facilities, Hellenic Center for Disease Control and Prevention, Athens, Greece
| | - Periklis Panagopoulos
- Department of Infection Control, University Hospital of Alexandroupolis, Alexandroupolis, Greece.,Second Department of Internal Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
| | - Philothei Markatou
- Department of Internal Medicine, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Elpida Gavana
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efstratios Maltezos
- Department of Infection Control, University Hospital of Alexandroupolis, Alexandroupolis, Greece.,Second Department of Internal Medicine, Medical School, Democritus University of Thrace, Alexandroupolis, Greece
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14
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Dowall SD, Carroll MW, Hewson R. Development of vaccines against Crimean-Congo haemorrhagic fever virus. Vaccine 2017; 35:6015-6023. [PMID: 28687403 PMCID: PMC5637709 DOI: 10.1016/j.vaccine.2017.05.031] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 04/24/2017] [Accepted: 05/10/2017] [Indexed: 11/19/2022]
Abstract
Crimean-Congo haemorrhagic fever virus (CCHFV) is a deadly human pathogen of the utmost seriousness being highly lethal causing devastating disease symptoms that result in intense and prolonged suffering to those infected. During the past 40years, this virus has repeatedly caused sporadic outbreaks responsible for relatively low numbers of human casualties, but with an alarming fatality rate of up to 80% in clinically infected patients. CCHFV is transmitted to humans by Hyalomma ticks and contact with the blood of viremic livestock, additionally cases of human-to-human transmission are not uncommon in nosocomial settings. The incidence of CCHF closely matches the geographical range of permissive ticks, which are widespread throughout Africa, Asia, the Middle East and Europe. As such, CCHFV is the most widespread tick-borne virus on earth. It is a concern that recent data shows the geographic distribution of Hyalomma ticks is expanding. Migratory birds are also disseminating Hyalomma ticks into more northerly parts of Europe thus potentially exposing naïve human populations to CCHFV. The virus has been imported into the UK on two occasions in the last five years with the first fatal case being confirmed in 2012. A licensed vaccine to CCHF is not available. In this review, we discuss the background and complications surrounding this limitation and examine the current status and recent advances in the development of vaccines against CCHFV.
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Affiliation(s)
- Stuart D Dowall
- Public Health England, Porton Down, Salisbury, Wiltshire SP4 0JG, UK
| | - Miles W Carroll
- Public Health England, Porton Down, Salisbury, Wiltshire SP4 0JG, UK
| | - Roger Hewson
- Public Health England, Porton Down, Salisbury, Wiltshire SP4 0JG, UK.
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15
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Guven O, Satilmis D, Sonmez FT, Demir B, Erdogan Ö. TICK INFESTATION: A 200-PATIENTS' SERIES. Afr J Infect Dis 2017; 11:62-67. [PMID: 28670641 PMCID: PMC5476814 DOI: 10.21010/ajid.v11i2.8] [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] [Indexed: 11/28/2022] Open
Abstract
Background: A great number of zoonotic diseases with high mortality rate are transmitted by ticks. We performed this study in order to investigate patients admitted to emergency department following a tick bite. We examined the patients and get knowledge about the infestation and we followed up them for possible tick-conducted disease symptoms and laboratory findings both clinically and serologically. Materials and Methods: The study presented was hold for one year, between 01.01.2012 and 31.12.2012. 200 tick infested cases, admitted to Emergency Department of Haydarpasa Numune Training and Research Hospital, were subjected in the study. Demographic patterns of the patients and the region they come from, infested area on body, admission time and blood analyzing results were detected. Results: Rate of adult patients to pediatric was 2:1; gender distribution was similar to each other. The most common body areas that ticks were removed from were lower extremity. The highest tick bite incidence was in summer and on weekends. No tick bite incident of Istanbul surrounding from the year 2012 progressed to a zoonotic disease. Conclusions: Although non-of the patients of our study has been diagnosed with Crimean-Congo hemorrhagic fever we informed all of them for the incubation period and call for observation during the time. Tick borne infections may present with vary of symptoms, the most sever of which is hemorrhagic diathesis and patients should be informed for the risks. Knowledge of local area fauna risks may guide physicians so studies on this topic are essential.
