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Daodu OB, Shaibu JO, Audu RA, Oluwayelu DO. Seromolecular survey and risk factor analysis of Crimean-Congo haemorrhagic fever orthonairovirus in occupationally exposed herdsmen and unexposed febrile patients in Kwara State, Nigeria. PLoS One 2024; 19:e0303099. [PMID: 38723009 PMCID: PMC11081240 DOI: 10.1371/journal.pone.0303099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 04/18/2024] [Indexed: 05/13/2024] Open
Abstract
Crimean-Congo haemorrhagic fever virus (CCHFV) is a globally significant tick-borne zoonotic pathogen that causes fatal haemorrhagic disease in humans. Despite constituting an ongoing public health threat, limited research exists on the presence of CCHFV among herdsmen, an occupationally exposed population that has prolonged contact with ruminants and ticks. This cross-sectional study, conducted between October 2018 and February 2020 in Kwara State, Nigeria, was aimed at assessing CCHFV seroprevalence among herdsmen and non-herdsmen febrile patients, and identifying the associated risk factors. Blood samples from herdsmen (n = 91) and febrile patients in hospitals (n = 646) were analyzed for anti-CCHFV IgG antibodies and CCHFV S-segment RNA using ELISA and RT-PCR, respectively. Results revealed a remarkably high CCHFV seroprevalence of 92.3% (84/91) among herdsmen compared to 7.1% (46/646) in febrile patients. Occupational risk factors like animal and tick contact, tick bites, and hand crushing of ticks significantly contributed to higher seroprevalence in the herdsmen (p<0.0001). Herdsmen were 156.5 times more likely (p<0.0001) to be exposed to CCHFV than febrile patients. Notably, the odds of exposure were significantly higher (OR = 191.3; p<0.0001) in herdsmen with a history of tick bites. Although CCHFV genome was not detectable in the tested sera, our findings reveal that the virus is endemic among herdsmen in Kwara State, Nigeria. CCHFV should be considered as a probable cause of febrile illness among humans in the study area. Given the nomadic lifestyle of herdsmen, further investigations into CCHF epidemiology in this neglected population are crucial. This study enhances our understanding of CCHFV dynamics and emphasizes the need for targeted interventions in at-risk communities.
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Affiliation(s)
- Oluwafemi Babatunde Daodu
- Department of Veterinary Microbiology, Virology Unit, Faculty of Veterinary Medicine, University of Ilorin, Ilorin, Kwara State, Nigeria
| | - Joseph Ojonugwa Shaibu
- Centre for Human Virology and Genomics, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Rosemary Ajuma Audu
- Centre for Human Virology and Genomics, Nigerian Institute of Medical Research, Yaba, Lagos State, Nigeria
| | - Daniel Oladimeji Oluwayelu
- Department of Veterinary Microbiology, Arbovirology Unit, Faculty of Veterinary Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
- Centre for Control and Prevention of Zoonoses, University of Ibadan, Ibadan, Oyo State, Nigeria
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Frías M, Fischer K, Castro-Scholten S, Bost C, Cano-Terriza D, Risalde MÁ, Acevedo P, Jiménez-Ruiz S, Sadeghi B, Groschup MH, Caballero-Gómez J, García-Bocanegra I. Epidemiologic Survey of Crimean-Congo Hemorrhagic Fever Virus in Suids, Spain. Emerg Infect Dis 2024; 30:984-990. [PMID: 38666621 PMCID: PMC11060457 DOI: 10.3201/eid3005.240074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024] Open
Abstract
We conducted a cross-sectional study in wild boar and extensively managed Iberian pig populations in a hotspot area of Crimean-Congo hemorrhagic fever virus (CCHFV) in Spain. We tested for antibodies against CCHFV by using 2 ELISAs in parallel. We assessed the presence of CCHFV RNA by means of reverse transcription quantitative PCR protocol, which detects all genotypes. A total of 113 (21.8%) of 518 suids sampled showed antibodies against CCHFV by ELISA. By species, 106 (39.7%) of 267 wild boars and 7 (2.8%) of 251 Iberian pigs analyzed were seropositive. Of the 231 Iberian pigs and 231 wild boars analyzed, none tested positive for CCHFV RNA. These findings indicate high CCHFV exposure in wild boar populations in endemic areas and confirm the susceptibility of extensively reared pigs to CCHFV, even though they may only play a limited role in the enzootic cycle.
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Kiwan P, Masse S, Piorkowski G, Ayhan N, Gasparine M, Vial L, Charrel RN, de Lamballerie X, Falchi A. Crimean-Congo Hemorrhagic Fever Virus in Ticks Collected from Cattle, Corsica, France, 2023. Emerg Infect Dis 2024; 30:1036-1039. [PMID: 38666687 PMCID: PMC11060454 DOI: 10.3201/eid3005.231742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024] Open
Abstract
We report the detection of Crimean-Congo hemorrhagic fever virus (CCHFV) in Corsica, France. We identified CCHFV African genotype I in ticks collected from cattle at 2 different sites in southeastern and central-western Corsica, indicating an established CCHFV circulation. Healthcare professionals and at-risk groups should be alerted to CCHFV circulation in Corsica.
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Frank MG, Weaver G, Raabe V. Crimean Congo Hemorrhagic Fever Virus for Clinicians-Virology, Pathogenesis, and Pathology. Emerg Infect Dis 2024; 30:847-853. [PMID: 38666566 PMCID: PMC11060449 DOI: 10.3201/eid3005.231646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2024] Open
Abstract
Crimean-Congo hemorrhagic fever (CCHF), caused by CCHF virus, is a tickborne disease that can cause a range of illness outcomes, from asymptomatic infection to fatal viral hemorrhagic fever; the disease has been described in >30 countries. We conducted a literature review to provide an overview of the virology, pathogenesis, and pathology of CCHF for clinicians. The virus life cycle and molecular interactions are complex and not fully described. Although pathogenesis and immunobiology are not yet fully understood, it is clear that multiple processes contribute to viral entry, replication, and pathological damage. Limited autopsy reports describe multiorgan involvement with extravasation and hemorrhages. Advanced understanding of CCHF virus pathogenesis and immunology will improve patient care and accelerate the development of medical countermeasures for CCHF.
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Büyüktuna SA, Yerlitaş Sİ, Zararsız GE, Doğan K, Kablan D, Bağcı G, Özer S, Baysal C, Çakır Y, Cephe A, Koçhan N, Zararız G, Doğan HO. Exploring free amino acid profiles in Crimean-Congo hemorrhagic fever patients: Implications for disease progression. J Med Virol 2024; 96:e29637. [PMID: 38773825 DOI: 10.1002/jmv.29637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 03/29/2024] [Accepted: 04/18/2024] [Indexed: 05/24/2024]
Abstract
This study investigated the intricate interplay between Crimean-Congo hemorrhagic fever virus infection and alterations in amino acid metabolism. The primary aim is to elucidate the impact of Crimean-Congo hemorrhagic fever (CCHF) on specific amino acid concentrations and identify potential metabolic markers associated with viral infection. One hundred ninety individuals participated in this study, comprising 115 CCHF patients, 30 CCHF negative patients, and 45 healthy controls. Liquid chromatography-tandem mass spectrometry techniques were employed to quantify amino acid concentrations. The amino acid metabolic profiles in CCHF patients exhibit substantial distinctions from those in the control group. Patients highlight distinct metabolic reprogramming, notably characterized by arginine, histidine, taurine, glutamic acid, and glutamine metabolism shifts. These changes have been associated with the underlying molecular mechanisms of the disease. Exploring novel therapeutic and diagnostic strategies addressing specific amino acids may offer potential means to mitigate the severity of the disease.
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Affiliation(s)
- Seyit Ali Büyüktuna
- Department of Infectious Disease and Clinical Microbiology, Cumhuriyet University School of Medicine, Sivas, Türkiye
| | - Serra İlayda Yerlitaş
- Department of Biostatistics, Erciyes University School of Medicine, Kayseri, Türkiye
- Drug Application and Research Center (ERFARMA), Erciyes University, Kayseri, Türkiye
| | - Gözde Ertük Zararsız
- Department of Biostatistics, Erciyes University School of Medicine, Kayseri, Türkiye
- Drug Application and Research Center (ERFARMA), Erciyes University, Kayseri, Türkiye
| | - Kübra Doğan
- Department of Biochemistry, Minister of Health Sivas Numan Hospital, Sivas, Türkiye
| | - Demet Kablan
- Department of Biochemistry, Cumhuriyet University School of Medicine, Sivas, Türkiye
| | - Gökhan Bağcı
- Faculty of Medicine, Medical Biochemistry, Altinbas University, Istanbul, Türkiye
| | - Selda Özer
- Department of Biochemistry, Cumhuriyet University School of Medicine, Sivas, Türkiye
| | - Cihad Baysal
- Department of Infectious Disease and Clinical Microbiology, Cumhuriyet University School of Medicine, Sivas, Türkiye
| | - Yasemin Çakır
- Department of Infectious Disease and Clinical Microbiology, Cumhuriyet University School of Medicine, Sivas, Türkiye
| | - Ahu Cephe
- Institutional Data Management and Analytics Unit, Erciyes University Rectorate, Kayseri, Türkiye
| | - Necla Koçhan
- İzmir Biomedicine and Genome Center (IBG), İzmir, Türkiye
| | - Gökmen Zararız
- Department of Biostatistics, Erciyes University School of Medicine, Kayseri, Türkiye
- Drug Application and Research Center (ERFARMA), Erciyes University, Kayseri, Türkiye
| | - Halef Okan Doğan
- Department of Biochemistry, Cumhuriyet University School of Medicine, Sivas, Türkiye
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Frank MG, Weaver G, Raabe V. Crimean-Congo Hemorrhagic Fever Virus for Clinicians-Epidemiology, Clinical Manifestations, and Prevention. Emerg Infect Dis 2024; 30:854-863. [PMID: 38666548 PMCID: PMC11060446 DOI: 10.3201/eid3005.231647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2024] Open
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is a tickborne infection that can range from asymptomatic to fatal and has been described in >30 countries. Early identification and isolation of patients with suspected or confirmed CCHF and the use of appropriate prevention and control measures are essential for preventing human-to-human transmission. Here, we provide an overview of the epidemiology, clinical features, and prevention and control of CCHF. CCHF poses a continued public health threat given its wide geographic distribution, potential to spread to new regions, propensity for genetic variability, and potential for severe and fatal illness, in addition to the limited medical countermeasures for prophylaxis and treatment. A high index of suspicion, comprehensive travel and epidemiologic history, and clinical evaluation are essential for prompt diagnosis. Infection control measures can be effective in reducing the risk for transmission but require correct and consistent application.
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S. Celina S, Černý J. Genetic background of adaptation of Crimean-Congo haemorrhagic fever virus to the different tick hosts. PLoS One 2024; 19:e0302224. [PMID: 38662658 PMCID: PMC11045102 DOI: 10.1371/journal.pone.0302224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 03/28/2024] [Indexed: 04/28/2024] Open
Abstract
Crimean-Congo haemorrhagic fever orthonairovirus (CCHFV) is a negative-sense, single-stranded RNA virus with a segmented genome and the causative agent of a severe Crimean-Congo haemorrhagic fever (CCHF) disease. The virus is transmitted mainly by tick species in Hyalomma genus but other ticks such as representatives of genera Dermacentor and Rhipicephalus may also be involved in virus life cycle. To improve our understanding of CCHFV adaptation to its tick species, we compared nucleotide composition and codon usage patterns among the all CCHFV strains i) which sequences and other metadata as locality of collection and date of isolation are available in GenBank and ii) which were isolated from in-field collected tick species. These criteria fulfilled 70 sequences (24 coding for S, 23 for M, and 23 for L segment) of virus isolates originating from different representatives of Hyalomma and Rhipicephalus genera. Phylogenetic analyses confirmed that Hyalomma- and Rhipicephalus-originating CCHFV isolates belong to phylogenetically distinct CCHFV clades. Analyses of nucleotide composition among the Hyalomma- and Rhipicephalus-originating CCHFV isolates also showed significant differences, mainly in nucleotides located at the 3rd codon positions indicating changes in codon usage among these lineages. Analyses of codon adaptation index (CAI), effective number of codons (ENC), and other codon usage statistics revealed significant differences between Hyalomma- and Rhipicephalus-isolated CCHFV strains. Despite both sets of strains displayed a higher adaptation to use codons that are preferred by Hyalomma ticks than Rhipicephalus ticks, there were distinct codon usage preferences observed between the two tick species. These findings suggest that over the course of its long co-evolution with tick vectors, CCHFV has optimized its codon usage to efficiently utilize translational resources of Hyalomma species.
