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Choi Y, Kim Y. Application of multiplex realtime PCR detection for hemorrhagic fever syndrome viruses. J Infect Public Health 2023; 16:1933-1941. [PMID: 37866271 DOI: 10.1016/j.jiph.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 09/13/2023] [Accepted: 10/05/2023] [Indexed: 10/24/2023] Open
Abstract
BACKGROUND Multiplex real-time PCR is a quick and cost effective method for detection of various gene simultaneously. HFSV (Hemorrhagic Fever Syndrome Virus) is a newly emerging infectious disease because of globalization and climate change. We tried to develop a molecular diagnostic technique for various causative viruses and evaluate its usefulness for improving public health. METHODS Molecular diagnostic test method that qualitatively detects viruses causing viral hemorrhagic fevers hired Taq-Man Real-time RT-PCR technique. The Ct value was experimentally observed three or more times at the RNA concentration before and after the detection limit. After designing a multiplex real-time RT-PCR test for target gene of selected 17 viruses, the detection limit for each target and the presence or absence of cross-reaction and interference reaction were evaluated to determine its availability. RESULTS Six kinds of viruses, including Crimean-Congo hemorrhagic fever virus, Omsk hemorrhagic fever virus, Sabia virus, Chapare virus, Yellow fever virus, and Variola virus (A4L gene, B12R gene), were able to confirm the detection limit of 0.5 copies/μl, and other Ebola virus, Marburg virus, Rift Valley fever virus, Kyasanur Forest disease virus, Junin virus, Guanarito virus, Machupo virus, Chikungunya virus, Hantavirus, Dengue virus types 1-4, and Lassa virus (L gene, GPC gene), and 11 kinds of viruses, the detection limit was confirmed at 5 copies/μl. No cross-reaction or interference between detected genes was observed. CONCLUSION The virus test method developed through this study using multiplex is expected to be used for public health and quarantine as a test method that can be used when a hemorrhagic fever virus of unknown cause is introduced.
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Affiliation(s)
- Yoonhyuk Choi
- Department of Convergence Engineering, Graduate School of Venture, Hoseo University, Seoul, 06724, South Korea; MDx Center, Diagnosis Division, iNtRON Biotechnology, South Korea
| | - Younghee Kim
- Department of Convergence Engineering, Graduate School of Venture, Hoseo University, Seoul, 06724, South Korea.
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2
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Li H, Bello A, Smith G, Kielich DMS, Strong JE, Pickering BS. Degenerate sequence-based CRISPR diagnostic for Crimean-Congo hemorrhagic fever virus. PLoS Negl Trop Dis 2022; 16:e0010285. [PMID: 35271569 PMCID: PMC8939784 DOI: 10.1371/journal.pntd.0010285] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 03/22/2022] [Accepted: 02/27/2022] [Indexed: 11/19/2022] Open
Abstract
CRISPR (clustered regularly interspaced short palindromic repeats), an ancient defense mechanism used by prokaryotes to cleave nucleic acids from invading viruses and plasmids, is currently being harnessed by researchers worldwide to develop new point-of-need diagnostics. In CRISPR diagnostics, a CRISPR RNA (crRNA) containing a "spacer" sequence that specifically complements with the target nucleic acid sequence guides the activation of a CRISPR effector protein (Cas13a, Cas12a or Cas12b), leading to collateral cleavage of RNA or DNA reporters and enormous signal amplification. CRISPR function can be disrupted by some types of sequence mismatches between the spacer and target, according to previous studies. This poses a potential challenge in the detection of variable targets such as RNA viruses with a high degree of sequence diversity, since mismatches can result from target variations. To cover viral diversity, we propose in this study that during crRNA synthesis mixed nucleotide types (degenerate sequences) can be introduced into the spacer sequence positions corresponding to viral sequence variations. We test this crRNA design strategy in the context of the Cas13a-based SHERLOCK (specific high-sensitivity enzymatic reporter unlocking) technology for detection of Crimean-Congo hemorrhagic fever virus (CCHFV), a biosafety level 4 pathogen with wide geographic distribution and broad sequence variability. The degenerate-sequence CRISPR diagnostic proves functional, sensitive, specific and rapid. It detects within 30-40 minutes 1 copy/μl of viral RNA from CCHFV strains representing all clades, and from more recently identified strains with new mutations in the CRISPR target region. Also importantly, it shows no cross-reactivity with a variety of CCHFV-related viruses. This proof-of-concept study demonstrates that the degenerate sequence-based CRISPR diagnostic is a promising tool of choice for effective detection of highly variable viral pathogens.
