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Senbill H, Karawia D, Zeb J, Alyami NM, Almeer R, Rahman S, Sparagano O, Baruah A. Molecular screening and genetic diversity of tick-borne pathogens associated with dogs and livestock ticks in Egypt. PLoS Negl Trop Dis 2024; 18:e0012185. [PMID: 38837987 DOI: 10.1371/journal.pntd.0012185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 05/02/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND The Middle East and North Africa (MENA) offer optimal climatic conditions for tick reproduction and dispersal. Research on tick-borne pathogens in this region is scarce. Despite recent advances in the characterization and taxonomic explanation of various tick-borne illnesses affecting animals in Egypt, no comprehensive examination of TBP (tick-borne pathogen) statuses has been performed. Therefore, the present study aims to detect the prevalence of pathogens harbored by ticks in Egypt. METHODOLOGY/PRINCIPAL FINDINGS A four-year PCR-based study was conducted to detect a wide range of tick-borne pathogens (TBPs) harbored by three economically important tick species in Egypt. Approximately 86.7% (902/1,040) of the investigated Hyalomma dromedarii ticks from camels were found positive with Candidatus Anaplasma camelii (18.8%), Ehrlichia ruminantium (16.5%), Rickettsia africae (12.6%), Theileria annulata (11.9%), Mycoplasma arginini (9.9%), Borrelia burgdorferi (7.7%), Spiroplasma-like endosymbiont (4.0%), Hepatozoon canis (2.4%), Coxiella burnetii (1.6%) and Leishmania infantum (1.3%). Double co-infections were recorded in 3.0% (27/902) of Hy. dromedarii ticks, triple co-infections (simultaneous infection of the tick by three pathogen species) were found in 9.6% (87/902) of Hy. dromedarii ticks, whereas multiple co-infections (simultaneous infection of the tick by ≥ four pathogen species) comprised 12% (108/902). Out of 1,435 investigated Rhipicephalus rutilus ticks collected from dogs and sheep, 816 (56.9%) ticks harbored Babesia canis vogeli (17.1%), Rickettsia conorii (16.2%), Ehrlichia canis (15.4%), H. canis (13.6%), Bo. burgdorferi (9.7%), L. infantum (8.4%), C. burnetii (7.3%) and Trypanosoma evansi (6.6%) in dogs, and 242 (16.9%) ticks harbored Theileria lestoquardi (21.6%), Theileria ovis (20.0%) and Eh. ruminantium (0.3%) in sheep. Double, triple, and multiple co-infections represented 11% (90/816), 7.6% (62/816), and 10.3% (84/816), respectively in Rh. rutilus from dogs, whereas double and triple co-infections represented 30.2% (73/242) and 2.1% (5/242), respectively in Rh. rutilus from sheep. Approximately 92.5% (1,355/1,465) of Rhipicephalus annulatus ticks of cattle carried a burden of Anaplasma marginale (21.3%), Babesia bigemina (18.2%), Babesia bovis (14.0%), Borrelia theleri (12.8%), R. africae (12.4%), Th. annulata (8.7%), Bo. burgdorferi (2.7%), and Eh. ruminantium (2.5%). Double, triple, and multiple co-infections represented 1.8% (25/1,355), 11.5% (156/1,355), and 12.9% (175/1,355), respectively. The detected pathogens' sequences had 98.76-100% similarity to the available database with genetic divergence ranged between 0.0001 to 0.0009% to closest sequences from other African, Asian, and European countries. Phylogenetic analysis revealed close similarities between the detected pathogens and other isolates mostly from African and Asian countries. CONCLUSIONS/SIGNIFICANCE Continuous PCR-detection of pathogens transmitted by ticks is necessary to overcome the consequences of these infection to the hosts. More restrictions should be applied from the Egyptian authorities on animal importations to limit the emergence and re-emergence of tick-borne pathogens in the country. This is the first in-depth investigation of TBPs in Egypt.