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Affiliation(s)
- Seyma S. Celina
- Faculty of Tropical AgriSciences, Center for Infectious Animal Diseases, Czech University of Life Sciences Prague, Prague, Czech Republic
| | - Jiří Černý
- Faculty of Tropical AgriSciences, Center for Infectious Animal Diseases, Czech University of Life Sciences Prague, Prague, Czech Republic
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Ohta K, Saka N, Nishi Y, Nishio M. Nairovirus polymerase mutations associated with the establishment of persistent infection in human cells. J Virol 2024; 98:e0169823. [PMID: 38358288 PMCID: PMC10949423 DOI: 10.1128/jvi.01698-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/23/2024] [Indexed: 02/16/2024] Open
Abstract
Crimean-Congo hemorrhagic fever virus (CCHFV), a tick-borne virus of the Orthonairovirus genus, persistently infects tick cells. It has been reported to establish persistent infection in non-human primates, but virological analysis has not yet been performed in human cells. Here, we investigated whether and how nairoviruses persistently infect human cells using Hazara orthonairovirus (HAZV), a surrogate model for CCHFV. We established a human cell line that was persistently infected with HAZV. Surprisingly, virions of persistently infected HAZV (HAZVpi) were not observed in the culture supernatants. There were five mutations (mut1, mut2, mut3, mut4, and mut5) in L protein of HAZVpi. Mutations in L protein of HAZVpi contribute to non-detection of virion in the supernatants. Lmut4 was found to cause low viral growth rate, despite its high polymerase activity. The low growth rate was restored by Lmut2, Lmut3, and Lmut5. The polymerase activity of Lmut1 was extremely low, and recombinant HAZV carrying Lmut1 (rHAZV/Lmut1) was not released into the supernatants. However, genomes of rHAZV/Lmut1 were retained in the infected cells. All mutations (Lmut1-5) found in L protein of HAZVpi were required for experimental reproduction of HAZVpi, and only Lmut1 and Lmut4 were insufficient. We demonstrated that point mutations in viral polymerase contribute to the establishment of persistent HAZV infection. Furthermore, innate immunity was found to be suppressed in HAZVpi-infected cells, which also potentially contributes to viral persistence. This is the first presentation of a possible mechanism behind how nairoviruses establish persistent infection in human cells. IMPORTANCE We investigated whether and how nairoviruses persistently infect human cells, using Hazara orthonairovirus (HAZV), a surrogate model for Crimean-Congo hemorrhagic fever virus. We established a human cell line that was persistently infected with HAZV. Five mutations were found in L protein of persistently infected HAZV (HAZVpi): mut1, mut2, mut3, mut4, and mut5. Among them, Lmut1 and Lmut4 restricted viral growth by low polymerase activity and low growth rate, respectively, leading to inhibition of viral overgrowth. The restriction of viral growth caused by Lmut1 and Lmut4 was compensated by other mutations, including Lmut2, Lmut3, and Lmut5. Each of the mutations found in L protein of HAZVpi was concluded to cooperatively modulate viral growth, which facilitates the establishment of persistent infection. Suppression of innate immunity also potentially contributes to virus persistence. This is the first presentation of a possible mechanism behind how nairoviruses establish persistent infection in human cells.
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Affiliation(s)
- Keisuke Ohta
- Department of Microbiology, School of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Naoki Saka
- Department of Microbiology, School of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Yuzuha Nishi
- Department of Microbiology, School of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Machiko Nishio
- Department of Microbiology, School of Medicine, Wakayama Medical University, Wakayama, Japan
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Lado S, Futas J, Plasil M, Loney T, Weidinger P, Camp JV, Kolodziejek J, Kannan DO, Horin P, Nowotny N, Burger PA. Crimean-Congo Hemorrhagic Fever Virus Past Infections Are Associated with Two Innate Immune Response Candidate Genes in Dromedaries. Cells 2021; 11:8. [PMID: 35011568 PMCID: PMC8750074 DOI: 10.3390/cells11010008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 12/15/2021] [Indexed: 12/16/2022] Open
Abstract
Dromedaries are an important livestock, used as beasts of burden and for meat and milk production. However, they can act as an intermediate source or vector for transmitting zoonotic viruses to humans, such as the Middle East respiratory syndrome coronavirus (MERS-CoV) or Crimean-Congo hemorrhagic fever virus (CCHFV). After several outbreaks of CCHFV in the Arabian Peninsula, recent studies have demonstrated that CCHFV is endemic in dromedaries and camel ticks in the United Arab Emirates (UAE). There is no apparent disease in dromedaries after the bite of infected ticks; in contrast, fever, myalgia, lymphadenopathy, and petechial hemorrhaging are common symptoms in humans, with a case fatality ratio of up to 40%. We used the in-solution hybridization capture of 100 annotated immune genes to genotype 121 dromedaries from the UAE tested for seropositivity to CCHFV. Through univariate linear regression analysis, we identified two candidate genes belonging to the innate immune system: FCAR and CLEC2B. These genes have important functions in the host defense against viral infections and in stimulating natural killer cells, respectively. This study opens doors for future research into immune defense mechanisms in an enzootic host against an important zoonotic disease.
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Affiliation(s)
- Sara Lado
- Research Institute of Wildlife Ecology, Department of Interdisciplinary Life Sciences, University of Veterinary Medicine Vienna, 1160 Vienna, Austria;
- Division of Infectious Diseases and Tropical Medicine, Department of Medicine I, Medical University of Vienna, 1090 Vienna, Austria
| | - Jan Futas
- Department of Animal Genetics, University of Veterinary Sciences Brno, 61242 Brno, Czech Republic; (J.F.); (M.P.); (P.H.)
- RG Animal Immunogenomics, CEITEC VETUNI Brno, 61242 Brno, Czech Republic
| | - Martin Plasil
- Department of Animal Genetics, University of Veterinary Sciences Brno, 61242 Brno, Czech Republic; (J.F.); (M.P.); (P.H.)
- RG Animal Immunogenomics, CEITEC VETUNI Brno, 61242 Brno, Czech Republic
| | - Tom Loney
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 505055, United Arab Emirates; (T.L.); (N.N.)
| | - Pia Weidinger
- Viral Zoonoses, Emerging and Vector-Borne Infections Group, Institute of Virology, University of Veterinary Medicine Vienna, 1210 Vienna, Austria; (P.W.); (J.V.C.); (J.K.)
| | - Jeremy V. Camp
- Viral Zoonoses, Emerging and Vector-Borne Infections Group, Institute of Virology, University of Veterinary Medicine Vienna, 1210 Vienna, Austria; (P.W.); (J.V.C.); (J.K.)
- Center for Virology, Medical University of Vienna, 1090 Vienna, Austria
| | - Jolanta Kolodziejek
- Viral Zoonoses, Emerging and Vector-Borne Infections Group, Institute of Virology, University of Veterinary Medicine Vienna, 1210 Vienna, Austria; (P.W.); (J.V.C.); (J.K.)
| | | | - Petr Horin
- Department of Animal Genetics, University of Veterinary Sciences Brno, 61242 Brno, Czech Republic; (J.F.); (M.P.); (P.H.)
- RG Animal Immunogenomics, CEITEC VETUNI Brno, 61242 Brno, Czech Republic
| | - Norbert Nowotny
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai 505055, United Arab Emirates; (T.L.); (N.N.)
- Viral Zoonoses, Emerging and Vector-Borne Infections Group, Institute of Virology, University of Veterinary Medicine Vienna, 1210 Vienna, Austria; (P.W.); (J.V.C.); (J.K.)
| | - Pamela A. Burger
- Research Institute of Wildlife Ecology, Department of Interdisciplinary Life Sciences, University of Veterinary Medicine Vienna, 1160 Vienna, Austria;
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Karaaslan E, Çetin NS, Kalkan-Yazıcı M, Hasanoğlu S, Karakeçili F, Özdarendeli A, Kalkan A, Kılıç AO, Doymaz MZ. Immune responses in multiple hosts to Nucleocapsid Protein (NP) of Crimean-Congo Hemorrhagic Fever Virus (CCHFV). PLoS Negl Trop Dis 2021; 15:e0009973. [PMID: 34851958 PMCID: PMC8635347 DOI: 10.1371/journal.pntd.0009973] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 11/03/2021] [Indexed: 12/24/2022] Open
Abstract
In 2019, the World Health Organization declared 3 billion to be at risk of developing Crimean Congo Hemorrhagic Fever (CCHF). The causative agent of this deadly infection is CCHFV. The data related to the biology and immunology of CCHFV are rather scarce. Due to its indispensable roles in the viral life cycle, NP becomes a logical target for detailed viral immunology studies. In this study, humoral immunity to NP was investigated in CCHF survivors, as well as in immunized mice and rabbits. Abundant antibody response against NP was demonstrated both during natural infection in humans and following experimental immunizations in mice and rabbits. Also, cellular immune responses to recombinant NP (rNP) was detected in multispecies. This study represents the most comprehensive investigation on NP as an inducer of both humoral and cellular immunity in multiple hosts and proves that rNP is an excellent candidate warranting further immunological studies specifically on vaccine investigations. Crimean Congo Hemorrhagic Fever Virus (CCHFV) is the most lethal human pathogen of medical importance after the dengue virus among arboviruses. The increasing geographic spread of Hyalomma ticks, which are responsible for viral transmission widespread, threatens billions of people. WHO currently declares the field of research on CCHFV as the second most urgently needed areas of investigations on emerging pathogens. About 10 to 40% of those infected with the virus lose their life due to the rapidly developing severe clinical manifestations. Pandemic potential and the lack of any approved treatment or vaccine make raise the studies on CCHFV as critical. The studies on CCHFV are challenging due to the necessities of BSL-4 facilities and the immunological characterization of individual structural proteins will lay the groundwork for the steps to be taken to treat and prevent this emerging disease. As is known from other RNA viruses, nucleoprotein (NP) has crucial roles in the viral life cycle, both in viral replication and transcription and in the formation of the virion structure. So far, detailed and comprehensive immunological characterizations on NP in multiple are not undertaken. Our study was set out to embark such detailed investigation. The strong humoral and cellular immune response to NP demonstrated by this study indicates that NP might be an excellent candidate for future scrutinies on vaccines and diagnostic reagents.