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Affiliation(s)
- Hongzhao Li
- National Centre for Foreign Animal Disease, Canadian Food Inspection Agency, Winnipeg, Canada
| | - Alexander Bello
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
| | - Greg Smith
- National Centre for Foreign Animal Disease, Canadian Food Inspection Agency, Winnipeg, Canada
| | - Dominic M. S. Kielich
- Department of Medical Microbiology and Infectious Diseases, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - James E. Strong
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada
- Department of Medical Microbiology and Infectious Diseases, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Department of Pediatrics & Child Health, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Bradley S. Pickering
- National Centre for Foreign Animal Disease, Canadian Food Inspection Agency, Winnipeg, Canada
- Department of Medical Microbiology and Infectious Diseases, College of Medicine, Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Iowa State University, College of Veterinary Medicine, Department of Veterinary Microbiology and Preventive Medicine, Ames, Iowa, United States of America
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3
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Matsuno K, Saijo M. [Crimean-Congo hemorrhagic fever]. Uirusu 2022; 72:19-30. [PMID: 37899226 DOI: 10.2222/jsv.72.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is an acute febrile illness with a high case fatality rate caused by the infection with Crimean-Congo hemorrhagic fever virus (CCHFV). The disease is endemic to a wide regions from the African continent to Asia through Europe. CCHFV is maintained in nature between Hyalomma species ticks and some species of animals. Humans are infected with CCHFV from CCHFV-positive tick bite or through a close contact with viremic animals in clucling hum am patients with CCHF. The CCHF-endemic regions depend on the distribution of the species of ticks such as Hyalomma species ticks, main vectors for CCHFV. There have been no confirmed cases of CCHF patients in Japan so far. CCHF is one of the zoonotic virus infections. Main clinical signs of the disease in humans are fever with nonspecific symptoms, and hemorrhage and deterioration in consciousness appear in severe cases. CCHF is classified in the disease category of viral hemorrhagic fevers, which include ebolavirus disease. Viral tick-borne diseases including tick-borne encephalitis, severe fever with thrombocytopenia syndrome, and Yezo virus infection, which has recently been discovered as a novel bunyavirus infection in Hokkaido, Japan, are becoming major concerns for public health in Japan. Trends of CCHF in terms of epidemiology should closely be monitored.
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Affiliation(s)
- Keita Matsuno
- Division of Risk Analysis and Management, International Institute for Zoonosis Control, Hokkaido University
- International Collaboration Unit, International Institute for Zoonosis Control, Hokkaido University
- One Health Research Center, Hokkaido University
| | - Masayuki Saijo
- Sapporo City Public Health Office
- National Institute of Infectious Diseases
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4
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Bartolini B, Gruber CE, Koopmans M, Avšič T, Bino S, Christova I, Grunow R, Hewson R, Korukluoglu G, Lemos CM, Mirazimi A, Papa A, Sanchez-Seco MP, Sauer AV, Zeller H, Nisii C, Capobianchi MR, Ippolito G, Reusken CB, Di Caro A. Laboratory management of Crimean-Congo haemorrhagic fever virus infections: perspectives from two European networks. ACTA ACUST UNITED AC 2020; 24. [PMID: 30722811 PMCID: PMC6386216 DOI: 10.2807/1560-7917.es.2019.24.5.1800093] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background Crimean-Congo haemorrhagic fever virus (CCHFV) is considered an emerging infectious disease threat in the European Union. Since 2000, the incidence and geographic range of confirmed CCHF cases have markedly increased, following changes in the distribution of its main vector, Hyalomma ticks. Aims To review scientific literature and collect experts’ opinion to analyse relevant aspects of the laboratory management of human CCHF cases and any exposed contacts, as well as identify areas for advancement of international collaborative preparedness and laboratory response plans. Methods We conducted a literature review on CCHF molecular diagnostics through an online search. Further, we obtained expert opinions on the key laboratory aspects of CCHF diagnosis. Consulted experts were members of two European projects, EMERGE (Efficient response to highly dangerous