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Affiliation(s)
- Oya Guven
- Haydarpasa Numune Training and Research Hospital, Department of Emergency Medicine, Turkey
| | - Dilay Satilmis
- Haydarpasa Numune Training and Research Hospital, Department of Emergency Medicine, Turkey
| | - Feruza Turan Sonmez
- Duzce University School of Medicine, Department of Emergency Medicine, Turkey
| | - Bilgehan Demir
- Malatya State Hospital, Department of Emergency Medicine, Turkey
| | - Özgür Erdogan
- Haydarpasa Numune Training and Research Hospital, Department of Emergency Medicine, Turkey
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16
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Al-Abri SS, Abaidani IA, Fazlalipour M, Mostafavi E, Leblebicioglu H, Pshenichnaya N, Memish ZA, Hewson R, Petersen E, Mala P, Nhu Nguyen TM, Rahman Malik M, Formenty P, Jeffries R. Current status of Crimean-Congo haemorrhagic fever in the World Health Organization Eastern Mediterranean Region: issues, challenges, and future directions. Int J Infect Dis 2017; 58:82-89. [PMID: 28259724 PMCID: PMC7110796 DOI: 10.1016/j.ijid.2017.02.018] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 02/17/2017] [Accepted: 02/20/2017] [Indexed: 01/19/2023] Open
Abstract
The paper provides a comprehensive overview of the status of Crimean-Congo hemorrhagic fever (CCHF) in countries across the World Health Organization Eastern Mediterranean Region (WHO EMR). The increasing incidence of CCHF disease in the region and its spread to new geographical areas is highlighted. Knowledge gaps concerning the burden and circulation of CCHF virus in the WHO EMR are identified. A strategic framework is described, which details the research and development work necessary to curb the ongoing and new threats posed by CCHF virus.
Crimean-Congo haemorrhagic fever (CCHF) is the most widespread, tick-borne viral disease affecting humans. The disease is endemic in many regions, such as Africa, Asia, Eastern and Southern Europe, and Central Asia. Recently, the incidence of CCHF has increased rapidly in the countries of the World Health Organization Eastern Mediterranean Region (WHO EMR), with sporadic human cases and outbreaks of CCHF being reported from a number of countries in the region. Despite the rapidly growing incidence of the disease, there are currently no accurate data on the burden of the disease in the region due to the different surveillance systems used for CCHF in these countries. In an effort to increase our understanding of the epidemiology and risk factors for the transmission of the CCHF virus (CCHFV; a Nairovirus of the family Bunyaviridae) in the WHO EMR, and to identify the current knowledge gaps that are hindering effective control interventions, a sub-regional meeting was organized in Muscat, Oman, from December 7 to 9, 2015. This article summarizes the current knowledge of the disease in the region, identifies the knowledge gaps that present challenges for the prevention and control of CCHFV, and details a strategic framework for research and development activities that would be necessary to curb the ongoing and new threats posed by CCHFV.
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Affiliation(s)
| | | | - Mehdi Fazlalipour
- Department of Arbovirus and Viral Hemorrhagic Fever, Pasteur Institute of Iran, Tehran, Iran
| | - Ehsan Mostafavi
- Research Centre for Emerging and Re-emerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Hakan Leblebicioglu
- Department of Infectious Diseases and Clinical Microbiology, Ondokuz Mayis University, Samsun, Turkey
| | - Natalia Pshenichnaya
- Head of Infectious Diseases Department, Infectious Disease Department, Rostov State Medical University, Moscow, Russia
| | - Ziad A Memish
- Hubert Department of Global Health, School of Public Health, Emory University, Atlanta, USA
| | - Roger Hewson
- Arboviruses and VHFs, WHO Collaborating Centre (Special Pathogens), National Infection Service Public Health England, Porton Down, Salisbury, UK
| | | | - Peter Mala
- Infectious Hazards Management, World Health Organization, Eastern Mediterranean Regional Office, Cairo, Egypt
| | - Tran Minh Nhu Nguyen
- Infectious Hazards Management, World Health Organization, Eastern Mediterranean Regional Office, Cairo, Egypt
| | - Mamunur Rahman Malik
- Infectious Hazards Management, World Health Organization, Eastern Mediterranean Regional Office, Cairo, Egypt.