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Affiliation(s)
- Elif Karaaslan
- Beykoz Institute of Life Sciences and Biotechnology, Bezmialem Vakıf University, Istanbul, Turkey
| | - Nesibe Selma Çetin
- Beykoz Institute of Life Sciences and Biotechnology, Bezmialem Vakıf University, Istanbul, Turkey
- Department of Medical Microbiology, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey
| | - Merve Kalkan-Yazıcı
- Beykoz Institute of Life Sciences and Biotechnology, Bezmialem Vakıf University, Istanbul, Turkey
| | - Sevde Hasanoğlu
- Beykoz Institute of Life Sciences and Biotechnology, Bezmialem Vakıf University, Istanbul, Turkey
| | - Faruk Karakeçili
- Department of Infectious Diseases and Clinical Microbiology, Erzincan University School of Medicine, Erzincan, Turkey
| | - Aykut Özdarendeli
- Erciyes University Vectors and Vector Borne Diseases Implementation and Research Center, Kayseri, Turkey; Department of Microbiology, Erciyes University School of Medicine, Kayseri, Turkey
- Department of Medical Microbiology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Ahmet Kalkan
- Department of Infectious Diseases and Clinical Microbiology, Medical Faculty, Karadeniz Technical University, Trabzon, Turkey
| | - Ali Osman Kılıç
- Department of Medical Microbiology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Mehmet Ziya Doymaz
- Beykoz Institute of Life Sciences and Biotechnology, Bezmialem Vakıf University, Istanbul, Turkey
- Department of Medical Microbiology, Faculty of Medicine, Bezmialem Vakıf University, Istanbul, Turkey
- * E-mail:
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Sahay RR, Shete AM, Yadav PD, Patil S, Majumdar T, Jain R, Nyayanit DA, Kaushal H, Panjwani SJ, Upadhyay KJ, Varevadiya CL, Vora A, Kanani A, Gangakhedkar RR. Sequential determination of viral load, humoral responses and phylogenetic analysis in fatal and non-fatal cases of Crimean-Congo hemorrhagic fever patients from Gujarat, India, 2019. PLoS Negl Trop Dis 2021; 15:e0009718. [PMID: 34460819 PMCID: PMC8432894 DOI: 10.1371/journal.pntd.0009718] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 09/10/2021] [Accepted: 08/08/2021] [Indexed: 11/18/2022] Open
Abstract
Background Thirty-four CCHF cases (17 fatal; 17 survived) were confirmed from Gujarat state, India during the year 2019. We aimed to find out the viral load, antibody kinetics, cytokine profile and phylogenetic analysis between fatal and non- fatal cases. Methods Thirty four cases were included in this study. Blood and urine samples were collected from all the cases on the day of admission to hospital. Non-fatal cases were followed weekly for understanding the profile of viral kinetics, anti-CCHFV IgM and IgG antibodies. We also quantified the cytokines in both fatal and non-fatal cases. For epidemiological correlation, livestock were screened for anti-CCHF IgG antibodies and the tick pool specimens were tested by real time RT-PCR. Virus isolation was attempted on tick pools and human specimens and phylogenetic analysis performed on human and ticks complete genome sequences. Results CCHF cases were detected throughout year in 2019 with the peak in August. Out of 34 cases, eight secondary CCHF cases were reported. Cases were predominantly detected in males and in 19–45 years age group (55.88%). The persistence of viremia was observed till 76th POD (post onset date) in one case whereas anti-CCHFV IgM and IgG was detected amongst these cases from the 2nd and 20th POD respectively. Positivity observed amongst livestock and tick pools were was 21.57% and 7.4% respectively. The cytokine analysis revealed a significant increase in the level of serum IL-6, IL-10 and IFN-γ during the acute phase of the infection, but interestingly IL-10 lowered to normal upon clearance of the virus in the clinically recovered case. Fatal cases had high viral RNA copy numbers. Bleeding from one or two mucosal sites was significantly associated with fatality (OR-16.47;p-0.0034 at 95% CI). We could do CCHF virus isolation from two cases. Phylogenetic analysis revealed circulation of re-assortment of Asian-West African genotypes in humans and ticks. Conclusions The persistence of CCHF viral RNA was detected till 76th POD in one of the survivors. The circulation of a re-assortment Asian-West African genotype in a CCHF case is also reported first time from India. Crimean Congo hemorrhagic fever is a zoonotic tick-borne viral hemorrhagic disease. This disease is reported from Europe, Mediterranean, north-western China, central Asia, Africa, and the Middle East. Several outbreaks of CCHF were reported from Gujarat and Rajasthan states, India from 2011 to 2019. In this study, we discuss the clinical, molecular, serological, and the cytokine data of 34 CCHF cases (17 fatal and 17 survived) which were detected from Gujarat state in the year 2019. A sequential weekly follow up of the CCHF survivors was performed to understand the viral kinetics and the antibody profile. Interestingly, the presence of persistence CCHF viral RNA was observed till 76th POD in one of the survivors. To our knowledge, we are reporting this long term persistence of viremia for the first time. We also observed that the anti-CCHFV IgM detection in the serum samples starts as soon as 2nd POD but anti-CCHFV IgG antibody could be detected in the majority of the cases only after the 28th POD. The cytokine analysis revealed a significant increase in the level of serum IL-6, IL-10 and IFN-γ during the acute phase of the infection, but interestingly IL-10 lowered to normal upon clearance of the virus in the clinically recovered case. We did the phylogenetic analysis and concluded the circulation of the Asian-West African re-assortment genotype in humans, which has not been reported from India prior to this study.
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MESH Headings
- Adolescent
- Adult
- Aged
- Animals
- Antibodies, Viral/blood
- Antibodies, Viral/immunology
- Cytokines/blood
- Female
- Genotype
- Hemorrhagic Fever Virus, Crimean-Congo/classification
- Hemorrhagic Fever Virus, Crimean-Congo/genetics
- Hemorrhagic Fever Virus, Crimean-Congo/isolation & purification
- Hemorrhagic Fever Virus, Crimean-Congo/physiology
- Hemorrhagic Fever, Crimean/blood
- Hemorrhagic Fever, Crimean/epidemiology
- Hemorrhagic Fever, Crimean/immunology
- Hemorrhagic Fever, Crimean/virology
- Humans
- Immunity, Humoral
- India/epidemiology
- Livestock/blood
- Livestock/virology
- Male
- Middle Aged
- Phylogeny
- RNA, Viral/genetics
- Ticks/virology
- Viral Load
- Young Adult
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Affiliation(s)
- Rima R. Sahay
- Indian Council of Medical Research-National Institute of Virology, Maximum Containment Facility, Pune, Maharashtra, India
| | - Anita M. Shete
- Indian Council of Medical Research-National Institute of Virology, Maximum Containment Facility, Pune, Maharashtra, India
| | - Pragya D. Yadav
- Indian Council of Medical Research-National Institute of Virology, Maximum Containment Facility, Pune, Maharashtra, India
- * E-mail:
| | - Savita Patil
- Indian Council of Medical Research-National Institute of Virology, Maximum Containment Facility, Pune, Maharashtra, India
| | - Triparna Majumdar
- Indian Council of Medical Research-National Institute of Virology, Maximum Containment Facility, Pune, Maharashtra, India
| | - Rajlaxmi Jain
- Indian Council of Medical Research-National Institute of Virology, Maximum Containment Facility, Pune, Maharashtra, India
| | - Dimpal A. Nyayanit
- Indian Council of Medical Research-National Institute of Virology, Maximum Containment Facility, Pune, Maharashtra, India
| | - Himanshu Kaushal
- Indian Council of Medical Research-National Institute of Virology, Maximum Containment Facility, Pune, Maharashtra, India
| | - Sunil J. Panjwani
- Government Medical College and Sir-T Hospital Bhavnagar, Gujarat, India
| | | | | | - Alpesh Vora
- Government Medical College and Sir-T Hospital Bhavnagar, Gujarat, India
| | - Amit Kanani
- Animal Husbandry Department, Foot and Mouth Disease Scheme, Ahmedabad, Gujarat, India
| | - Raman R. Gangakhedkar
- Epidemiology and Communicable Diseases (ECD) Division, Indian Council of Medical Research, New Delhi, India
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12
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Dai S, Deng F, Wang H, Ning Y. Crimean-Congo Hemorrhagic Fever Virus: Current Advances and Future Prospects of Antiviral Strategies. Viruses 2021; 13:v13071195. [PMID: 34206476 PMCID: PMC8310003 DOI: 10.3390/v13071195] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/09/2021] [Accepted: 06/18/2021] [Indexed: 02/03/2023] Open
Abstract
Crimean-Congo hemorrhagic fever virus (CCHFV) is a widespread, tick-borne pathogen that causes Crimean-Congo hemorrhagic fever (CCHF) with high morbidity and mortality. CCHFV is transmitted to humans through tick bites or direct contact with patients or infected animals with viremia. Currently, climate change and globalization have increased the transmission risk of this biosafety level (BSL)-4 virus. The treatment options of CCHFV infection remain limited and there is no FDA-approved vaccine or specific antivirals, which urges the identification of potential therapeutic targets and the design of CCHF therapies with greater effort. In this article, we discuss the current progress and some future directions in the development of antiviral strategies against CCHFV.
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Affiliation(s)
- Shiyu Dai
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan 430071, China;
| | - Fei Deng
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan 430071, China;
- Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan 430071, China
- Correspondence: (F.D.); (H.W.); (Y.N.); Tel./Fax: +86-27-8719-8465 (F.D.); +86-27-8719-9353 (H.W.); +86-27-8719-7200 (Y.N.)
| | - Hualin Wang
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan 430071, China;
- Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan 430071, China
- Correspondence: (F.D.); (H.W.); (Y.N.); Tel./Fax: +86-27-8719-8465 (F.D.); +86-27-8719-9353 (H.W.); +86-27-8719-7200 (Y.N.)
| | - Yunjia Ning
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan 430071, China;
- Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan 430071, China
- Correspondence: (F.D.); (H.W.); (Y.N.); Tel./Fax: +86-27-8719-8465 (F.D.); +86-27-8719-9353 (H.W.); +86-27-8719-7200 (Y.N.)
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13
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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14
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Bayyurt B, Bakir M, Engin A, Oksuz C, Arslan S. Investigation of NEAT1, IFNG-AS1, and NRIR expression in Crimean-Congo hemorrhagic fever. J Med Virol 2021; 93:3300-3304. [PMID: 33064349 DOI: 10.1002/jmv.26606] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 09/22/2020] [Accepted: 10/13/2020] [Indexed: 12/23/2022]
Abstract
Crimean-Congo hemorrhagic fever (CCHF), whose causative agent is CCHF orthonairovirus (CCHFV), demonstrates different symptoms in patients. Long noncoding RNAs (lncRNAs) take part in various pathological processes of viral diseases. They are prominent regulators of antiviral immune responses. To our knowledge, this study is the first study to investigate nuclear paraspeckle assembly transcript 1 (NEAT1), interferon (IFN) gamma antisense RNA 1 (IFNG-AS1), and negative regulator of IFN response (NRIR) expression in CCHF in the literature. We selected these lncRNAs because they are related to IFN signal or IFN-stimulated genes. We investigated NEAT1, IFNG-AS1, and NRIR gene expression in patients with CCHF. Total RNA was extracted from blood samples of 100 volunteers and NEAT1, IFNG-AS1, and NRIR expression were measured using a quantitative real-time polymerase chain reaction. NRIR expression was statistically significant in cases versus controls (p < .001), fatals versus controls (p < .001), and fatals versus nonfatals (p = .01). Furthermore, NRIR was found statistically significant at some clinical parameters including alanine aminotransferase (p = .03), international normalized ratio (p = .03), prothrombin time (p = .02), and active partial thromboplastin time (p = .01) in CCHF cases. NEAT1 and IFNG-AS1 expression were downregulated in the case and fatal groups which were compared with controls. Our results demonstrate that NRIR may be important in CCHF pathogenesis and the target of CCHF treatment.