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Affiliation(s)
- Haytham Senbill
- Department of Entomology, Faculty of Agriculture, Assam Agricultural University, Jorhat, Assam, India
- Department of Applied Entomology & Zoology, Faculty of Agriculture, Alexandria University, Alexandria, Egypt
| | - Donia Karawia
- Department of Pesticide Chemistry & Technology, Faculty of Agriculture, Alexandria University, Alexandria, Egypt
| | - Jehan Zeb
- Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong, China
- Department of Zoology, Govt. Ghazi Umara Khan Degree College Samarbagh, Higher Education Department, Khyber Pakhtunkhwa, Pakistan
| | - Nouf M Alyami
- Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Rafa Almeer
- Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Sahidur Rahman
- Department of Entomology, Faculty of Agriculture, Assam Agricultural University, Jorhat, Assam, India
| | - Olivier Sparagano
- Agricultural Sciences and Practice, Royal Agricultural University (RAU), Cirencester, United Kingdom
| | - Aiswarya Baruah
- Department of Agricultural Biotechnology, Faculty of Agriculture, Assam Agricultural University, Jorhat, Assam, India
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Aslam M, Abbas RZ, Alsayeqh A. Distribution pattern of Crimean-Congo Hemorrhagic Fever in Asia and the Middle East. Front Public Health 2023; 11:1093817. [PMID: 36778537 PMCID: PMC9909290 DOI: 10.3389/fpubh.2023.1093817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 01/02/2023] [Indexed: 01/27/2023] Open
Abstract
Crimean-Congo Hemorrhagic Fever (CCHF) is one of the most important vector-borne diseases of zoonotic potential that can be acquired following the bite of the Hyalomma species of ticks. It is a highly prevalent disease in Asia and the Middle East. The risk factors of this disease are contact with infected tissue, blood, patient, or livestock in the acute viremic phase, infected tick bites, or the manual removal of ticks. The disease is clinically described as progressive hemorrhages, fever, and pain in musculature. Biochemical tests reveal elevated levels of creatinine phosphokinase, alanine transaminase, aspartate aminotransferase, and lactate dehydrogenase. Clotting time is prolonged in pro-thrombin tests, and pathogenesis is mostly related to the disruption of the epithelium during viral replication and indirectly by secreting cytotoxic molecules. These molecules cause endothelial activation and result in the loss of function. Supportive therapy is given through blood or plasma infusions to treat or manage the patients. According to the most advanced studies, CCHF can be treated by Ribavirin, which is an antiviral drug that shows excellent results in preventing the disease. Health-care staff are more prone to infection. The hemorrhagic phase represents a high risk for accidental exposures. This literature review presents a comprehensive overview of the viral epidemiology, zoonotic perspectives, and significant risk factors of CCHF in various Middle East and Asian countries. Furthermore, the pathophysiology and preventive strategies of CCHF have also been discussed as well as legislation and policies regarding public outreach programs, research, and development aimed at infection prevention and control that are required at a global level.