| | - Pierre Formenty
- Infectious Hazards Management, World Health Organization, Geneva, Switzerland
| | - Rosanna Jeffries
- Infectious Hazards Management, World Health Organization, Geneva, Switzerland
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17
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Atkinson R, Burt F, Rybicki EP, Meyers AE. Plant-produced Crimean-Congo haemorrhagic fever virus nucleoprotein for use in indirect ELISA. J Virol Methods 2016; 236:170-177. [PMID: 27474493 DOI: 10.1016/j.jviromet.2016.07.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 07/22/2016] [Accepted: 07/22/2016] [Indexed: 11/21/2022]
Abstract
Crimean-Congo haemorrhagic fever (CCHF) is a disease of serious public concern caused by the CCHF virus (CCHFV). Anti-CCHFV IgG in humans can be detected using ELISA with native antigen prepared from cell cultures which have been infected with virus or from brain tissue of suckling mice which have been inoculated with virus. However, the preparation of these reagents requires high biosafety levels and is expensive. A safer, more cost-effective recombinantly-produced NP reagent is desirable. Recently, plants have been shown to be a cost-effective and safe system for expression of recombinant proteins. This work describes cloning of the CCHFV NP gene into three different plant expression systems and comparison of expression in Nicotiana benthamiana. The highest expressing construct was selected. Expressed NP was purified by ammonium sulphate fractionation prior to histidine affinity chromatography. Purified NP was tested in an indirect ELISA to determine if the recombinant antigen was able to detect anti-CCHFV IgG in sera from convalescent patients. Plant-produced NP detected IgG antibodies against CCHFV in 13/13 serum samples from convalescent patients and 0/13 samples collected from volunteers with no history of CCHFV infection. Results were compared with commercially available immunofluorescent assays and 100% concordance was obtained between the two assays. This suggests that a full evaluation of the plant produced NP for application as a safe recombinant is warranted.
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Affiliation(s)
- Richard Atkinson
- Biopharming Research Unit, Department of Molecular and Cell Biology, University of Cape Town, P Bag X3, Rondebosch 7701, South Africa.
| | - Felicity Burt
- Department of Medical Microbiology and Virology, National Health Laboratory Service Universitas and Faculty of Health Sciences, University of Free State, P O Box 339, Bloemfontein 9300, South Africa.
| | - Edward P Rybicki
- Biopharming Research Unit, Department of Molecular and Cell Biology, University of Cape Town, P Bag X3, Rondebosch 7701, South Africa; Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Observatory 7925, South Africa.
| | - Ann E Meyers
- Biopharming Research Unit, Department of Molecular and Cell Biology, University of Cape Town, P Bag X3, Rondebosch 7701, South Africa.
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18
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Dreshaj S, Ahmeti S, Ramadani N, Dreshaj G, Humolli I, Dedushaj I. Current situation of Crimean-Congo hemorrhagic fever in Southeastern Europe and neighboring countries: a public health risk for the European Union? Travel Med Infect Dis 2016; 14:81-91. [PMID: 27044611 DOI: 10.1016/j.tmaid.2016.03.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 03/21/2016] [Accepted: 03/22/2016] [Indexed: 12/29/2022]
Abstract
UNLABELLED Crimean-Congo hemorrhagic fever (CCHF) is the most widespread tick-borne viral infection of humans, occurring across western China through southern Asia, Middle East, and Southeastern Europe (SEE) and in the most of African countries. CCHF virus is maintained through vertical and horizontal transmission in several genera of ticks, mainly in Hyalomma, which spreads the virus to a variety of wild and domestic mammals, which develop a transient viremia without signs of illness. Human infections occur through tick bite or exposure to the blood or other body fluids of an infected animal or of a CCHF patient. In SEE the number of clinical cases of CCHF as well as the areal of the infected ticks continuously rapidly increased after 2000. The aim of this study was to present actual situation of CCHF in SEE. Sources of information include published literature and personal unpublished data. CONCLUSIONS Based on: 1. Hyaloma's presence in Western EU countries, 2. Changes in climatic conditions and 3. Absence of an active vaccination against CCHF, it can be expected that this disease will continue to present real threat for human health in SEE and Southwestern Europe (SWE).