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Affiliation(s)
- Burcu Bayyurt
- Department of Medical Biology, Faculty of Medicine, Sivas Cumhuriyet University, Sivas, Turkey
| | - Mehmet Bakir
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Sivas Cumhuriyet University, Sivas, Turkey
| | - Aynur Engin
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Sivas Cumhuriyet University, Sivas, Turkey
| | - Caner Oksuz
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Sivas Cumhuriyet University, Sivas, Turkey
| | - Serdal Arslan
- Department of Medical Biology, Faculty of Medicine, Sivas Cumhuriyet University, Sivas, Turkey
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15
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Choubdar N, Karimian F, Koosha M, Oshaghi MA. An integrated overview of the bacterial flora composition of Hyalomma anatolicum, the main vector of CCHF. PLoS Negl Trop Dis 2021; 15:e0009480. [PMID: 34106924 PMCID: PMC8216544 DOI: 10.1371/journal.pntd.0009480] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 06/21/2021] [Accepted: 05/16/2021] [Indexed: 12/26/2022] Open
Abstract
The microbial flora associated with Hyalomma anatolicum ticks was investigated using culture-dependent (CD) and independent (next generation sequencing, NGS) methods. The bacterial profiles of different organs, development stages, sexes, and of host cattle skins were analyzed using the CD method. The egg and female gut microbiota were investigated using NGS. Fourteen distinct bacterial strains were identified using the CD method, of which Bacillus subtilis predominated in eggs, larval guts and in adult female and male guts, suggesting probable transovarial transmission. Bacillus velezensis and B. subtilis were identified in cattle skin and tick samples, suggesting that skin is the origin of tick bacteria. H.anatolicum males harbour lower bacterial diversity and composition than females. The NGS analysis revealed five different bacterial phyla across all samples, Proteobacteria contributing to >95% of the bacteria. In all, 56611sequences were generated representing 6,023 OTUs per female gut and 421 OTUs per egg. Francisellaceae family and Francisella make up the vast majority of the OTUs. Our findings are consistent with interference between Francisella and Rickettsia. The CD method identified bacteria, such B. subtilis that are candidates for vector control intervention approaches such paratransgenesis whereas NGS revealed high Francisella spp. prevalence, indicating that integrated methods are more accurate to characterize microbial community and diversity.
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Affiliation(s)
- Nayyereh Choubdar
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fateh Karimian
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mona Koosha
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Oshaghi
- Department of Medical Entomology and Vector Control, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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16
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Kajihara M, Simuunza M, Saasa N, Dautu G, Mori-Kajihara A, Qiu Y, Nakao R, Eto Y, Furumoto H, Hang’ombe BM, Orba Y, Sawa H, Simulundu E, Fukushi S, Morikawa S, Saijo M, Arikawa J, Kabilika S, Monze M, Mukonka V, Mweene A, Takada A, Yoshimatsu K. Serologic and molecular evidence for circulation of Crimean-Congo hemorrhagic fever virus in ticks and cattle in Zambia. PLoS Negl Trop Dis 2021; 15:e0009452. [PMID: 34061841 PMCID: PMC8195391 DOI: 10.1371/journal.pntd.0009452] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 06/11/2021] [Accepted: 05/07/2021] [Indexed: 11/19/2022] Open
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne zoonosis with a high case fatality rate in humans. Although the disease is widely found in Africa, Europe, and Asia, the distribution and genetic diversity of CCHF virus (CCHFV) are poorly understood in African countries. To assess the risks of CCHF in Zambia, where CCHF has never been reported, epidemiologic studies in cattle and ticks were conducted. Through an indirect immunofluorescence assay, CCHFV nucleoprotein-specific serum IgG was detected in 8.4% (88/1,047) of cattle. Among 290 Hyalomma ticks, the principal vector of CCHFV, the viral genome was detected in 11 ticks. Phylogenetic analyses of the CCHFV S and M genome segments revealed that one of the detected viruses was a genetic reassortant between African and Asian strains. This study provides compelling evidence for the presence of CCHFV in Zambia and its transmission to vertebrate hosts. Crimean-Congo hemorrhagic fever (CCHF) is a severe viral disease mainly transmitted by ticks. Effective prophylactics and therapeutics have not been established for this disease yet. While CCHF is endemic in Africa, information on the distribution and genetic diversity of CCHF virus (CCHFV) is quite limited in many Sub-Saharan African countries. In this study, we conducted serologic and molecular epidemiologic investigations for CCHFV infection in cattle and ticks in Zambia. Serologic screening revealed that 8.4% of cattle were tested positive for CCHFV-specific IgG. Hyalomma ticks infected with CCHFV were also identified by genetic screening. Phylogenetic analyses showed that one of the CCHFVs detected in Zambia was a genetic reassortant between African and Asian CCHFV strains. Currently, Zambia is considered CCHF-free country because CCHF cases have never been reported. However, the findings in this study indicate that CCHFV is maintained in Hyalomma ticks and occasionally transmitted to vertebrate hosts such as cattle in Zambia. Further epidemiologic studies and continuous monitoring of CCHFV infection should be implemented in the southern African region.
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Affiliation(s)
- Masahiro Kajihara
- Research Center for Zoonosis Control, Hokkaido University, Sapporo, Japan
| | - Martin Simuunza
- School of Veterinary Medicine, the University of Zambia, Lusaka, Zambia
- Africa Centre of Excellence for Infectious Diseases of Humans and Animals, University of Zambia, Lusaka, Zambia
| | - Ngonda Saasa
- School of Veterinary Medicine, the University of Zambia, Lusaka, Zambia
| | - George Dautu
- Central Veterinary Research Institute, Ministry of Fisheries and Livestock, Lusaka, Zambia
| | | | - Yongjin Qiu
- Research Center for Zoonosis Control, Hokkaido University, Sapporo, Japan
| | - Ryo Nakao
- Graduate School of Infectious Diseases, Faculty of Veterinary Medicine, Hokkaido University, Sapporo, Japan
| | - Yoshiki Eto
- Research Center for Zoonosis Control, Hokkaido University, Sapporo, Japan
| | - Hayato Furumoto
- JICA Zambia Office, Japan International Cooperation Agency, Lusaka, Zambia
| | - Bernard M. Hang’ombe
- School of Veterinary Medicine, the University of Zambia, Lusaka, Zambia
- Africa Centre of Excellence for Infectious Diseases of Humans and Animals, University of Zambia, Lusaka, Zambia
| | - Yasuko Orba
- Research Center for Zoonosis Control, Hokkaido University, Sapporo, Japan
| | - Hirofumi Sawa
- Research Center for Zoonosis Control, Hokkaido University, Sapporo, Japan
- School of Veterinary Medicine, the University of Zambia, Lusaka, Zambia
| | - Edgar Simulundu
- School of Veterinary Medicine, the University of Zambia, Lusaka, Zambia
| | - Shuetsu Fukushi
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Shigeru Morikawa
- Department of Veterinary Science, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masayuki Saijo
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Jiro Arikawa
- Department of Microbiology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Swithine Kabilika
- Department of Veterinary Services, Ministry of Fisheries and Livestock, Lusaka, Zambia
| | - Mwaka Monze
- Virology Laboratory, University Teaching Hospital, Lusaka, Zambia
| | | | - Aaron Mweene
- School of Veterinary Medicine, the University of Zambia, Lusaka, Zambia
| | - Ayato Takada
- Research Center for Zoonosis Control, Hokkaido University, Sapporo, Japan
- School of Veterinary Medicine, the University of Zambia, Lusaka, Zambia
- * E-mail: (AT); (KY)
| | - Kumiko Yoshimatsu
- Department of Microbiology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
- * E-mail: (AT); (KY)
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17
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Belobo JTE, Kenmoe S, Kengne-Nde C, Emoh CPD, Bowo-Ngandji A, Tchatchouang S, Sowe Wobessi JN, Mbongue Mikangue CA, Tazokong HR, Kingue Bebey SR, Atembeh Noura E, Ka’e AC, Guiamdjo Simo RE, Modiyinji AF, Ngongang DT, Che E, Kenfack S, Nzukui ND, Amvongo Adjia N, Babassagana IT, Mahamat G, Mbaga DS, Mbacham WF, Sadeuh-Mbah SA, Njouom R. Worldwide epidemiology of Crimean-Congo Hemorrhagic Fever Virus in humans, ticks and other animal species, a systematic review and meta-analysis. PLoS Negl Trop Dis 2021; 15:e0009299. [PMID: 33886556 PMCID: PMC8096040 DOI: 10.1371/journal.pntd.0009299] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 05/04/2021] [Accepted: 03/08/2021] [Indexed: 11/18/2022] Open
Abstract
There are uncertainties about the global epidemiological data of infections due to Crimean-Congo hemorrhagic fever virus (CCHFV). We estimated the global case fatality rate (CFR) of CCHFV infections and the prevalence of CCHFV in humans, ticks and other animal species. We also explored the socio-demographic and clinical factors that influence these parameters. In this systematic review with meta-analyses we searched publications from database inception to 03rd February 2020 in Pubmed, Scopus, and Global Index Medicus. Studies included in this review provided cross-sectional data on the CFR and/or prevalence of one or more targets used for the detection of CCHFV. Two independent investigators selected studies to be included. Data extraction and risk of bias assessment were conducted independently by all authors. Data collected were analysed using a random effect meta-analysis. In all, 2345 records were found and a total of 312 articles (802 prevalence and/or CFR data) that met the inclusion criteria were retained. The overall CFR was 11.7% (95% CI = 9.1-14.5), 8.0% (95% CI = 1.0-18.9), and 4.7% (95% CI = 0.0-37.6) in humans with acute, recent, and past CCHFV infections respectively. The overall CCHFV acute infections prevalence was 22.5% (95% CI = 15.7-30.1) in humans, 2.1% (95% CI = 1.3-2.9) in ticks, and 4.5% (95% CI = 1.9-7.9) in other animal species. The overall CCHFV recent infections seroprevalence was 11.6% (95% CI = 7.9-16.4) in humans and 0.4% (95% CI = 0.0-2.9) in other animal species. The overall CCHFV past infections seroprevalence was 4.3% (95% CI = 3.3-5.4) in humans and 12.0% (95% CI = 9.9-14.3) in other animal species. CFR was higher in low-income countries, countries in the WHO African, South-East Asia and Eastern Mediterranean regions, in adult and ambulatory patients. CCHFV detection rate in humans were higher in CCHFV suspected cases, healthcare workers, adult and hospitalized patients, ticks of the genus Ornithodoros and Amblyomma and in animals of the orders Perissodactyla and Bucerotiformes. This review highlights a significant disease burden due to CCHFV with a strong disparity according to country income levels, geographic regions, various human categories and tick and other animal species. Preventive measures in the light of these findings are expected.