and emerging pathogens at EU level) and EVD-LabNet (Emerging Viral Diseases-Expert Laboratory Network). Results Consensus was reached on relevant and controversial aspects of CCHF disease with implications for laboratory management of human CCHF cases, including biosafety, diagnostic algorithm and advice to improve lab capabilities. Knowledge on the diffusion of CCHF can be obtained by promoting syndromic approach to infectious diseases diagnosis and by including CCHFV infection in the diagnostic algorithm of severe fevers of unknown origin. Conclusion No effective vaccine and/or therapeutics are available at present so outbreak response relies on rapid identification and appropriate infection control measures. Frontline hospitals and reference laboratories have a crucial role in the response to a CCHF outbreak, which should integrate laboratory, clinical and public health responses.
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Affiliation(s)
- Barbara Bartolini
- 'L. Spallanzani' National Institute for Infectious Diseases IRCCS (INMI), WHO Collaborating Center for Clinical Care, Diagnosis, Response and Training on Highly Infectious Diseases, Rome, Italy
| | - Cesare Em Gruber
- 'L. Spallanzani' National Institute for Infectious Diseases IRCCS (INMI), WHO Collaborating Center for Clinical Care, Diagnosis, Response and Training on Highly Infectious Diseases, Rome, Italy
| | - Marion Koopmans
- Erasmus MC, Department of Viroscience, WHO Collaborating Centre for Arbovirus and Viral Hemorrhagic Fever Reference and Research, Rotterdam, The Netherlands
| | - Tatjana Avšič
- Institute of Microbiology and Immunology, Faculty of Medicine, Ljubljana, Slovenia
| | - Sylvia Bino
- Control of Infectious Diseases Department Institute of Public Health, Tirana, Albania
| | - Iva Christova
- National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | | | - Roger Hewson
- Public Health England, National Infection Service WHO Collaborating Centre for Virus Reference and Research (Special Pathogens), Porton Down, Salisbury, United Kingdom
| | | | - Cinthia Menel Lemos
- Consumers, Health, Agriculture and Food Executive Agency (CHAFEA), Luxembourg, Luxembourg
| | - Ali Mirazimi
- Department of Laboratory Medicine, Clinical Microbiology, Karolinska Institute and Karolinska University Hospital, Solna, Sweden.,National Veterinary Institute, Uppsala, Sweden.,Public Health agency of Sweden, Solna, Sweden
| | - Anna Papa
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Aisha V Sauer
- European Commission, Directorate General for Health and Food Safety, Unit for Crisis Management and Preparedness in Health, Luxembourg, Luxembourg
| | - Hervè Zeller
- European Center for Disease Prevention and Control, Office of the Chief Scientist, Stockholm, Sweden
| | - Carla Nisii
- 'L. Spallanzani' National Institute for Infectious Diseases IRCCS (INMI), WHO Collaborating Center for Clinical Care, Diagnosis, Response and Training on Highly Infectious Diseases, Rome, Italy
| | - Maria Rosaria Capobianchi
- 'L. Spallanzani' National Institute for Infectious Diseases IRCCS (INMI), WHO Collaborating Center for Clinical Care, Diagnosis, Response and Training on Highly Infectious Diseases, Rome, Italy
| | - Giuseppe Ippolito
- 'L. Spallanzani' National Institute for Infectious Diseases IRCCS (INMI), WHO Collaborating Center for Clinical Care, Diagnosis, Response and Training on Highly Infectious Diseases, Rome, Italy
| | - Chantal B Reusken
- Authors contributed equally to the work and share last authorship.,Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.,Erasmus MC, Department of Viroscience, WHO Collaborating Centre for Arbovirus and Viral Hemorrhagic Fever Reference and Research, Rotterdam, The Netherlands
| | - Antonino Di Caro
- Authors contributed equally to the work and share last authorship.,'L. Spallanzani' National Institute for Infectious Diseases IRCCS (INMI), WHO Collaborating Center for Clinical Care, Diagnosis, Response and Training on Highly Infectious Diseases, Rome, Italy
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5
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Abstract
Crimean-Congo hemorrhagic fever is the most geographically widespread tick-borne virus, with infection resulting in mortality in up to 30% of cases. Clinical diagnosis alone is difficult due to the nonspecific nature of symptoms; therefore, laboratory diagnostics should be utilized for patients with residence in or travel to regions of endemicity in whom the disease is suspected. This minireview provides an overview of laboratory tests available for Crimean-Congo hemorrhagic fever (CCHF) and their utility in diagnosis with a focus on diagnosing CCHF in humans.