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Affiliation(s)
- Shemsedin Dreshaj
- Clinic of Infectious Diseases, Prishtina University Clinical Centre, Kosovo.
| | - Sali Ahmeti
- Clinic of Infectious Diseases, Prishtina University Clinical Centre, Kosovo
| | | | - Gresa Dreshaj
- Family Medicine, Primary Health Care, Prishtina, Kosovo
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Mohd Shukri M, Ling Kho K, Ghane Kisomi M, Lani R, Marlina S, Muhd Radzi SF, Tee Tay S, Ping Wong L, Awang Mahmud AB, Hassan Nizam QN, Abu Bakar S, Zandi K. Seroprevalence report on tick-borne encephalitis virus and Crimean-Congo hemorrhagic fever virus among Malaysian's farm workers. BMC Public Health 2015. [PMID: 26205588 PMCID: PMC4513429 DOI: 10.1186/s12889-015-1901-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background Tick-borne encephalitis virus (TBEV) and Crimean-Congo haemorrhagic fever virus (CCHFV) are important tick-borne viruses. Despite their wide geographical distribution and ease of acquisition, the prevalence of both viruses in Malaysia is still unknown. This study was conducted to determine the seroprevalence for TBEV and CCHFV among Malaysian farm workers as a high-risk group within the population. Methods We gave questionnaires to 209 farm workers and invited them to participate in the study. Eighty-five agreed to do so. We then collected and tested sera for the presence of anti-TBEV IgG (immunoglobulin G) and anti-CCHFV IgG using a commercial enzyme-linked immunosorbent assay (ELISA) kit. We also tested seroreactive samples against three other related flaviviruses: dengue virus (DENV), West Nile virus (WNV) and Japanese encephalitis virus (JEV) using the ELISA method. Results The preliminary results showed the presence of anti-TBEV IgG in 31 (36.5 %) of 85 sera. However, when testing all the anti-TBEV IgG positive sera against the other three antigenically related flaviviruses to exclude possible cross reactivity, only five (4.2 %) sera did not show any cross reactivity. Interestingly, most (70.97 %) seropositives subjects mentioned tick-bite experience. However, there was no seroreactive sample for CCHFV. Conclusions These viruses migrate to neighbouring countries so they should be considered threats for the future, despite the low seroprevalence for TBEV and no serological evidence for CCHFV in this study. Therefore, further investigation involving a large number of human, animal and tick samples that might reveal the viruses’ true prevalence is highly recommended.
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Affiliation(s)
- Munirah Mohd Shukri
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Kai Ling Kho
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Masoumeh Ghane Kisomi
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Rafidah Lani
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Suria Marlina
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Siti Fatimah Muhd Radzi
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Sun Tee Tay
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Li Ping Wong
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Awang Bulgiba Awang Mahmud
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | | | - Sazaly Abu Bakar
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
| | - Keivan Zandi
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
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20
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Leblebicioglu H, Sunbul M, Memish ZA, Al-Tawfiq JA, Bodur H, Ozkul A, Gucukoglu A, Chinikar S, Hasan Z. Consensus report: Preventive measures for Crimean-Congo Hemorrhagic Fever during Eid-al-Adha festival. Int J Infect Dis 2015; 38:9-15. [PMID: 26183413 DOI: 10.1016/j.ijid.2015.06.029] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 06/29/2015] [Accepted: 06/30/2015] [Indexed: 11/26/2022] Open
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is endemic in Eurasian countries such as, Turkey, Pakistan, Afghanistan and Iran. CCHF virus is spread by the Hyalomma tick, which is found mainly on cattle and sheep. Muslim countries, in which these animals are sacrificed during Eid-Al-Adha, are among the countries where CCHF is endemic, and it has been observed that CCHF is associated with practices surrounding the Eid-ad-Adha festival. The dates for Eid-Al-Adha drift 10 days earlier in each year according to Georgian calendar. In previous years Eid-al-Adha occurred in autumn-winter months however in the next 10-15 years it will be take place in the summer months when CCHF is more prevalent. This may lead to a rise in the number of cases due to increased dissemination of CCHF virus with uncontrolled animal movements in and between countries. This consensus report focuses on the variable practices regarding animal handling in different regions and possible preventative measures to reduce the incidence of CCHF. Environmental hygiene and personal protection are essential parts of prevention. There is a need for international collaborative preparedness and response plans for prevention and management of CCHF during Eid-Al-Adha in countries where the disease is prevalent.