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Affiliation(s)
- Jean Thierry Ebogo Belobo
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaoundé, Cameroon
- Department of Biochemistry, Faculty of Science, The University of Yaounde I, Yaoundé, Cameroon
| | - Sebastien Kenmoe
- Virology Department, Centre Pasteur of Cameroon, Yaoundé, Cameroon
- * E-mail: (SK); (RN)
| | - Cyprien Kengne-Nde
- Epidemiological Surveillance, Evaluation and Research Unit, National AIDS Control Committee, Yaoundé, Cameroon
| | | | - Arnol Bowo-Ngandji
- Department of Microbiology, Faculty of Science, The University of Yaounde I, Yaoundé, Cameroon
| | | | | | | | - Hervé Raoul Tazokong
- Department of Microbiology, Faculty of Science, The University of Yaounde I, Yaoundé, Cameroon
| | | | - Efietngab Atembeh Noura
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaoundé, Cameroon
| | - Aude Christelle Ka’e
- Virology Department, Chantal Biya International Reference Centre, Yaoundé, Cameroon
| | | | | | - Dimitri Tchami Ngongang
- Department of Microbiology, Faculty of Science, The University of Yaounde I, Yaoundé, Cameroon
| | - Emmanuel Che
- Department of Microbiology, Faculty of Science, The University of Yaounde I, Yaoundé, Cameroon
| | - Sorel Kenfack
- Department of Microbiology, Faculty of Science, The University of Yaounde I, Yaoundé, Cameroon
| | - Nathalie Diane Nzukui
- School of Health Sciences-Catholic University of Central Africa, Department of Medical Microbiology, Yaoundé, Cameroon
| | - Nathalie Amvongo Adjia
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaoundé, Cameroon
| | | | - Gadji Mahamat
- Department of Microbiology, Faculty of Science, The University of Yaounde I, Yaoundé, Cameroon
| | - Donatien Serge Mbaga
- Department of Microbiology, Faculty of Science, The University of Yaounde I, Yaoundé, Cameroon
| | - Wilfred Fon Mbacham
- Department of Biochemistry, Faculty of Science, The University of Yaounde I, Yaoundé, Cameroon
| | | | - Richard Njouom
- Virology Department, Centre Pasteur of Cameroon, Yaoundé, Cameroon
- * E-mail: (SK); (RN)
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Schulz A, Barry Y, Stoek F, Ba A, Schulz J, Haki ML, Sas MA, Doumbia BA, Kirkland P, Bah MY, Eiden M, Groschup MH. Crimean-Congo hemorrhagic fever virus antibody prevalence in Mauritanian livestock (cattle, goats, sheep and camels) is stratified by the animal's age. PLoS Negl Trop Dis 2021; 15:e0009228. [PMID: 33844691 PMCID: PMC8081336 DOI: 10.1371/journal.pntd.0009228] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 04/28/2021] [Accepted: 02/09/2021] [Indexed: 11/19/2022] Open
Abstract
Crimean-Congo hemorrhagic fever virus (CCHFV) is one of the most widespread zoonotic arthropod-borne viruses in many parts of Africa, Europe and Asia. It belongs to the family of Nairoviridae in the genus of Orthonairovirus. The main reservoir and vector are ticks of the genus Hyalomma. Livestock animals (such as cattle, small ruminants and camels) develop a viremias lasting up to two weeks with absence of clinical symptoms, followed by seroconversion. This study was carried out to assess risk factors that affect seroprevalence rates in different species. In total, 928 livestock animal samples (cattle = 201; sheep = 247; goats = 233; camels = 247) from 11 out of 13 regions in Mauritania were assayed for CCHFV-specific immunoglobulin G (IgG) antibodies using enzyme-linked immunosorbent assays (ELISA) (including a novel indirect camel-IgG-specific CCHFV ELISA). Inconclusive results were resolved by an immunofluorescence assay (IFA). A generalized linear mixed-effects model (GLMM) was used to draw conclusions about the impact of certain factors (age, species, sex and region) which might have influenced the CCHFV antibody status of surveyed animals. In goats and sheep, about 15% of the animals were seropositive, whereas in cattle (69%) and camels (81%), the prevalence rate was significantly higher. On average, cattle and camels were up to twice to four times older than small ruminants. Interestingly, the seroprevalence in all species was directly linked to the age of the animals, i.e. older animals had significantly higher seroprevalence rates than younger animals. The highest CCHFV seroprevalence in Mauritania was found in camels and cattle, followed by small ruminants. The large proportion of positive animals in cattle and camels might be explained by the high ages of the animals. Future CCHFV prevalence studies should at least consider the age of surveyed animals in order to avoid misinterpretations. Crimean-Congo hemorrhagic fever virus (CCHFV) is a silent threat that repeatedly causes severe hemorrhagic disease in humans who have been in close contact with livestock of endemic countries. The detection of CCHFV IgG antibodies in livestock can be a first indication whether the virus circulates in a given region and is thus a valuable diagnostic tool for determining the endemic status. Interestingly, earlier data from Mauritania showed a noticeable difference in IgG prevalence between sheep (18%) and cattle (67%). In contrast to sheep and cattle, current monitoring data on CCHFV IgG antibody presence in camels and goats in Mauritania is very limited. This study was conducted to provide a comprehensive up-to-date overview of CCHFV seroprevalences in the four most important Mauritanian livestock species (cattle, sheep, goats and camels). It attempts to highlight the role of potential risk factors responsible for deviating prevalences. In addition, we developed a camel-specific IgG ELISA, which can be used in future CCHFV seroprevalence studies. Furthermore, findings of this study contribute to a better understanding of the current epidemiological CCHFV situation in sub-Saharan Africa and which role different livestock species play regarding the viral circulation in endemic regions.
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Affiliation(s)
- Ansgar Schulz
- Friedrich-Loeffler-Institut, Institute of Novel and Emerging Infectious Diseases, Greifswald-Insel Riems, Germany
| | - Yahya Barry
- L’Office National de Recherche et de Développement de l’Elevage (ONARDEL), Nouakchott, Mauritania
| | - Franziska Stoek
- Friedrich-Loeffler-Institut, Institute of Novel and Emerging Infectious Diseases, Greifswald-Insel Riems, Germany
| | - Aliou Ba
- L’Office National de Recherche et de Développement de l’Elevage (ONARDEL), Nouakchott, Mauritania
| | - Jana Schulz
- Friedrich-Loeffler-Institut, Institute of Novel and Emerging Infectious Diseases, Greifswald-Insel Riems, Germany
| | - Mohamed L. Haki
- L’Office National de Recherche et de Développement de l’Elevage (ONARDEL), Nouakchott, Mauritania
| | - Miriam A. Sas
- Friedrich-Loeffler-Institut, Institute of Novel and Emerging Infectious Diseases, Greifswald-Insel Riems, Germany
| | | | - Peter Kirkland
- Elizabeth Macarthur Agriculture Institute, Menangle, Australia
| | - Mohamed Y. Bah
- Ministère du Développement Rural, Nouakchott, Mauritania
| | - Martin Eiden
- Friedrich-Loeffler-Institut, Institute of Novel and Emerging Infectious Diseases, Greifswald-Insel Riems, Germany
| | - Martin H. Groschup
- Friedrich-Loeffler-Institut, Institute of Novel and Emerging Infectious Diseases, Greifswald-Insel Riems, Germany
- * E-mail:
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Monsalve Arteaga L, Muñoz Bellido JL, Negredo AI, García Criado J, Vieira Lista MC, Sánchez Serrano JÁ, Vicente Santiago MB, López Bernús A, de Ory Manchón F, Sánchez Seco MP, Leralta N, Alonso Sardón M, Muro A, Belhassen-García M. New circulation of genotype V of Crimean-Congo haemorrhagic fever virus in humans from Spain. PLoS Negl Trop Dis 2021; 15:e0009197. [PMID: 33617538 PMCID: PMC7943016 DOI: 10.1371/journal.pntd.0009197] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 03/09/2021] [Accepted: 02/02/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Crimean-Congo haemorrhagic fever (CCHF) is a widespread tick-borne viral disease caused by the Crimean-Congo haemorrhagic fever virus (CCHFV). CCHFV has been implicated in severe viral haemorrhagic fever outbreaks. During the summer of 2016, the first two cases with genotype III (Africa 3) were reported in Spain. The first objective of our study was to determine the presence of CCHFV among patients with febrile illness during the spring and summer periods in 2017 and 2018. Finally, we perform a phylogenetic analysis to determine the genotype of the virus. METHODOLOGY We prospectively evaluated patients aged 18 years and older who came to the emergency department at the Salamanca's University Hospital (HUS) with fever. Specific IgM and IgG antibodies against CCHFV by ELISA and one immunofluorescence assay against two different proteins (nucleoprotein and glycoprotein C) was done. Moreover, molecular detection by Real Time PCR was performed in all collected samples. A phylogenetic analysis was carried out to genetically characterize CCHFV detected in this study. PRINCIPAL FINDINGS A total of 133 patients were selected. The mean age was 67.63 years and 60.9% were male. One-third of the patients presented an acute undifferentiated febrile illness. Three patients had anti-CCHFV IgG antibodies, suggesting a previous infection. One patient had anti-CCHFV IgM antibodies and a confirmatory RT-PCR. Phylogenetic analysis indicated that the virus corresponds to the European genotype V. This patient came to the emergency department at HUS in August 2018 presenting an acute febrile syndrome with thrombopenia and liver impairment. CONCLUSIONS We describe a new circulation of European genotype V CCHFV in Spain. Moreover, this study suggests that CCHFV is an identifiable cause of febrile illness of unknown origin in Spain. Thus, CCHF could be suspected in patients with fever, liver damage, and/or haemorrhagic disorders, particularly in people with risk activities who present in the spring or summer.
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Affiliation(s)
- Lia Monsalve Arteaga
- Infectious and Tropical Diseases Group (e-INTRO), IBSAL-CIETUS (Biomedical Research Institute of Salamanca-Research Center for Tropical Diseases at the University of Salamanca), Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
| | - Juan Luis Muñoz Bellido
- Servicio de Microbiología y Parasitología, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - Ana Isabel Negredo
- Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Red de Investigación Colaborativa en Enfermedades Tropicales, Madrid, Spain
| | - Jorge García Criado
- Emergency Department, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - Maria Carmen Vieira Lista
- Infectious and Tropical Diseases Group (e-INTRO), IBSAL-CIETUS (Biomedical Research Institute of Salamanca-Research Center for Tropical Diseases at the University of Salamanca), Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
| | | | - María Belén Vicente Santiago
- Infectious and Tropical Diseases Group (e-INTRO), IBSAL-CIETUS (Biomedical Research Institute of Salamanca-Research Center for Tropical Diseases at the University of Salamanca), Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
| | - Amparo López Bernús
- Infectious and Tropical Diseases Group (e-INTRO), IBSAL-CIETUS (Biomedical Research Institute of Salamanca-Research Center for Tropical Diseases at the University of Salamanca), Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
- Internal Medicine and Infectious Disease Department, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
| | - Fernando de Ory Manchón
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, España; Ciber en Salud Pública (CIBERESP), Instituto de Salud Carlos III, Spain
| | - María Paz Sánchez Seco
- Arbovirus and Imported Viral Diseases Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Red de Investigación Colaborativa en Enfermedades Tropicales, Madrid, Spain
| | - Nuria Leralta
- Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, España; Ciber en Salud Pública (CIBERESP), Instituto de Salud Carlos III, Spain
| | - Montserrat Alonso Sardón
- Infectious and Tropical Diseases Group (e-INTRO), IBSAL-CIETUS (Biomedical Research Institute of Salamanca-Research Center for Tropical Diseases at the University of Salamanca), Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
| | - Antonio Muro
- Infectious and Tropical Diseases Group (e-INTRO), IBSAL-CIETUS (Biomedical Research Institute of Salamanca-Research Center for Tropical Diseases at the University of Salamanca), Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
| | - Moncef Belhassen-García
- Infectious and Tropical Diseases Group (e-INTRO), IBSAL-CIETUS (Biomedical Research Institute of Salamanca-Research Center for Tropical Diseases at the University of Salamanca), Faculty of Pharmacy, University of Salamanca, Salamanca, Spain
- Internal Medicine and Infectious Disease Department, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain
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Khalafalla AI, Li Y, Uehara A, Hussein NA, Zhang J, Tao Y, Bergeron E, Ibrahim IH, Al Hosani MA, Yusof MF, Alhammadi ZM, Alyammahi SM, Gasim EF, Ishag HZA, Hosani FAL, Gerber SI, Almuhairi SS, Tong S. Identification of a novel lineage of Crimean-Congo haemorrhagic fever virus in dromedary camels, United Arab Emirates. J Gen Virol 2021; 102:001473. [PMID: 33231536 PMCID: PMC8749806 DOI: 10.1099/jgv.0.001473] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Crimean-Congo haemorrhagic fever virus (CCHFV) is a tick-borne virus causing Crimean-Congo haemorrhagic fever (CCHF), a disease reported to have a high fatality rate in numerous countries. The virus is geographically widespread due to its vector, and numerous wild and domestic animals can develop asymptomatic infection. Serological and limited molecular evidence of CCHFV has previously been reported in Camelus dromedarius (the dromedary, or one-humped camel) in the United Arab Emirates (UAE). In this study, 238 camel samples were screened for CCHFV RNA where 16 camel samples were positive for CCHFV by RT-PCR. Analysis of full-length CCHFV genome sequences revealed a novel lineage in camels from the UAE, and potential reassortment of the M segment of the genome.