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6
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Gruber CEM, Bartolini B, Castilletti C, Mirazimi A, Hewson R, Christova I, Avšič T, Grunow R, Papa A, Sánchez-Seco MP, Kopmans M, Ippolito G, Capobianchi MR, Reusken CBEM, Di Caro A. Geographical Variability Affects CCHFV Detection by RT-PCR: A Tool for In-Silico Evaluation of Molecular Assays. Viruses 2019; 11:E953. [PMID: 31623214 PMCID: PMC6833031 DOI: 10.3390/v11100953] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 10/15/2019] [Indexed: 01/21/2023] Open
Abstract
The Crimean-Congo hemorrhagic fever virus (CCHFV) is considered to be a major emerging infectious threat, according to the WHO R&D blueprint. A wide range of CCHFV molecular assays have been developed, employing varied primer/probe combinations. The high genetic variability of CCHFV often hampers the efficacy of available molecular tests and can affect their diagnostic potential. Recently, increasing numbers of complete CCHFV genomic sequences have become available, allowing a better appreciation of the genomic evolution of this virus. We summarized the current knowledge on molecular methods and developed a new bioinformatics tool to evaluate the existing assays for CCHFV detection, with a special focus on strains circulating in different geographical areas. Twenty-two molecular methods and 181 sequences of CCHFV were collected, respectively, from PubMed and GenBank databases. Up to 28 mismatches between primers and probes of each assay and CCHFV strains were detected through in-silico PCR analysis. Combinations of up to three molecular methods markedly decreased the number of mismatches within most geographic areas. These results supported the good practice of CCHFV detection of performing more than one assay, aimed for different sequence targets. The choice of the most appropriate tests must take into account patient's travel history and geographic distribution of the different CCHFV strains.
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Affiliation(s)
- Cesare E M Gruber
- National Institute for Infectious Diseases (INMI) "L. Spallanzani" IRCCS, WHO Collaborating Center for clinical care, diagnosis, response and training on Highly Infectious Diseases, 00149 Rome, Italy.
| | - Barbara Bartolini
- National Institute for Infectious Diseases (INMI) "L. Spallanzani" IRCCS, WHO Collaborating Center for clinical care, diagnosis, response and training on Highly Infectious Diseases, 00149 Rome, Italy.
| | - Concetta Castilletti
- National Institute for Infectious Diseases (INMI) "L. Spallanzani" IRCCS, WHO Collaborating Center for clinical care, diagnosis, response and training on Highly Infectious Diseases, 00149 Rome, Italy.
| | - Ali Mirazimi
- Public Health agency of Sweden, 17182 Solna, Sweden.
- National veterinary Institute, 75189 Uppsala, Sweden.