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Affiliation(s)
- Hakan Leblebicioglu
- Department of Infectious Diseases and Clinical Microbiology, Medical School, Ondokuz Mayis University, Samsun, Turkey.
| | - Mustafa Sunbul
- Department of Infectious Diseases and Clinical Microbiology, Medical School, Ondokuz Mayis University, Samsun, Turkey.
| | - Ziad A Memish
- Public Health Directorate, Ministry of Health, Riyadh, Saudi Arabia; College of Medicine, Al-Faisal University, Riyadh, Saudi Arabia.
| | - Jaffar A Al-Tawfiq
- Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia; Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Hurrem Bodur
- Department of Infectious Diseases and Clinical Microbiology, Ankara Numune Education and Research Hospital, Ankara, Turkey.
| | - Aykut Ozkul
- Department of Virology, Faculty of Veterinary Medicine, Ankara University, Ankara, Turkey.
| | - Ali Gucukoglu
- Department of Food Hygiene & Technology, Faculty of Veterinary Medicine, Ondokuz Mayis University, Samsun, Turkey.
| | - Sadegh Chinikar
- Arboviruses and Viral Haemorrhagic Fevers Laboratory National Reference, Laboratory, Pasteur Institute of Iran, Tehran, Iran.
| | - Zahra Hasan
- Pathology and Laboratory Medicine, The Aga Khan University, Karachi, Pakistan.
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Papa A, Mirazimi A, Köksal I, Estrada-Pena A, Feldmann H. Recent advances in research on Crimean-Congo hemorrhagic fever. J Clin Virol 2014; 64:137-43. [PMID: 25453328 DOI: 10.1016/j.jcv.2014.08.029] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 08/25/2014] [Indexed: 11/29/2022]
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is an expanding tick-borne hemorrhagic disease with increasing human and animal health impact. Immense knowledge was gained over the past 10 years mainly due to advances in molecular biology, but also driven by an increased global interest in CCHFV as an emerging/re-emerging zoonotic pathogen. In the present article, we discuss the advances in research with focus on CCHF ecology, epidemiology, pathogenesis, diagnostics, prophylaxis and treatment. Despite tremendous achievements, future activities have to concentrate on the development of vaccines and antivirals/therapeutics to combat CCHF. Vector studies need to continue for better public and animal health preparedness and response. We conclude with a roadmap for future research priorities.