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Affiliation(s)
- Munazza Aslam
- Department of Pathology, Faculty of Veterinary Science, University of Agriculture, Faisalabad, Pakistan
| | - Rao Zahid Abbas
- Department of Parasitology, Faculty of Veterinary Science, University of Agriculture, Faisalabad, Pakistan
| | - Abdullah Alsayeqh
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Qassim University, Buraidah, Qassim, Saudi Arabia,*Correspondence: Abdullah Alsayeqh ✉
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Perveen N, Khan G. Crimean–Congo hemorrhagic fever in the Arab world: A systematic review. Front Vet Sci 2022; 9:938601. [PMID: 36176697 PMCID: PMC9513365 DOI: 10.3389/fvets.2022.938601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 08/25/2022] [Indexed: 11/23/2022] Open
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is an important tick-borne viral infection with a fatality rate of up to 50% during outbreaks. Crimean-Congo hemorrhagic fever virus (CCHFV) is sustained in the ecosystem in benign form through vertical and horizontal transmission cycles involving tick vectors, wildlife, and livestock. Hyalomma ticks are considered the major source of human infection. CCHF occurs most often among butchers, slaughterhouse workers, and farmworkers through infected tick bites or/and contact with blood and tissues of infected livestock. The nosocomial transmission can occur in auxiliary nurses and physicians through contact with the infected patients. The widespread distribution of CCHFV most probably occurred by ticks on migratory birds, or through international travel and trade of livestock and wildlife. During co-infections of ticks and vertebrates, reassortment among genome segments could play a significant role in generating diversity, and hence, a potential risk for the emergence of novel variants. In this systematic review, we aimed to determine the epidemiology, transmission, distribution, mortality, and clinical features of CCHF in 22 Arab countries, comprising the Arab world. Based on the analysis of 57 studies published from 1978 to 2021, we found 20 tick species that could be associated with CCHFV transmission. During the 43-year period, 321 cases of CCHF were reported from 9/22 Arab countries, Iraq, Kuwait, UAE, Saudi Arabia, Oman, Sudan, Egypt, Tunisia, and Mauritania. The mean case fatality rate was 29% during various outbreaks. Individuals working in abattoirs/slaughter houses, livestock farms, and healthcare were most at risk. Contact with blood or body secretions from infected animals and patients was the most common mode of transmission. A number of different animals, including cattle, goats, sheep, and camels were reported to be seropositive for CCHFV. The highest seroprevalence was observed in camels (29%), followed by cattle (21%), goats (15%), and sheep (14%). We discuss these results in the context of policy-making and potential preventative measures that can be implemented to reduce the burden of CCHF in the Arab world.
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Affiliation(s)
- Nighat Perveen
- Department of Biology, College of Science, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Gulfaraz Khan
- Department of Microbiology & Immunology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
- *Correspondence: Gulfaraz Khan
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Tsapko NV, Volynkina AS, Evchenko AY, Lisitskaya YV, Shaposhnikova LI. Detection of Crimean-Congo hemorrhagic fever virus in ticks collected from South Russia. Ticks Tick Borne Dis 2021; 13:101890. [PMID: 34953335 DOI: 10.1016/j.ttbdis.2021.101890] [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: 02/26/2021] [Revised: 11/30/2021] [Accepted: 12/13/2021] [Indexed: 11/18/2022]
Abstract
Crimean-Congo hemorrhagic fever (CCHF) has a central role among tick-borne infections in southern Russia. Multiple cases of disease are recorded annually in most regions with the СCHF foci; moreover, an expansion of the geographic range of the disease has been noted. Since 1999, more than 2300 people have fallen ill in Russia. Ticks are the main vectors and reservoirs of the Crimean-Congo hemorrhagic fever virus (CCHFV). As it is currently known, CCHFV has been detected in ticks of 33 species. In the period 2012-2019 in the south of the European part of Russia, more than 38,000 ticks of 14 species of the genera Hyalomma, Rhipicephalus, Dermacentor, Haemaphysalis and Ixodes were tested for the presence of CCHFV. Among 4,188 tick pools studied, the virus was detected in 252 (6%). The main vector, as expected, is H. marginatum (81% of positive pools). The same species is the most numerous among the studied ticks (66%). Apart from H. marginatum, the virus was detected in the following species: H. scupense, R. rossicus, R. turanicus, R. bursa, R. annulatus, D. marginatus, Haem. punctata and Ixodes ricinus. Most of the positive results were obtained from ticks collected from vertebrate hosts. As for H. marginatum, R. rossicus, D. marginatus, and Haem. punctata, the virus was detected in questing unfed specimens collected from vegetation and soil surface, which indicates the participation of these ticks in the circulation of the virus.