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Affiliation(s)
- Abdelmalik I. Khalafalla
- Veterinary Laboratories Division, Abu Dhabi Agriculture and Food Safety Authority, PO Box 52150, Abu Dhabi, UAE
| | - Yan Li
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Atlanta, Georgia, USA
| | - Anna Uehara
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Atlanta, Georgia, USA
- Oak Ridge Institute for Science Education, Oak Ridge, Tennessee, USA
| | - Nasareldien A. Hussein
- Veterinary Laboratories Division, Abu Dhabi Agriculture and Food Safety Authority, PO Box 52150, Abu Dhabi, UAE
| | - Jing Zhang
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Atlanta, Georgia, USA
| | - Ying Tao
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Atlanta, Georgia, USA
| | - Eric Bergeron
- Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Division of High-Consequence Pathogens and Pathology, Atlanta, Georgia, USA
| | | | - Mohamed A. Al Hosani
- Veterinary Laboratories Division, Abu Dhabi Agriculture and Food Safety Authority, PO Box 52150, Abu Dhabi, UAE
| | - Mohd F. Yusof
- Veterinary Laboratories Division, Abu Dhabi Agriculture and Food Safety Authority, PO Box 52150, Abu Dhabi, UAE
| | - Zulaikha M. Alhammadi
- Veterinary Laboratories Division, Abu Dhabi Agriculture and Food Safety Authority, PO Box 52150, Abu Dhabi, UAE
| | - Saeed M. Alyammahi
- Veterinary Laboratories Division, Abu Dhabi Agriculture and Food Safety Authority, PO Box 52150, Abu Dhabi, UAE
| | - Esmat F. Gasim
- Veterinary Laboratories Division, Abu Dhabi Agriculture and Food Safety Authority, PO Box 52150, Abu Dhabi, UAE
| | - Hassan Z. A. Ishag
- Veterinary Laboratories Division, Abu Dhabi Agriculture and Food Safety Authority, PO Box 52150, Abu Dhabi, UAE
| | | | - Susan I. Gerber
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Atlanta, Georgia, USA
| | - Salama S. Almuhairi
- Veterinary Laboratories Division, Abu Dhabi Agriculture and Food Safety Authority, PO Box 52150, Abu Dhabi, UAE
| | - Suxiang Tong
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases, Division of Viral Diseases, Atlanta, Georgia, USA
- *Correspondence: Suxiang Tong,
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21
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Qaderi S, Mardani M, Shah A, Shah J, Bazgir N, Sayad J, Ghandchi E, Samsami M, Bagherpour JZ. Crimean-Congo Hemorrhagic Fever (CCHF) in Afghanistan: A retrospective single center study. Int J Infect Dis 2020; 103:323-328. [PMID: 33278621 DOI: 10.1016/j.ijid.2020.11.208] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 11/26/2020] [Accepted: 11/26/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Crimean-Congo Hemorrhagic Fever (CCHF) is a particular regional concern because of endemicity in Afghanistan and many neighboring countries. The prevalence of CCHF has been increasing in this region. These concerns are compounded because there is no vaccine or therapeutic for CCHF and Afghanistan lacks adequate public health infrastructure in preventing, detecting, and containing cases. This investigation aimed to study the epidemiological, clinical, and laboratory features of CCHF in Afghanistan that might be useful in prevention and case detection, particularly in a limited resource setting. METHOD A descriptive and analytic retrospective study of epidemiological, clinical, and laboratory features of confirmed patients (enzyme-linked immunosorbent assay (ELISA)-positive for CCHF) who were admitted to referral infectious center of Afghanistan from March 2017, to December 2018, was carried out. RESULTS There were 51 ELISA-confirmed CCHF patients, comprised of 14 females and 37 males. The mean age was 30 years of age, and there were 11 deaths. The case fatality rate (CFR) was 21.6% and was not significant between sexes (p = 0.8). Most cases were recorded from June to September, which is the period containing Eid-al-Adha. With regard to occupation, 13.7% and 11.8% of subjects were butchers and shepherds, respectively. The leading clinical manifestations were fever, hemorrhage, and myalgia. The mean time between onset of symptoms and admission to the hospital was 4.9 days in recovered cases and 4.7 days for expired cases. CONCLUSION The prevalence of CCHF is increasing in Afghanistan. The majority of cases visited the hospital during the late phase of infection. This delay can negatively affect the efficacy of treatment and lead to severe health outcomes. Our findings reveal that impaired Alanine aminotransferase (ALT), hemorrhagic manifestations (including epistaxis), and impaired consciousness were factors associated with a higher mortality rate. These biomarkers may provide a clue to possible early effective interventions and increasing the chance of survival of the patients.
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Affiliation(s)
- Shohra Qaderi
- Department of Infectious Diseases and Tropical Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Infectious Diseases, Kabul Antani Hospital, Kabul Medical University, Kabul, Afghanistan.
| | - Masoud Mardani
- Department of Infectious Diseases and Tropical Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Asghar Shah
- Division of Biology and Medicine, Brown University, Providence, RI, USA.
| | - Jaffer Shah
- Drexel University College of Medicine, PA, USA.
| | - Narges Bazgir
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Jalal Sayad
- Department of Infectious Diseases, Kabul Antani Hospital, Kabul Medical University, Kabul, Afghanistan.
| | - Ehsan Ghandchi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Majid Samsami
- Department of Surgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Javad Zebarjadi Bagherpour
- Department of Surgery, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Hua BL, Scholte FEM, Ohlendorf V, Kopp A, Marklewitz M, Drosten C, Nichol ST, Spiropoulou C, Junglen S, Bergeron É. A single mutation in Crimean-Congo hemorrhagic fever virus discovered in ticks impairs infectivity in human cells. eLife 2020; 9:e50999. [PMID: 33084573 PMCID: PMC7652417 DOI: 10.7554/elife.50999] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 10/08/2020] [Indexed: 12/20/2022] Open
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is the most widely distributed tick-borne viral infection in the world. Strikingly, reported mortality rates for CCHF are extremely variable, ranging from 5% to 80% (Whitehouse, 2004). CCHF virus (CCHFV, Nairoviridae) exhibits extensive genomic sequence diversity across strains (Deyde et al., 2006; Sherifi et al., 2014). It is currently unknown if genomic diversity is a factor contributing to variation in its pathogenicity. We obtained complete genome sequences of CCHFV directly from the tick reservoir. These new strains belong to a solitary lineage named Europe 2 that is circumstantially reputed to be less pathogenic than the epidemic strains from Europe 1 lineage. We identified a single tick-specific amino acid variant in the viral glycoprotein region that dramatically reduces its fusion activity in human cells, providing evidence that a glycoprotein precursor variant, present in ticks, has severely impaired function in human cells.
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Affiliation(s)
- Brian L Hua
- Centers for Disease Control and PreventionAtlantaUnited States
| | | | - Valerie Ohlendorf
- Institute of Virology, Charité-Universitätsmedizin Berlin, corporate member of Free University Berlin, Humboldt-University Berlin, and Berlin Institute of HealthBerlinGermany
- German Center for Infection Research (DZIF)BerlinGermany
| | - Anne Kopp
- Institute of Virology, Charité-Universitätsmedizin Berlin, corporate member of Free University Berlin, Humboldt-University Berlin, and Berlin Institute of HealthBerlinGermany
- German Center for Infection Research (DZIF)BerlinGermany
| | - Marco Marklewitz
- Institute of Virology, Charité-Universitätsmedizin Berlin, corporate member of Free University Berlin, Humboldt-University Berlin, and Berlin Institute of HealthBerlinGermany
- German Center for Infection Research (DZIF)BerlinGermany
| | - Christian Drosten
- Institute of Virology, Charité-Universitätsmedizin Berlin, corporate member of Free University Berlin, Humboldt-University Berlin, and Berlin Institute of HealthBerlinGermany
- German Center for Infection Research (DZIF)BerlinGermany
| | - Stuart T Nichol
- Centers for Disease Control and PreventionAtlantaUnited States
| | | | - Sandra Junglen
- Institute of Virology, Charité-Universitätsmedizin Berlin, corporate member of Free University Berlin, Humboldt-University Berlin, and Berlin Institute of HealthBerlinGermany
- German Center for Infection Research (DZIF)BerlinGermany
| | - Éric Bergeron
- Centers for Disease Control and PreventionAtlantaUnited States
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23
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Moroso M, Verlhac P, Ferraris O, Rozières A, Carbonnelle C, Mély S, Endtz HP, Peyrefitte CN, Paranhos-Baccalà G, Viret C, Faure M. Crimean-Congo hemorrhagic fever virus replication imposes hyper-lipidation of MAP1LC3 in epithelial cells. Autophagy 2020; 16:1858-1870. [PMID: 31905032 PMCID: PMC8386629 DOI: 10.1080/15548627.2019.1709765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 12/15/2019] [Accepted: 12/18/2019] [Indexed: 01/28/2023] Open
Abstract
Crimean-Congo hemorrhagic fever virus (CCHFV) is a virus that causes severe liver dysfunctions and hemorrhagic fever, with high mortality rate. Here, we show that CCHFV infection caused a massive lipidation of LC3 in hepatocytes. This lipidation was not dependent on ATG5, ATG7 or BECN1, and no signs for recruitment of the alternative ATG12-ATG3 pathway for lipidation was found. Both virus replication and protein synthesis were required for the lipidation of LC3. Despite an augmented transcription of SQSTM1, the amount of proteins did not show a massive and sustained increase in infected cells, indicating that degradation of SQSTM1 by macroautophagy/autophagy was still occurring. The genetic alteration of autophagy did not influence the production of CCHFV particles demonstrating that autophagy was not required for CCHFV replication. Thus, the results indicate that CCHFV multiplication imposes an overtly elevated level of LC3 mobilization that involves a possibly novel type of non-canonical lipidation. Abbreviations: BECN1: Beclin 1; CCHF: Crimean-Congo hemorrhagic fever; CCHFV: Crimean-Congo hemorrhagic fever virus; CHX: cycloheximide; ER: endoplasmic reticulum; GFP: green fluorescent protein; GP: glycoproteins; MAP1LC3: microtubule associated protein 1 light chain 3; MOI: multiplicity of infection; n.i.: non-infected; NP: nucleoprotein; p.i.: post-infection; SQSTM1: sequestosome 1.
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Affiliation(s)
- Marie Moroso
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Lyon, France
- Emerging Pathogens Laboratory, Fondation Mérieux, Lyon, France
| | - Pauline Verlhac
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Lyon, France
| | - Olivier Ferraris
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Lyon, France
- Emerging Pathogens Laboratory, Fondation Mérieux, Lyon, France
- Département Microbiologie et Maladies Infectieuses, Biomedical Research Institute of the French Army (IRBA), Brétigny-sur-Orge, France
| | - Aurore Rozières
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Lyon, France
| | | | - Stéphane Mély
- Laboratoire P4 Inserm-Jean Mérieux, US003 Inserm, Lyon, France
| | - Hubert P. Endtz
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Lyon, France
- Emerging Pathogens Laboratory, Fondation Mérieux, Lyon, France
| | - Christophe N. Peyrefitte
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Lyon, France
- Emerging Pathogens Laboratory, Fondation Mérieux, Lyon, France
- Département Microbiologie et Maladies Infectieuses, Biomedical Research Institute of the French Army (IRBA), Brétigny-sur-Orge, France
| | - Glaucia Paranhos-Baccalà
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Lyon, France
- Emerging Pathogens Laboratory, Fondation Mérieux, Lyon, France
| | - Christophe Viret
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Lyon, France
| | - Mathias Faure
- CIRI, Centre International de Recherche en Infectiologie, Univ Lyon, Lyon, France
- Equipe Labellisée par la Fondation pour la Recherche Médicale, FRM, France
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24
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Cross RW, Prasad AN, Borisevich V, Geisbert JB, Agans KN, Deer DJ, Fenton KA, Geisbert TW. Crimean-Congo hemorrhagic fever virus strains Hoti and Afghanistan cause viremia and mild clinical disease in cynomolgus monkeys. PLoS Negl Trop Dis 2020; 14:e0008637. [PMID: 32790668 PMCID: PMC7447009 DOI: 10.1371/journal.pntd.0008637] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 08/25/2020] [Accepted: 07/24/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Development of vaccines and therapies against Crimean-Congo hemorrhagic fever virus (CCHFV) have been hindered by the lack of immunocompetent animal models. Recently, a lethal nonhuman primate model based on the CCHFV Hoti strain was reported. CCHFV Hoti caused severe disease in cynomolgus monkeys with 75% lethality when given by the intravenous (i.v.) route. METHODOLOGY/PRINCIPAL FINDINGS In a series of experiments, eleven cynomologus monkeys were exposed i.v. to CCHFV Hoti and four macaques were exposed i.v. to CCHFV Afghanistan. Despite transient viremia and changes in clinical pathology such as leukopenia and thrombocytopenia developing in all 15 animals, all macaques survived to the study endpoint without developing severe disease. CONCLUSIONS/SIGNIFICANCE We were unable to attribute differences in the results of our study versus the previous report to differences in the CCHFV Hoti stock, challenge dose, origin, or age of the macaques. The observed differences are most likely the result of the outbred nature of macaques and low animal numbers often used by necessity and for ethical considerations in BSL-4 studies. Nonetheless, while we were unable to achieve severe disease or lethality, the CCHFV Hoti and Afghanistan macaque models are useful for screening medical countermeasures using biomarkers including viremia and clinical pathology to assess efficacy.