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Affiliation(s)
- Anna Papa
- Department of Microbiology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Ali Mirazimi
- Swedish Institute for Communicable Disease Control, SE 171 82 Sweden; National Veterinary Institute, SE-756 51 Sweden; Dept for Clinical and Experimental Medicine, Linkopings University, SE-581 83 Sweden
| | - Iftihar Köksal
- Karadeniz Technical University, Medical Faculty, Department of Infectious Diseases, Trabzon, Turkey
| | | | - Heinz Feldmann
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Hamilton, USA
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Lani R, Moghaddam E, Haghani A, Chang LY, AbuBakar S, Zandi K. Tick-borne viruses: a review from the perspective of therapeutic approaches. Ticks Tick Borne Dis 2014; 5:457-65. [PMID: 24907187 DOI: 10.1016/j.ttbdis.2014.04.001] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 03/07/2014] [Accepted: 04/01/2014] [Indexed: 12/30/2022]
Abstract
Several important human diseases worldwide are caused by tick-borne viruses. These diseases have become important public health concerns in recent years. The tick-borne viruses that cause diseases in humans mainly belong to 3 families: Bunyaviridae, Flaviviridae, and Reoviridae. In this review, we focus on therapeutic approaches for several of the more important tick-borne viruses from these 3 families. These viruses are Crimean-Congo hemorrhagic fever virus (CCHF) and the newly discovered tick-borne phleboviruses, known as thrombocytopenia syndromevirus (SFTSV), Heartland virus and Bhanja virus from the family Bunyaviridae, tick-borne encephalitis virus (TBEV), Powassan virus (POWV), Louping-ill virus (LIV), Omsk hemorrhagic fever virus (OHFV), Kyasanur Forest disease virus (KFDV), and Alkhurma hemorrhagic fever virus (AHFV) from the Flaviviridae family. To date, there is no effective antiviral drug available against most of these tick-borne viruses. Although there is common usage of antiviral drugs such as ribavirin for CCHF treatment in some countries, there are concerns that ribavirin may not be as effective as once thought against CCHF. Herein, we discuss also the availability of vaccines for the control of these viral infections. The lack of treatment and prevention approaches for these viruses is highlighted, and we hope that this review may increase public health awareness with regard to the threat posed by this group of viruses.
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Affiliation(s)
- Rafidah Lani
- Tropical Infectious Disease Research and Education Centre (TIDREC), Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ehsan Moghaddam
- Tropical Infectious Disease Research and Education Centre (TIDREC), Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Amin Haghani
- Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, University Putra Malaysia, Malaysia
| | - Li-Yen Chang
- Tropical Infectious Disease Research and Education Centre (TIDREC), Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Sazaly AbuBakar
- Tropical Infectious Disease Research and Education Centre (TIDREC), Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Keivan Zandi
- Tropical Infectious Disease Research and Education Centre (TIDREC), Department of Medical Microbiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
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Balci E, Borlu A, Kilic AU, Demiraslan H, Oksuzkaya A, Doganay M. Tularemia outbreaks in Kayseri, Turkey: An evaluation of the effect of climate change and climate variability on tularemia outbreaks. J Infect Public Health 2014; 7:125-32. [DOI: 10.1016/j.jiph.2013.09.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 08/29/2013] [Accepted: 09/18/2013] [Indexed: 11/28/2022] Open
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Petrova ID, Kononova YV, Chausov EV, Shestopalov AM, Tishkova FH. Genetic variants of the Crimean-Congo hemorrhagic fever virus circulating in endemic areas of Southern Tajikistan in 2009. MOLECULAR GENETICS, MICROBIOLOGY AND VIROLOGY 2013. [DOI: 10.3103/s0891416813030063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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26
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Xia H, Zhao J, Li Y, Yin S, Tang S, Zhang Z, Yu J, Kou Z, Fan Z, Li T. Infection and propagation of Crimean-Congo hemorrhagic fever virus in embryonated chicken eggs. Virus Res 2013; 173:344-9. [PMID: 23352881 DOI: 10.1016/j.virusres.2013.01.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Revised: 01/12/2013] [Accepted: 01/14/2013] [Indexed: 11/15/2022]
Abstract
The embryonated chicken egg (ECE) provides a convenient, space-saving incubator for the cultivation of many kinds of animal viruses where the egg can be easily observed for viral replication throughout the development of the chicken embryo. Within the family Bunyaviridae, the embryonated egg has been used as a host system for many viruses such as Rift Valley fever virus and Akabane virus. The current study was conducted to determine the cultivation of Crimean-Congo hemorrhagic fever virus (CCHFV) in ECE. Four-day-old eggs were infected with CCHFV via the yolk sac route and harvested embryonic tissues and amino-allantoic fluid (AAF) that were used for virus passage and viral RNA (vRNA) detection. Quantification of vRNA copies was performed by quantitative reverse transcription polymerase chain reaction (qRT-PCR). Our study indicated that CCHFV caused the death of the embryonated egg in a dose-dependent manner and the 50% egg infectious dose (EID50) was determined to be 6.47×10(5) copies/egg. CCHFV replicated and passaged well in the egg and high viral loads were detected both in embryonic tissue (10(9-10) copies/g) and AAF (10(7-9) copies/ml) of the embryonated egg. Thus, ECE could be used for viral cultivation and preservation, and as a potential host infection model for the study of the pathogenesis of CCHFV.