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Affiliation(s)
- Nikolay V Tsapko
- Laboratory of Medical parasitology, Stavropol Research Anti-Plague Institute, Stavropol, 13-15 Sovetskaya Str., Stavropol 355035, Russian Federation.
| | - Anna S Volynkina
- Laboratory of Medical parasitology, Stavropol Research Anti-Plague Institute, Stavropol, 13-15 Sovetskaya Str., Stavropol 355035, Russian Federation
| | - Anna Yu Evchenko
- Laboratory of Medical parasitology, Stavropol Research Anti-Plague Institute, Stavropol, 13-15 Sovetskaya Str., Stavropol 355035, Russian Federation
| | - Yana V Lisitskaya
- Laboratory of Medical parasitology, Stavropol Research Anti-Plague Institute, Stavropol, 13-15 Sovetskaya Str., Stavropol 355035, Russian Federation
| | - Ludmila I Shaposhnikova
- Laboratory of Medical parasitology, Stavropol Research Anti-Plague Institute, Stavropol, 13-15 Sovetskaya Str., Stavropol 355035, Russian Federation
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Temur AI, Kuhn JH, Pecor DB, Apanaskevich DA, Keshtkar-Jahromi M. Epidemiology of Crimean-Congo Hemorrhagic Fever (CCHF) in Africa-Underestimated for Decades. Am J Trop Med Hyg 2021; 104:1978-1990. [PMID: 33900999 PMCID: PMC8176481 DOI: 10.4269/ajtmh.20-1413] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 02/09/2021] [Indexed: 01/15/2023] Open
Abstract
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.
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Affiliation(s)
- Ahmet Irfan Temur
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Bezmialem Vakif University, Istanbul, Turkey
| | - Jens H. Kuhn
- Integrated Research Facility, Division of Clinical Research, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Fort Detrick, Frederick, Maryland
| | - David B. Pecor
- Department of Entomology, Walter Reed Biosystematics Unit, Smithsonian Institution, Suitland, Maryland
- Department of Entomology, Walter Reed Army Institute of Research, Silver Spring, Maryland
| | - Dmitry A. Apanaskevich
- US National Tick Collection, The James H. Oliver Jr. Institute for Coastal Plain Science, Georgia Southern University, Statesboro, Georgia
| | - Maryam Keshtkar-Jahromi
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Tipih T, Burt FJ. Crimean-Congo Hemorrhagic Fever Virus: Advances in Vaccine Development. Biores Open Access 2020; 9:137-150. [PMID: 32461819 PMCID: PMC7247048 DOI: 10.1089/biores.2019.0057] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/27/2020] [Indexed: 01/12/2023] Open
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is a severe human disease with mortality rates of up to 30%. The disease is widespread in Africa, Asia, the Middle East and Eastern Europe. The last few years have seen disease emergence in Spain for the first time and disease re-emergence in other regions of the world after periods of inactivity. Factors, such as climate change, movement of infected ticks, animals, and changes in human activity, are likely to broaden endemic foci. There are therefore concerns that CCHF might emerge in currently nonendemic regions. The absence of approved vaccines or therapies heightens these concerns; thus Crimean-Congo hemorrhagic fever virus (CCHFV) is listed by the World Health Organization as a priority organism. However, the current sporadic nature of CCHF cases may call for targeted vaccination of risk groups as opposed to mass vaccinations. CCHF vaccine development has accelerated in recent years, partly because of the discovery of CCHF animal models. In this review, we discuss CCHF risk groups who are most likely to benefit from vaccine development, the merits and demerits of available CCHF animal models, and the various approaches which have been explored for CCHF vaccine development. Lastly, we present concluding remarks and research areas which can be further explored to enhance the available CCHFV vaccine data.