- Department of laboratory Medicine, Clinical Microbiology, Karolinska Institute and Karolinska, 17177 Stockholm, Sweden.
| | - Roger Hewson
- Public Health England, National Infection Service WHO Collaborating Centre for Virus Reference and Research (Special Pathogens) Porton Down, Salisbury SP40JG, UK.
| | - Iva Christova
- National Reference Laboratory on Vector-Borne Pathogens, Leptospira and Listeria, Microbiology Department, National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria.
| | - Tatjana Avšič
- Faculty of Medicine, Institute of Microbiology and Immunology, 1000 Ljubljana, Slovenia.
| | - Roland Grunow
- Centre for Biological Threats and Special Pathogens, Highly Pathogenic Microorganisms (ZBS 2), Robert Koch Institute, 13353 Berlin, Germany.
| | - Anna Papa
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
| | - María P Sánchez-Seco
- National Centre of Microbiology, Institute of Health "Carlos III", Majadahonda, 28220 Madrid, Spain.
| | - Marion Kopmans
- Erasmus MC, Department of Viroscience, WHO Collaborating Centre for arbovirus and viral hemorrhagic fever reference and research, 3015 CN Rotterdam, The Netherlands.
| | - Giuseppe Ippolito
- National Institute for Infectious Diseases (INMI) "L. Spallanzani" IRCCS, WHO Collaborating Center for clinical care, diagnosis, response and training on Highly Infectious Diseases, 00149 Rome, Italy.
| | - Maria R Capobianchi
- National Institute for Infectious Diseases (INMI) "L. Spallanzani" IRCCS, WHO Collaborating Center for clinical care, diagnosis, response and training on Highly Infectious Diseases, 00149 Rome, Italy.
| | - Chantal B E M Reusken
- Erasmus MC, Department of Viroscience, WHO Collaborating Centre for arbovirus and viral hemorrhagic fever reference and research, 3015 CN Rotterdam, The Netherlands.
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands.
| | - Antonino Di Caro
- National Institute for Infectious Diseases (INMI) "L. Spallanzani" IRCCS, WHO Collaborating Center for clinical care, diagnosis, response and training on Highly Infectious Diseases, 00149 Rome, Italy.
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7
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Abstract
Introduction: Crimean-Congo hemorrhagic fever (CCHF) is a potentially severe tick-borne viral disease endemic in several regions of Europe, Africa, and Asia. Rapid and reliable diagnosis is essential for early initiation of patient's treatment and for prompt implementation of appropriate precaution and infection control measures to prevent further spread of the disease. Areas covered: A literature search was undertaken on available approaches for laboratory diagnosis of CCHF infections, and the advantages and limitations of the assays are discussed. Expert opinion: Given that the genetic variability among CCHFV strains is high, attention has to be paid on the molecular protocols to detect all currently known genetic lineages of the virus as the emergence of CCHFV strains belonging to various lineages in new environments is not unexpected. In severe cases, the antibody production may be delayed or absent. It is important that the laboratories involved in CCHFV diagnostics to run quality control assays. Standardized assays and point-of-care tests with high sensitivity and specificity are needed. It is expected that the application of next-generation sequencing will be a powerful tool for CCHF diagnostics. Awareness, preparedness, and surveillance are required for prompt detection of CCHF cases.
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Affiliation(s)
- Anna Papa
- a Department of Microbiology , Medical School, Aristotle University of Thessaloniki , Thessaloniki , Greece
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8
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Mazzola LT, Kelly-Cirino C. Diagnostic tests for Crimean-Congo haemorrhagic fever: a widespread tickborne disease. BMJ Glob Health 2019; 4:e001114. [PMID: 30899574 PMCID: PMC6407549 DOI: 10.1136/bmjgh-2018-001114] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 10/17/2018] [Accepted: 10/23/2018] [Indexed: 01/12/2023] Open
Abstract
Crimean-Congo haemorrhagic fever (CCHF) is a widespread tickborne disease that circulates in wild and domestic animal hosts, and causes severe and often fatal haemorrhagic fever in infected humans. Due to the lack of treatment options or vaccines, and a high fatality rate, CCHF virus (CCHFV) is considered a high-priority pathogen according to the WHO R&D Blueprint. Several commercial reverse transcriptase PCR (RT-PCR) and serological diagnostic assays for CCHFV are already available, including febrile agent panels to distinguish CCHFV from other viral haemorrhagic fever agents; however, the majority of international laboratories use inhouse assays. As CCHFV has numerous amplifying animal hosts, a cross-sectoral 'One Health' approach to outbreak prevention is recommended to enhance notifications and enable early warning for genetic and epidemiological shifts in the human, animal and tick populations. However, a lack of guidance for surveillance in animals, harmonisation of case identification and validated serodiagnostic kits for animal testing hinders efforts to strengthen surveillance systems. Additionally, as RT-PCR tests tend to be lineage-specific for regional circulating strains, there is a need for pan-lineage sensitive diagnostics. Adaptation of existing tests to point-of-care molecular diagnostic platforms that can be implemented in clinic or field-based settings would be of value given the potential for CCHFV outbreaks in remote or low-resource areas. Finally, improved access to clinical specimens for validation of diagnostics would help to accelerate development of new tests. These gaps should be addressed by updated target product profiles for CCHFV diagnostics.