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Affiliation(s)
- Han Xia
- State Key Laboratory of Virology, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
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Ftika L, Maltezou HC. Viral haemorrhagic fevers in healthcare settings. J Hosp Infect 2013; 83:185-92. [PMID: 23333147 DOI: 10.1016/j.jhin.2012.10.013] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Accepted: 10/02/2012] [Indexed: 01/20/2023]
Abstract
Viral haemorrhagic fevers (VHFs) typically manifest as rapidly progressing acute febrile syndromes with profound haemorrhagic manifestations and very high fatality rates. VHFs that have the potential for human-to-human transmission and onset of large nosocomial outbreaks include Crimean-Congo haemorrhagic fever, Ebola haemorrhagic fever, Marburg haemorrhagic fever and Lassa fever. Nosocomial outbreaks of VHFs are increasingly reported nowadays, which likely reflects the dynamics of emergence of VHFs. Such outbreaks are associated with an enormous impact in terms of human lives and costs for the management of cases, contact tracing and containment. Surveillance, diagnostic capacity, infection control and the overall preparedness level for management of a hospital-based VHF event are very limited in most endemic countries. Diagnostic capacities for VHFs should increase in the field and become affordable. Availability of appropriate protective equipment and education of healthcare workers about safe clinical practices and infection control is the mainstay for the prevention of nosocomial spread of VHFs.
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Affiliation(s)
- L Ftika
- Department for Interventions in Healthcare Facilities, Hellenic Centre for Disease Control and Prevention, Athens, Greece
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Abstract
The 6th International Conference on Emerging Zoonoses, held at Cancun, Mexico, 24-27 February 2011, offered 84 participants from 18 countries, a snapshot of current research in numerous zoonoses caused by viruses, bacteria or prions. Co-chaired by Professors Heinz Feldmann and Jürgen Richt, the conference explored 10 topics: (i) The ecology of emerging zoonotic diseases; (ii) The role of wildlife in emerging zoonoses; (iii) Cross-species transmission of zoonotic pathogens; (iv) Emerging and neglected influenza viruses; (v) Haemorrhagic fever viruses; (vi) Emerging bacterial diseases; (vii) Outbreak responses to zoonotic diseases; (viii) Food-borne zoonotic diseases; (ix) Prion diseases; and (x) Modelling and prediction of emergence of zoonoses. Human medicine, veterinary medicine and environmental challenges are viewed as a unity, which must be considered under the umbrella of 'One Health'. Several presentations attempted to integrate the insights gained from field data with mathematical models in the search for effective control measures of specific zoonoses. The overriding objective of the research presentations was to create, improve and use the tools essential to address the risk of contagions in a globalized society. In seeking to fulfil this objective, a three-step approach has often been applied: (i) use cultured cells, model and natural animal hosts and human clinical models to study infection; (ii) combine traditional histopathological and biochemical approaches with functional genomics, proteomics and computational biology; and (iii) obtain signatures of virulence and insights into mechanisms of host defense response, immune evasion and pathogenesis. This meeting review summarizes 39 of the conference presentations and mentions briefly the 16 articles in this Special Supplement, most of which were presented at the conference in earlier versions. The full affiliations of all presenters and many colleagues have been included to facilitate further inquiries from readers.
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Affiliation(s)
- R E Kahn
- Diagnostic Medicine/Pathobiology Department, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506, USA
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