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Affiliation(s)
- Thomas Tipih
- Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
| | - Felicity Jane Burt
- Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein, South Africa
- National Health Laboratory Service, Bloemfontein, South Africa
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Blair PW, Kuhn JH, Pecor DB, Apanaskevich DA, Kortepeter MG, Cardile AP, Polanco Ramos A, Keshtkar-Jahromi M. An Emerging Biothreat: Crimean-Congo Hemorrhagic Fever Virus in Southern and Western Asia. Am J Trop Med Hyg 2019; 100:16-23. [PMID: 30652673 DOI: 10.4269/ajtmh.18-0553] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Tick-borne Crimean-Congo hemorrhagic fever virus (CCHFV) is endemic in numerous countries, but the epidemiology and epizoology of Crimean-Congo hemorrhagic fever (CCHF) remain to be defined for most regions of the world. Using a broad database search approach, we reviewed the literature on CCHF and CCHFV in Southern and Western Asia to better define the disease burden in these areas. We used a One Health approach, moving beyond a focus solely on human disease burden to more comprehensively define this burden by reviewing CCHF case reports, human and animal CCHFV seroprevalence studies, and human and animal CCHFV isolations. In addition, we used published literature to estimate the distribution of Hyalomma ticks and infection of these ticks by CCHFV. Using these data, we propose a new classification scheme for organizing the evaluated countries into five categories by level of evidence for CCHF endemicity. Twelve countries have reported CCHF cases, five from Southern Asia and seven from Western Asia. These were assigned to level 1 or 2. Eleven countries that have evidence of vector circulation but did not report confirmed CCHF cases were assigned to level 3 or 4. This classification scheme was developed to inform policy toward strengthening CCHF disease surveillance in the Southern and Western Asia regions. In particular, the goal of this review was to inform international organizations, local governments, and health-care professionals about current shortcomings in CCHFV surveillance in these two high-prevalence regions.
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Affiliation(s)
- Paul W Blair
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jens H Kuhn
- Integrated Research Facility at Fort Detrick, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Frederick, Maryland
| | - David B Pecor
- Department of Entomology, Smithsonian Institution Museum Support Center, Suitland, Maryland
| | | | | | - Anthony P Cardile
- United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Frederick, Maryland
| | | | - Maryam Keshtkar-Jahromi
- Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Ayatollahi J, Shahcheraghi SH, Mirjalili M. Report of nine cases of Crimean-Congo haemorrhagic fever From Iran. Niger Med J 2015; 56:156-9. [PMID: 25838635 PMCID: PMC4382609 DOI: 10.4103/0300-1652.153409] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Crimean-Congo haemorrhagic fever (CCHF) is an often fatal viral infection described in about 30 countries around the world. It is transmitted to humans by the bite of an infected tick and by direct contact with blood or tissue from infected humans and livestock. In the following, we report nine cases of CCHF disease. This paper reported nine human CCHF cases, two in Tabas and Bandar Abbas and seven in Yazd. They were 21-, 33-, 28-, 29-, 61, 34, 35, 36 and 52 year-old men. The first, second and third patients were butchers and other patients were farmers. CCHF should be investigated in the patients with fever, bleeding and low platelet counts.
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Affiliation(s)
- Jamshid Ayatollahi
- Department of Infectious Diseases, Infectious and Tropical Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyed Hossein Shahcheraghi
- Department of Infectious Diseases, Infectious and Tropical Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mahmood Mirjalili
- Department of Infectious Diseases, Infectious and Tropical Diseases Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Sargianou M, Papa A. Epidemiological and behavioral factors associated with Crimean-Congo hemorrhagic fever virus infections in humans. Expert Rev Anti Infect Ther 2013; 11:897-908. [PMID: 24053271 DOI: 10.1586/14787210.2013.827890] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Crimean-Congo hemorrhagic fever (CCHF), a viral disease with high fatality rate, is endemic in many countries in Europe, the Middle East, Asia and Africa. It is transmitted to humans either by tick bite or by direct contact with blood or tissues of viremic patients or livestock. Aim of the present study was to review the main epidemiological characteristics of the disease worldwide, with special attempt to show the epidemiological and behavioral factors that play a role in acquisition of the infection. It is obvious that these factors differ among countries, and the knowledge and understanding of the transmission routes in each region facilitates the implementation of proper control measures, the awareness enhancement and the prevention of the disease.
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Affiliation(s)
- Maria Sargianou
- Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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