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Affiliation(s)
- Laura T Mazzola
- Emerging Threats Programme, Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
| | - Cassandra Kelly-Cirino
- Emerging Threats Programme, Foundation for Innovative New Diagnostics (FIND), Geneva, Switzerland
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Koehler JW, Delp KL, Hall AT, Olschner SP, Kearney BJ, Garrison AR, Altamura LA, Rossi CA, Minogue TD. Sequence Optimized Real-Time Reverse Transcription Polymerase Chain Reaction Assay for Detection of Crimean-Congo Hemorrhagic Fever Virus. Am J Trop Med Hyg 2018; 98:211-215. [PMID: 29165231 DOI: 10.4269/ajtmh.17-0165] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Crimean-Congo hemorrhagic fever virus (CCHFV) is a tick-borne virus of the genus Nairovirus within the family Bunyaviridae. Infection can result in general myalgia, fever, and headache with some patients developing hemorrhagic fever with mortality rates ranging from 5% to 30%. CCHFV has a wide geographic range that includes Africa, Asia, the Middle East, and Europe with nucleotide sequence variation approaching 20% across the three negative-sense RNA genome segments. While phylogenetic clustering generally aligns with geographic origin of individual strains, distribution can be wide due to tick/CCHFV dispersion via migrating birds. This sequence diversity negatively impacts existing molecular diagnostic assays, leading to false negative diagnostic results. Here, we updated a previously developed CCHFV real-time reverse transcription polymerase chain reaction (RT-PCR) assay to include strains not detected using that original assay. Deep sequencing of eight different CCHFV strains, including three that were not detectable using the original assay, identified sequence variants within this assay target region. New primers and probe based on the sequencing results and newly deposited sequences in GenBank greatly improved assay sensitivity and inclusivity with the exception of the genetically diverse strain AP92. For example, we observed a four log improvement in IbAr10200 detection with a new limit of detection of 256 PFU/mL. Subsequent comparison of this assay to another commonly used CCHFV real-time RT-PCR assay targeting a different region of the viral genome showed improved detection, and both assays could be used to mitigate CCHFV diversity for diagnostics. Overall, this work demonstrated the importance of continued viral sequencing efforts for robust diagnostic assay development.
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Affiliation(s)
- Jeffrey W Koehler
- Diagnostic Systems Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Korey L Delp
- Diagnostic Systems Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Adrienne T Hall
- Diagnostic Systems Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Scott P Olschner
- Diagnostic Systems Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Brian J Kearney
- Diagnostic Systems Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Aura R Garrison
- Virology Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Louis A Altamura
- Diagnostic Systems Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Cynthia A Rossi
- Diagnostic Systems Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
| | - Timothy D Minogue
- Diagnostic Systems Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland
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10
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Abstract
Crimean-Congo hemorrhagic fever virus (CCHFV) is a widely distributed hemorrhagic fever virus and the cause of hemorrhagic disease in Africa, Southern and Eastern Europe, the Middle East, India and Asia. Recent emergence of CCHFV into Spain indicates that the geographic range of this virus is expanding and the presence of its tick vector in several countries without reported disease suggest that CCHFV will continue to spread. Research into CCHFV was historically limited by a lack of suitable animal models and tools to study viral pathogenesis. However, in the past few years the toolset for studying CCHFV has expanded with small animal and non-human primate models for CCHFV being developed along with a reverse genetics system that allows for investigation of viral determinants of disease. These tools have been utilized to understand how CCHFV antagonizes host restriction factors and to develop novel vaccine candidates that may help limit the substantial morbidity and mortality in humans caused by CCHFV.
