Crimean-Congo haemorrhagic fever: An outbreak in India

Insight into Hyalomma anatolicum biology by comparative genomics analyses

Hyalomma anatolicum is an obligatory blood-sucking ectoparasite and contributes to the transmission of Crimean-Congo haemorrhagic fever (CCHF) virus, Theileria spp. and Babesia spp. Progress in exploring the adaptive strategy of this ectoparasite and developing tools to fight it has been hindered by the lack of a complete genome. Herein, we assembled the genome using diverse sources of data from multiple sequencing platforms and annotated the 1.96 Gb genome of Hy. anatolicum. Comparative genome analyses and the predicted protein encoding genes reveal unique facets of this genome, including gene family expansion associated with blood feeding and digestion, multi-gene families involved in detoxification, a great number of neuropeptides and corresponding receptors regulating tick growth, development, and reproduction, and glutathione S-transferase genes playing roles in insecticide resistance and detoxification of multiple xenobiotic factors. This high quality reference genome provides fundamental data for obtaining insights into a variety of aspects of tick biology and developing novel strategies to fight notorious tick vectors of human and animal pathogens.

Seroprevalence and Risk Factors of Crimean-Congo Hemorrhagic Fever in Cattle of Smallholder Farmers in Central Malawi

Crimean-Congo hemorrhagic fever virus (CCHFV) is endemic in Africa, Asia, and Eastern Europe where it circulates among animals and ticks causing sporadic outbreaks in humans. Although CCHF is endemic in sub-Saharan Africa, epidemiological information is lacking in many countries, including Malawi. To assess the risk of CCHF in Malawi, we conducted an epidemiological study in cattle reared by smallholder livestock farmers in central Malawi. A cross-sectional study was conducted in April 2020 involving seven districts, four from Kasungu and three from Lilongwe Agriculture Development Divisions. A structured questionnaire was administered to farmers to obtain demographic, animal management, and ecological risk factors data. Sera were collected from randomly selected cattle and screened for CCHF virus (CCHFV) specific antibodies using a commercial ELISA kit. Ticks were collected from cattle and classified morphologically to species level. An overall CCHFV seropositivity rate of 46.9% (n = 416; 95% CI: 42.0–51.8%) was observed. The seropositivity was significantly associated with the age of cattle (p < 0.001), sex (p < 0.001), presence of ticks in herds (p = 0.01), district (p = 0.025), and type of grazing lands (p = 0.013). Five species of ticks were identified, including Hyalomma truncatum, a known vector of CCHFV. Ticks of the species Hyalomma truncatum were not detected in two districts with the highest seroprevalence for CCHF and vector competency must be further explored in the study area. To our knowledge, this is the first report of serologic evidence of the presence of CCHV among smallholder cattle in central Malawi. This study emphasizes the need for continued monitoring of CCHFV infection among livestock, ticks, and humans for the development of data-based risk mitigation strategies.

A review on Hyalomma species infestations on human and animals and progress on management strategies

The Hyalomma species of ticks have gained additional attention due to their role in the transmission of Theileria annulata infection in animals and the Crimean-Congo Haemorrhagic Fever (CCHF) virus in humans. Apart from these, many other pathogens viz., other species of Theileria, a few species of Babesia, Rickettsia and viruses are either maintained or transmitted by this tick species. The medium to large size species with longer proboscis has inflicted additional burden on the overall impact of tick infestations. Being a multi-host species, management of the species is very challenging. Presently, the traditional method of tick management using chemical acaricides is found insufficient and unsustainable. Henceforth, the overall burden of tick infestations and tick-borne diseases are increasing gradually. After the successful development of vaccines against cattle tick, Rhipicephalus microplus, the anti-Hyalomma vaccine is considered a feasible and sustainable management option. In the recent past research on herbal acaricides and its possible application for tick control seems promising. Other eco-friendly methods are still under experimental stage. The present review is focused on impact of Hyalomma species infestation on human and animal health with special emphasis on progress on its sustainable management.

Characterization of a novel STAT 2 knock-out hamster model of Crimean-Congo hemorrhagic fever virus pathogenesis

Crimean-Congo hemorrhagic fever virus (CCHFV) is a tick-borne pathogen causing a febrile illness in humans, which can progress to hemorrhagic manifestations, multi-organ failure, and death. Current mouse models of CCHFV infection reliably succumb to virus challenge but vary in their ability to reflect signs of disease similar to humans. In this study, we established a signal transducer and activator of transcription 2 (STAT2) knockout hamster model to expand the repertoire of animal models of CCHFV pathogenesis that can be used for therapeutic development. These hamsters demonstrated a systemic and lethal disease in response to infection. Hallmarks of human disease were observed including petechial rash, blood coagulation dysfunction, and various biochemistry and blood cell count abnormalities. Furthermore, we also demonstrated the utility of this model for anti-CCHFV therapeutic evaluation. The STAT2 knock-out hamster model of CCHFV infection may provide some further insights into clinical disease, viral pathogenesis, and pave the way for testing of potential drug and vaccine candidates.

Atypical Presentation of Crimean-Congo Hemorrhagic Fever as Ascending Paralysis with Rhabdomyolysis

Crimean–Congo hemorrhagic fever (CCHF) is a tick-borne disease caused by a arbovirus. It is asymptomatic in infected animals but a serious threat to the health of individuals. In human, it starts with nonspecific febrile diseases and progresses into severe hemorrhagic syndrome with high-casual fatality. Here, we report a case of CCHF with atypical presentation of ascending paralysis and rhabdomyolysis.

Contact Tracing for an Imported Case of Crimean-Congo Hemorrhagic Fever - Experience from a Tertiary Care Center in Kerala, South India

A 30-year-old male working in an abattoir in UAE returned home to Kerala, South India, after getting diagnosed with Crimean-Congo hemorrhagic fever infection. He was admitted to a tertiary care center on the day of arrival and was placed under isolation. Due to the risk of spread of infection among health-care workers, contact-tracing and symptom-monitoring activities were undertaken. As strict standard contact precautions, isolation, contact identification and listing, quarantine, and sensitization of health-care workers were implemented, no secondary cases occurred.