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Affiliation(s)
- Robert W. Cross
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, United States of America
- Department of Microbiology & Immunology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Abhishek N. Prasad
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, United States of America
- Department of Microbiology & Immunology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Viktoriya Borisevich
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, United States of America
- Department of Microbiology & Immunology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Joan B. Geisbert
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, United States of America
- Department of Microbiology & Immunology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Krystle N. Agans
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, United States of America
- Department of Microbiology & Immunology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Daniel J. Deer
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, United States of America
- Department of Microbiology & Immunology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Karla A. Fenton
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, United States of America
- Department of Microbiology & Immunology, University of Texas Medical Branch, Galveston, Texas, United States of America
| | - Thomas W. Geisbert
- Galveston National Laboratory, University of Texas Medical Branch, Galveston, Texas, United States of America
- Department of Microbiology & Immunology, University of Texas Medical Branch, Galveston, Texas, United States of America
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Álvarez-Rodríguez B, Tiede C, Hoste ACR, Surtees RA, Trinh CH, Slack GS, Chamberlain J, Hewson R, Fresco A, Sastre P, Tomlinson DC, Millner PA, Edwards TA, Barr JN. Characterization and applications of a Crimean-Congo hemorrhagic fever virus nucleoprotein-specific Affimer: Inhibitory effects in viral replication and development of colorimetric diagnostic tests. PLoS Negl Trop Dis 2020; 14:e0008364. [PMID: 32492018 PMCID: PMC7295242 DOI: 10.1371/journal.pntd.0008364] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 06/15/2020] [Accepted: 05/05/2020] [Indexed: 12/23/2022] Open
Abstract
Crimean-Congo hemorrhagic fever orthonairovirus (CCHFV) is one of the most widespread medically important arboviruses, causing human infections that result in mortality rates of up to 60%. We describe the selection of a high-affinity small protein (Affimer-NP) that binds specifically to the nucleoprotein (NP) of CCHFV. We demonstrate the interference of Affimer-NP in the RNA-binding function of CCHFV NP using fluorescence anisotropy, and its inhibitory effects on CCHFV gene expression in mammalian cells using a mini-genome system. Solution of the crystallographic structure of the complex formed by these two molecules at 2.84 Å resolution revealed the structural basis for this interference, with the Affimer-NP binding site positioned at the critical NP oligomerization interface. Finally, we validate the in vitro application of Affimer-NP for the development of enzyme-linked immunosorbent and lateral flow assays, presenting the first published point-of-care format test able to detect recombinant CCHFV NP in spiked human and animal sera.
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Affiliation(s)
| | - Christian Tiede
- School of Molecular and Cellular Biology, University of Leeds, Leeds, United Kingdom
| | - Alexis C. R. Hoste
- School of Molecular and Cellular Biology, University of Leeds, Leeds, United Kingdom
- INGENASA, Inmunología y Genética Aplicada S.A., Madrid, Spain
| | - Rebecca A. Surtees
- School of Molecular and Cellular Biology, University of Leeds, Leeds, United Kingdom
| | - Chi H. Trinh
- School of Molecular and Cellular Biology, University of Leeds, Leeds, United Kingdom
| | - Gillian S. Slack
- National Infection Service, Public Health England, Porton Down, Salisbury, United Kingdom
| | - John Chamberlain
- National Infection Service, Public Health England, Porton Down, Salisbury, United Kingdom
| | - Roger Hewson
- National Infection Service, Public Health England, Porton Down, Salisbury, United Kingdom
| | - Alba Fresco
- INGENASA, Inmunología y Genética Aplicada S.A., Madrid, Spain
| | - Patricia Sastre
- INGENASA, Inmunología y Genética Aplicada S.A., Madrid, Spain
| | - Darren C. Tomlinson
- School of Molecular and Cellular Biology, University of Leeds, Leeds, United Kingdom
| | - Paul A. Millner
- School of Molecular and Cellular Biology, University of Leeds, Leeds, United Kingdom
| | - Thomas A. Edwards
- School of Molecular and Cellular Biology, University of Leeds, Leeds, United Kingdom
| | - John N. Barr
- School of Molecular and Cellular Biology, University of Leeds, Leeds, United Kingdom
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Kozak RA, Fraser RS, Biondi MJ, Majer A, Medina SJ, Griffin BD, Kobasa D, Stapleton PJ, Urfano C, Babuadze G, Antonation K, Fernando L, Booth S, Lillie BN, Kobinger GP. Dual RNA-Seq characterization of host and pathogen gene expression in liver cells infected with Crimean-Congo Hemorrhagic Fever Virus. PLoS Negl Trop Dis 2020; 14:e0008105. [PMID: 32251473 PMCID: PMC7162549 DOI: 10.1371/journal.pntd.0008105] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 04/16/2020] [Accepted: 01/30/2020] [Indexed: 12/13/2022] Open
Abstract
Crimean-Congo hemorrhagic fever virus (CCHFV) is a tick-borne virus that can cause a hemorrhagic fever in humans, with a case fatality rate of up to 40%. Cases of CCHFV have been reported in Africa, Asia, and southern Europe; and recently, due to the expanding range of its vector, autochthonous cases have been reported in Spain. Although it was discovered over 70 years ago, our understanding of the pathogenesis of this virus remains limited. We used RNA-Seq in two human liver cell lines (HepG2 and Huh7) infected with CCHFV (strain IbAr10200), to examine kinetic changes in host expression and viral replication simultaneously at 1 and 3 days post infection. Through this, numerous host pathways were identified that were modulated by the virus including: antiviral response and endothelial cell leakage. Notably, the genes encoding DDX60, a cytosolic component of the RIG-I signalling pathway and OAS2 were both shown to be dysregulated. Interestingly, PTPRR was induced in Huh7 cells but not HepG2 cells. This has been associated with the TLR9 signalling cascade, and polymorphisms in TLR9 have been associated with poor outcomes in patients. Additionally, we performed whole-genome sequencing on CCHFV to assess viral diversity over time, and its relationship to the host response. As a result, we have demonstrated that through next-generation mRNA deep-sequencing it is possible to not only examine mRNA gene expression, but also to examine viral quasispecies and typing of the infecting strain. This demonstrates a proof-of-principle that CCHFV specimens can be analyzed to identify both the virus and host biomarkers that may have implications for prognosis.
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Affiliation(s)
- Robert A. Kozak
- Department of Laboratory Medicine & Molecular Diagnostics, Division of Microbiology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Russell S. Fraser
- Department of Pathology and Microbiology, Atlantic Veterinary College, University of Prince Edward Island, Charlottetown, Prince Edward Island, Canada
| | - Mia J. Biondi
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
- Toronto Centre for Liver Disease, Toronto General Hospital, University Health Network, Toronto, Ontario, Canada
| | - Anna Majer
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Sarah J. Medina
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Bryan D. Griffin
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Darwyn Kobasa
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Patrick J. Stapleton
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Chantel Urfano
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Giorgi Babuadze
- Infectious Diseases Research Centre, Université Laval, Quebec City, Quebec, Canada
| | - Kym Antonation
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Lisa Fernando
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Stephanie Booth
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
| | - Brandon N. Lillie
- Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Gary P. Kobinger
- National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada
- Infectious Diseases Research Centre, Université Laval, Quebec City, Quebec, Canada
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Mathengtheng L, Goedhals D, Bester PA, Goedhals J, Burt FJ. Persistence of Crimean-Congo Hemorrhagic Fever Virus RNA. Emerg Infect Dis 2020; 26:385-387. [PMID: 31961316 PMCID: PMC6986852 DOI: 10.3201/eid2602.191460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Crimean-Congo hemorrhagic fever virus (CCHFV) causes severe disease with fatalities. Awareness of potential sources of infection is important to reduce risk to healthcare workers and contacts. We detected CCHFV RNA in formalin-fixed, paraffin-embedded tissues from a spontaneous abortion that were submitted for histology 9 weeks after a suspected CCHFV infection in the mother.
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Baumann J, Knüpfer M, Ouedraogo J, Traoré BY, Heitzer A, Kané B, Maiga B, Sylla M, Kouriba B, Wölfel R. Lassa and Crimean-Congo Hemorrhagic Fever Viruses, Mali. Emerg Infect Dis 2019; 25:999-1002. [PMID: 31002054 PMCID: PMC6478234 DOI: 10.3201/eid2505.181047] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We report detection of Lassa virus and Crimean-Congo hemorrhagic fever virus infections in the area of Bamako, the capital of Mali. Our investigation found 2 cases of infection with each of these viruses. These results show the potential for both of these viruses to be endemic to Mali.
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29
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Jalali T, Salehi-Vaziri M, Pouriayevali MH, Mousavi Gargari SL. Evaluation of Crimean-Congo Hemorrhagic Fever Orthonairovirus AviTagged Nucleoprotein for Potential Application in Diagnosis. Iran Biomed J 2019; 23:379-87. [PMID: 31104398 PMCID: PMC6800536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 11/24/2018] [Accepted: 12/05/2018] [Indexed: 10/15/2023]
Abstract
Background Crimean-Congo hemorrhagic fever (CCHF) is an acute viral zoonotic disease, with a mortality rate of 30-50%. There is no approved vaccine or any specific antiviral treatment for CCHF; therefore, the rapid diagnosis seems to be crucial for both efficient supportive therapy and control of infection spread. In this study, the potency of recombinant nucleoprotein of virus expressed in prokaryotic system was investigated for diagnosis of the infection. Methods The DNA sequence of complete nucleoprotein ORF was codon optimized based on E. coli codon usage and synthesized commercially. The gene was subcloned in pCA4 vector and expressed in E. coli BL21 (DE3). Refolding and simultaneous purification of nucleoprotein were performed using protein folding liquid chromatography method. The recombinant nucleoprotein was analyzed by Western blotting, ELISA, immunofluorescence assay, and circular dichroism. Forty eight human samples, in three IgM positive and three negative control groups, were evaluated using recombinant nucleoprotein in a capture ELISA setting. Serum from healthy individuals, those suspected to viral hemorrhagic fevers, and positive samples of Chikungunya and Dengue were considered as negative controls. Results The existence and structure of recombinant nucleoprotein were verified and confirmed. Capture IgM ELISA detected all positive samples (sensitivity of 100%), but none of the 25 negative samples was detected as positive (specificity of 100%). The test also detected all the included genotypes of virus. Discussion Our recombinant nucleoprotein can be used in IgM capture ELISA for easy and efficient detection of CCHF in any lab in endemic regions.