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Affiliation(s)
- David W Hawman
- Laboratory of Virology, Division of Intramural Research, NIAID/NIH, Hamilton, Montana, 59840, USA
| | - Heinz Feldmann
- Laboratory of Virology, Division of Intramural Research, NIAID/NIH, Hamilton, Montana, 59840, USA
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11
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Sas MA, Vina-Rodriguez A, Mertens M, Eiden M, Emmerich P, Chaintoutis SC, Mirazimi A, Groschup MH. A one-step multiplex real-time RT-PCR for the universal detection of all currently known CCHFV genotypes. J Virol Methods 2018; 255:38-43. [PMID: 29408661 DOI: 10.1016/j.jviromet.2018.01.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 01/25/2018] [Accepted: 01/25/2018] [Indexed: 10/18/2022]
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is a fatal disease in humans, which is endemic in many countries of Africa, Southern Asia and Southeastern Europe. It is caused by the Crimean-Congo hemorrhagic fever virus (CCHFV), which is an arthropod-borne virus (arbovirus) transmitted by ixodid ticks, mainly of the genus Hyalomma. Animals like hares, hedgehogs, cattle, camels and small ruminants can become infected without developing clinical signs. Seroconversion occurs after a short viremia of up to two weeks, and thus seroprevalence studies in ruminants can be used to reveal risk areas for the human population. Virus detection by real-time quantitative reverse transcription polymerase chain reaction (RT-qPCR) is essential to prove an actual circulation of CCHFV in a country and is also used as diagnostic method for acute human CCHFV infections. In this study, a new universal one-step multiplex real-time RT-qPCR for the sensitive and specific detection of CCHFV is presented. For this purpose, 14 new primers and 2 probes were simultaneously used to detect RNAs representing all six CCHFV genotypes. Additionally, a GC-mirrored sequence within the synthetic RNAs enables the discrimination between true positive samples and unintentional laboratory contaminations. CCHFV negative samples from different animal species and ten different members of the order Bunyavirales were eventually tested to reveal the specificity of the new RT-qPCR.
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Affiliation(s)
- Miriam A Sas
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald - Isle of Riems, Germany
| | - Ariel Vina-Rodriguez
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald - Isle of Riems, Germany
| | - Marc Mertens
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald - Isle of Riems, Germany
| | - Martin Eiden
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald - Isle of Riems, Germany
| | - Petra Emmerich
- Department of Virology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; Department of Tropical Medicine and Infectious Diseases, Center of Internal Medicine II, University of Rostock, 18057 Rostock, Germany
| | - Serafeim C Chaintoutis
- Diagnostic Laboratory, Department of Clinical Sciences, School of Veterinary Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ali Mirazimi
- Department of Laboratory Medicine, Karolinska Institute, Stockholm, Sweden
| | - Martin H Groschup
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Federal Research Institute for Animal Health, Greifswald - Isle of Riems, Germany.
