A mathematical model for Crimean-Congo haemorrhagic fever: tick-borne dynamics with conferred host immunity

The Impact of Host Abundance on the Epidemiology of Tick-Borne Infection

Tick-borne diseases are an increasing global public health concern due to an expanding geographical range and increase in abundance of tick-borne infectious agents. A potential explanation for the rising impact of tick-borne diseases is an increase in tick abundance which may be linked to an increase in density of the hosts on which they feed. In this study, we develop a model framework to understand the link between host density, tick demography and tick-borne pathogen epidemiology. Our model links the development of specific tick stages to the specific hosts on which they feed. We show that host community composition and host density have an impact on tick population dynamics and that this has a consequent impact on host and tick epidemiological dynamics. A key result is that our model framework can exhibit variation in host infection prevalence for a fixed density of one host type due to changes in density of other host types that support different tick life stages. Our findings suggest that host community composition may play a crucial role in explaining the variation in prevalence of tick-borne infections in hosts observed in the field.

Systematic Review on Crimean–Congo Hemorrhagic Fever Enzootic Cycle and Factors Favoring Virus Transmission: Special Focus on France, an Apparently Free-Disease Area in Europe

Crimean–Congo hemorrhagic fever (CCHF) is a viral zoonotic disease resulting in hemorrhagic syndrome in humans. Its causative agent is naturally transmitted by ticks to non-human vertebrate hosts within an enzootic sylvatic cycle. Ticks are considered biological vectors, as well as reservoirs for CCHF virus (CCHFV), as they are able to maintain the virus for several months or even years and to transmit CCHFV to other ticks. Although animals are not symptomatic, some of them can sufficiently replicate the virus, becoming a source of infection for ticks as well as humans through direct contact with contaminated body fluids. The recent emergence of CCHF in Spain indicates that tick–human interaction rates promoting virus transmission are changing and lead to the emergence of CCHF. In other European countries such as France, the presence of one of its main tick vectors and the detection of antibodies targeting CCHFV in animals, at least in Corsica and in the absence of human cases, suggest that CCHFV could be spreading silently. In this review, we study the CCHFV epidemiological cycle as hypothesized in the French local context and select the most likely parameters that may influence virus transmission among tick vectors and non-human vertebrate hosts. For this, a total of 1,035 articles dating from 1957 to 2021 were selected for data extraction. This study made it possible to identify the tick species that seem to be the best candidate vectors of CCHFV in France, but also to highlight the importance of the abundance and composition of local host communities on vectors' infection prevalence. Regarding the presumed transmission cycle involving Hyalomma marginatum, as it might exist in France, at least in Corsica, it is assumed that tick vectors are still weakly infected and the probability of disease emergence in humans remains low. The likelihood of factors that may modify this equilibrium is discussed.

Ticks on the Run: A Mathematical Model of Crimean-Congo Haemorrhagic Fever (CCHF)-Key Factors for Transmission

Crimean-Congo haemorrhagic fever (CCHF) is a zoonotic disease caused by the Crimean-Congo hemorrhagic fever virus (CCHFV). Ticks of the genus Hyalomma are the main vectors and represent a reservoir for the virus. CCHF is maintained in nature in an endemic vertebrate-tick-vertebrate cycle. The disease is prevalent in wide geographical areas including Asia, Africa, South-Eastern Europe and the Middle East. It is of great importance for the public health given its occasionally high case/fatality ratio of CCHFV in humans. Climate change and the detection of possible CCHFV vectors in Central Europe suggest that the establishment of the transmission in Central Europe may be possible in future. We have developed a compartment-based nonlinear Ordinary Differential Equation (ODE) system to model the disease transmission cycle including blood sucking ticks, livestock and human. Sensitivity analysis of the basic reproduction number R0 shows that decreasing the tick survival time is an efficient method to control the disease. The model supports us in understanding the influence of different model parameters on the spread of CCHFV. Tick-to-tick transmission through co-feeding and the CCHFV circulation through transstadial and transovarial transmission are important factors to sustain the disease cycle. The proposed model dynamics are calibrated through an empirical multi-country analysis and multidimensional plot reveals that the disease-parameter sets of different countries burdened with CCHF are different. This information may help decision makers to select efficient control strategies.

Epidemiology of Crimean-Congo Hemorrhagic Fever (CCHF) in Africa-Underestimated for Decades

Crimean-Congo hemorrhagic fever (CCHF) is endemic in Africa, but the epidemiology remains to be defined. Using a broad database search, we reviewed the literature to better define CCHF evidence in Africa. We used a One Health approach to define the impact of CCHF by reviewing case reports, human and animal serology, and records of CCHF virus (CCHFV) isolations (1956-mid-2020). In addition, published and unpublished collection data were used to estimate the geographic distribution of Hyalomma ticks and infection vectors. We implemented a previously proposed classification scheme for organizing countries into five categories by the level of evidence. From January 1, 1956 to July 25, 2020, 494 CCHF cases (115 lethal) were reported in Africa. Since 2000, nine countries (Kenya, Mali, Mozambique, Nigeria, Senegal, Sierra Leone, South Sudan, Sudan, and Tunisia) have reported their first CCHF cases. Nineteen countries reported CCHF cases and were assigned level 1 or level 2 based on maturity of their surveillance system. Thirty countries with evidence of CCHFV circulation in the absence of CCHF cases were assigned level 3 or level 4. Twelve countries for which no data were available were assigned level 5. The goal of this review is to inform international organizations, local governments, and healthcare professionals about shortcomings in CCHF surveillance in Africa to assist in a movement toward strengthening policy to improve CCHF surveillance.

Dynamic Modeling of Crimean Congo Hemorrhagic Fever Virus (CCHFV) Spread to Test Control Strategies

Crimean Congo hemorrhagic fever is a zoonotic disease which has emerged or re-emerged recently in Eastern Europe and Turkey. The causative agent is a virus, mainly transmitted by ticks of the species Hyalomma marginatum (Koch, 1844, Ixodida, Amblyommidae). To test potential scenarios for the control of pathogen spread, a dynamic mechanistic model has been developed that takes into account the major processes involved in tick population dynamics and pathogen spread. The tick population dynamics model represents both abiotic (meteorological variables) and biotic (hare and cattle densities) factors in the determination of processes (development, host finding, and mortality). The infection model consists of an SIRS model for the host part whereas a lifelong infectiousness was considered for ticks. The model was first applied to a zone in Central Anatolia (Turkey). Simulated dynamics represent the average reported level of infection in vectors and hosts. A sensitivity analysis to parameter value has been carried out and highlighted the role of transstadial transmission as well as acquisition of the pathogen by immature stages. Applying the model to different sites of Turkey shows different patterns in the dynamics of acarological risk (number of infectious questing adults). This model was thereafter used to test control strategies. Simulation results indicate that acaricide treatments and decrease in hare density could have valuable effects when combined, either on the acarological risk or on the prevalence in cattle. The kind of model we have developed provides insight into the ability of different strategies to prevent and control disease spread.