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12
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Evidence for widespread infection of African bats with Crimean-Congo hemorrhagic fever-like viruses. Sci Rep 2016; 6:26637. [PMID: 27217069 PMCID: PMC4877572 DOI: 10.1038/srep26637] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 05/03/2016] [Indexed: 11/23/2022] Open
Abstract
Crimean Congo hemorrhagic fever virus (CCHFV) is a highly virulent tick-borne pathogen that causes hemorrhagic fever in humans. The geographic range of human CCHF cases largely reflects the presence of ticks. However, highly similar CCHFV lineages occur in geographically distant regions. Tick-infested migratory birds have been suggested, but not confirmed, to contribute to the dispersal. Bats have recently been shown to carry nairoviruses distinct from CCHFV. In order to assess the presence of CCHFV in a wide range of bat species over a wide geographic range, we analyzed 1,135 sera from 16 different bat species collected in Congo, Gabon, Ghana, Germany, and Panama. Using a CCHFV glycoprotein-based indirect immunofluorescence test (IIFT), we identified reactive antibodies in 10.0% (114/1,135) of tested bats, pertaining to 12/16 tested species. Depending on the species, 3.6%–42.9% of cave-dwelling bats and 0.6%–7.1% of foliage-living bats were seropositive (two-tailed t-test, p = 0.0447 cave versus foliage). 11/30 IIFT-reactive sera from 10 different African bat species had neutralizing activity in a virus-like particle assay. Neutralization of full CCHFV was confirmed in 5 of 7 sera. Widespread infection of cave-dwelling bats may indicate a role for bats in the life cycle and geographic dispersal of CCHFV.
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Cikman A, Aydin M, Gulhan B, Karakecili F, Kesik OA, Ozcicek A, Akin H, Kara M. Seroprevalence of Crimean-Congo Hemorrhagic Fever Virus in Erzincan Province, Turkey, Relationship with Geographic Features and Risk Factors. Vector Borne Zoonotic Dis 2016; 16:199-204. [PMID: 26808904 DOI: 10.1089/vbz.2015.1879] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To determine the seroprevalence and risk factors associated with Crimean-Congo hemorrhagic fever virus (CCHFV) in residents of Erzincan, Turkey. Although CCHFV is endemic in Erzincan, this is the first study to evaluate its seroprevalence in this region. This study included a total of 372 subjects, 174 of whom had been exposed to or bitten by ticks, 145 of whom worked with livestock, and 53 of whom resided in the city and did not have exposure to livestock. Data on CCHFV IgG and IgM antibodies were extracted from serum samples collected from all subjects using an ELISA. All samples were tested for CCHFV IgG and CCHFV IgM. Only IgM-positive samples were processed for detection of viral RNA through RT-PCR. Using seropositive cases only, we performed spatial analyses to evaluate correlations between seroprevalence and geographic location (i.e., proximity to rivers, altitude, and slope angle of land). In this study, 14.0% (52/322) of the total subjects were positive for CCHFV IgG. Seven of the individuals were positive both for CCHFV IgG and CCHFV IgM. Of these seven, only one sample tested positive for CCHFV RNA. Individuals who worked with livestock in the rural areas and had a history of tick exposure were statistically more likely to test positive for CCHFV IgG than individuals from the city and not exposed to ticks (p < 0.05). Seroprevalence was affected by geographic characteristics, including distance to rivers, altitude, and slope angle of land. We observed a high seroprevalence of CCHFV in Erzincan, which is similar to that observed in other endemic regions of Turkey. CCHFV seroprevalence rates are found to be quite high in the people who live in the sloping fields at certain heights and where there are a lot of rivers and streams.
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Affiliation(s)
- Aytekin Cikman
- 1 Department of Medical Microbiology, Erzincan University , Erzincan, Turkey
| | - Merve Aydin
- 1 Department of Medical Microbiology, Erzincan University , Erzincan, Turkey
| | - Baris Gulhan
- 1 Department of Medical Microbiology, Erzincan University , Erzincan, Turkey
| | - Faruk Karakecili
- 2 Department of Infectious Diseases, Faculty of Medicine, Erzincan University , Erzincan, Turkey
| | - Ozan Arif Kesik
- 3 Department of Geography, Faculty of Arts and Sciences, Erzincan University , Erzincan, Turkey
| | - Adalet Ozcicek
- 4 Department of Internal Medicine, Faculty of Medicine, Erzincan University , Erzincan, Turkey
| | - Hicran Akin
- 2 Department of Infectious Diseases, Faculty of Medicine, Erzincan University , Erzincan, Turkey
| | - Murat Kara
- 1 Department of Medical Microbiology, Erzincan University , Erzincan, Turkey
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