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Affiliation(s)
- Tahmineh Jalali
- Department of Biology, Faculty of Basic Sciences, Shahed University, Tehran, Iran
- Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran
| | - Mostafa Salehi-Vaziri
- Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran
- Reaserch Center for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Mohammad Hassan Pouriayevali
- Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran
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30
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Jalali T, Salehi-Vaziri M, Pouriayevali MH, Mousavi Gargari SL. Evaluation of Crimean-Congo Hemorrhagic Fever Orthonairovirus AviTagged Nucleoprotein for Potential Application in Diagnosis. ibj 2019. [PMID: 31104398 PMCID: PMC6800536 DOI: 10.29252/ibj.23.6.379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background: Crimean-Congo hemorrhagic fever (CCHF) is an acute viral zoonotic disease, with a mortality rate of 30-50%. There is no approved vaccine or any specific antiviral treatment for CCHF; therefore, the rapid diagnosis seems to be crucial for both efficient supportive therapy and control of infection spread. In this study, the potency of recombinant nucleoprotein of virus expressed in prokaryotic system was investigated for diagnosis of the infection. Methods: The DNA sequence of complete nucleoprotein ORF was codon optimized based on E. coli codon usage and synthesized commercially. The gene was subcloned in pCA4 vector and expressed in E. coli BL21 (DE3). Refolding and simultaneous purification of nucleoprotein were performed using protein folding liquid chromatography method. The recombinant nucleoprotein was analyzed by Western blotting, ELISA, immunofluorescence assay, and circular dichroism. Forty eight human samples, in three IgM positive and three negative control groups, were evaluated using recombinant nucleoprotein in a capture ELISA setting. Serum from healthy individuals, those suspected to viral hemorrhagic fevers, and positive samples of Chikungunya and Dengue were considered as negative controls. Results: The existence and structure of recombinant nucleoprotein were verified and confirmed. Capture IgM ELISA detected all positive samples (sensitivity of 100%), but none of the 25 negative samples was detected as positive (specificity of 100%). The test also detected all the included genotypes of virus. Conclusion: Our recombinant nucleoprotein can be used in IgM capture ELISA for easy and efficient detection of CCHF in any lab in endemic regions.
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Affiliation(s)
- Tahmineh Jalali
- Department of Biology, Faculty of Basic Sciences, Shahed University, Tehran, Iran
- Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran
| | - Mostafa Salehi-Vaziri
- Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran
- Reaserch Center for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Mohammad Hassan Pouriayevali
- Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, Iran
| | - Seyed Latif Mousavi Gargari
- Department of Biology, Faculty of Basic Sciences, Shahed University, Tehran, Iran
- Corresponding Author: Seyed Latif Mousavi Gargari , Department of Biology, Shahed University, Khalije Fars Highway, Tehran 3319118651, Iran; Tel.: (+98-21) 51212232; E-mail:
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Abstract
We studied the clinical and epidemiologic features of an outbreak of Crimean-Congo hemorrhagic fever in Herat Province, Afghanistan. The study comprised 63 patients hospitalized in 2017. The overall case-fatality rate was 22.2%; fatal outcome was significantly associated with a negative IgM test result, longer prothrombin time, and nausea.
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Ahmeti S, Berisha L, Halili B, Ahmeti F, von Possel R, Thomé-Bolduan C, Michel A, Priesnitz S, Reisinger EC, Günther S, Krüger A, Sherifi K, Jakupi X, Hemmer CJ, Emmerich P. Crimean-Congo Hemorrhagic Fever, Kosovo, 2013-2016. Emerg Infect Dis 2019; 25:321-324. [PMID: 30666932 PMCID: PMC6346452 DOI: 10.3201/eid2502.171999] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
During 2013–2016, a total of 32 patients were treated for Crimean-Congo hemorrhagic fever in Prishtina, Kosovo; 11 died. In the 11 patients who died, findings included viral loads >1 × 108.5/mL, lactate dehydrogenase >2,700 U/mL, bleeding, and impaired consciousness. Ribavirin therapy had no noticeable effect in this small patient sample.
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Bower H, El Karsany M, Alzain M, Gannon B, Mohamed R, Mahmoud I, Eldegail M, Taha R, Osman A, Mohamednour S, Semper A, Atkinson B, Carter D, Dowall S, Furneaux J, Graham V, Mellors J, Osborne J, Pullan ST, Slack GS, Brooks T, Hewson R, Beeching NJ, Whitworth J, Bausch DG, Fletcher TE. Detection of Crimean-Congo Haemorrhagic Fever cases in a severe undifferentiated febrile illness outbreak in the Federal Republic of Sudan: A retrospective epidemiological and diagnostic cohort study. PLoS Negl Trop Dis 2019; 13:e0007571. [PMID: 31291242 PMCID: PMC6645580 DOI: 10.1371/journal.pntd.0007571] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 07/22/2019] [Accepted: 06/22/2019] [Indexed: 01/12/2023] Open
Abstract
Background Undifferentiated febrile illness (UFI) is one of the most common reasons for people seeking healthcare in low-income countries. While illness and death due to specific infections such as malaria are often well-quantified, others are frequently uncounted and their impact underappreciated. A number of high consequence infectious diseases, including Ebola virus, are endemic or epidemic in the Federal Republic of Sudan which has experienced at least 12 UFI outbreaks, frequently associated with haemorrhage and high case fatality rates (CFR), since 2012. One of these occurred in Darfur in 2015/2016 with 594 cases and 108 deaths (CFR 18.2%). The aetiology of these outbreaks remains unknown. Methodology/Principal findings We report a retrospective cohort study of the 2015/2016 Darfur outbreak, using a subset of 65 of 263 outbreak samples received by the National Public Health Laboratory which met selection criteria of sufficient sample volume and epidemiological data. Clinical features included fever (95.8%), bleeding (95.7%), headache (51.6%) and arthralgia (42.2%). No epidemiological patterns indicative of person-to-person transmission or health-worker cases were reported. Samples were tested at the Public Health England Rare and Imported Pathogens Laboratory using a bespoke panel of likely pathogens including haemorrhagic fever viruses, arboviruses and Rickettsia, Leptospira and Borrelia spp. Seven (11%) were positive for Crimean-Congo haemorrhagic fever virus (CCHFV) by real-time reverse transcription PCR. The remaining samples tested negative on all assays. Conclusions/Significance CCHFV is an important cause of fever and haemorrhage in Darfur, but not the sole major source of UFI outbreaks in Sudan. Prospective studies are needed to explore other aetiologies, including novel pathogens. The presence of CCHFV has critical infection, prevention and control as well as clinical implications for future response. Our study reinforces the need to boost surveillance, lab and investigative capacity to underpin effective response, and for local and international health security. The Federal Republic of Sudan has had at least 12 outbreaks of febrile illness of unknown cause associated with symptoms of haemorrhage and high case fatality rates since 2012. Outbreaks without clear diagnosis are concerning, particularly in countries such as Sudan where a range of high consequence diseases, including viral haemorrhagic fevers, are endemic or epidemic, and local laboratory capacity is limited. We transferred historical samples stored in the National Public Health Authority from one of these outbreaks that occurred in Darfur 2015–2016 to the Public Health England Laboratory at Porton, UK, and tested them against a wide range of infectious diseases to try to identify the cause, and to help the Sudanese Federal Ministry of Health to develop and target their limited laboratory capacity. We found that Crimean-Congo Haemorrhagic Fever was an important cause but not the only source of cases in this outbreak. This has implications for prevention and control as well as for treating cases. Our study also highlighted the need for future studies to explore other possible causes, including new pathogens, and reinforced the need to boost surveillance, lab and investigative capacity for more timely and complete outbreak response.
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Affiliation(s)
- Hilary Bower
- UK Public Health Rapid Support Team, London, United Kingdom
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
- * E-mail:
| | - Mubarak El Karsany
- Department of Medical Microbiology, Karary University, Khartoum, Sudan
- National Public Health Laboratory, Federal Ministry of Health, Khartoum, Sudan
| | - Mazza Alzain
- Communicable Disease Surveillance and Event Unit, Federal Ministry of Health, Khartoum, Sudan
| | - Benedict Gannon
- UK Public Health Rapid Support Team, London, United Kingdom
- Global Public Health, Public Health England, London, United Kingdom
| | - Rehab Mohamed
- National Public Health Laboratory, Federal Ministry of Health, Khartoum, Sudan
| | - Iman Mahmoud
- National Public Health Laboratory, Federal Ministry of Health, Khartoum, Sudan
| | - Mawahib Eldegail
- National Public Health Laboratory, Federal Ministry of Health, Khartoum, Sudan
| | - Rihab Taha
- National Public Health Laboratory, Federal Ministry of Health, Khartoum, Sudan
| | - Abdalla Osman
- National Public Health Laboratory, Federal Ministry of Health, Khartoum, Sudan
| | - Salim Mohamednour
- Communicable Disease Surveillance and Event Unit, Federal Ministry of Health, Khartoum, Sudan
| | - Amanda Semper
- National Infection Service, Public Health England, Porton, United Kingdom
| | - Barry Atkinson
- National Infection Service, Public Health England, Porton, United Kingdom
| | - Daniel Carter
- National Infection Service, Public Health England, Porton, United Kingdom
| | - Stuart Dowall
- National Infection Service, Public Health England, Porton, United Kingdom
| | - Jenna Furneaux
- National Infection Service, Public Health England, Porton, United Kingdom
| | - Victoria Graham
- National Infection Service, Public Health England, Porton, United Kingdom
| | - Jack Mellors
- National Infection Service, Public Health England, Porton, United Kingdom
| | - Jane Osborne
- National Infection Service, Public Health England, Porton, United Kingdom
| | - Steven T. Pullan
- National Infection Service, Public Health England, Porton, United Kingdom
| | - Gillian S. Slack
- National Infection Service, Public Health England, Porton, United Kingdom
| | - Tim Brooks
- National Infection Service, Public Health England, Porton, United Kingdom
| | - Roger Hewson
- National Infection Service, Public Health England, Porton, United Kingdom
| | - Nicholas J. Beeching
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Jimmy Whitworth
- UK Public Health Rapid Support Team, London, United Kingdom
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Daniel G. Bausch
- UK Public Health Rapid Support Team, London, United Kingdom
- Global Public Health, Public Health England, London, United Kingdom
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Tom E. Fletcher
- Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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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: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Voorhees MA, Padilla SL, Jamsransuren D, Koehler JW, Delp KL, Adiyadorj D, Baasandagwa U, Jigjav B, Olschner SP, Minogue TD, Schoepp RJ. Crimean-Congo Hemorrhagic Fever Virus, Mongolia, 2013-2014. Emerg Infect Dis 2019; 24:2202-2209. [PMID: 30457521 PMCID: PMC6256378 DOI: 10.3201/eid2412.180175] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
During 2013–2014, we collected 1,926 serum samples from humans and 4,583 ticks (Hyalomma asiaticum or Dermacentor nuttalli) in select regions of Mongolia to determine the risk for Crimean-Congo hemorrhagic fever virus (CCHFV) infection among humans in this country. Testing of human serum samples by ELISA demonstrated an overall CCHFV antibody prevalence of 1.4%; Bayankhongor Province had the highest prevalence, 2.63%. We pooled and analyzed tick specimens by real-time reverse transcription PCR; 1 CCHFV-positive H. asiaticum tick pool from Ömnögovi was identified. In phylogenetic analyses, the virus’s partial small segment clustered with CCHFV isolates from Central Asia, and the complete medium segment grouped with CCHFV isolates from Africa, Asia, and the Middle East. This study confirms CCHFV endemicity in Mongolia and provides information on risk for CCHFV infection. Further research is needed to better define the risk for CCHFV disease to improve risk mitigation, diagnostics, and surveillance.
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MESH Headings
- Animals
- Antibodies, Neutralizing/immunology
- Antibodies, Viral/immunology
- Computational Biology
- Geography, Medical
- Hemorrhagic Fever Virus, Crimean-Congo/classification
- Hemorrhagic Fever Virus, Crimean-Congo/genetics
- Hemorrhagic Fever Virus, Crimean-Congo/isolation & purification
- Hemorrhagic Fever, Crimean/epidemiology
- Hemorrhagic Fever, Crimean/history
- Hemorrhagic Fever, Crimean/transmission
- Hemorrhagic Fever, Crimean/virology
- History, 21st Century
- Humans
- Immunoglobulin G/immunology
- Mongolia/epidemiology
- Neutralization Tests
- Phylogeny
- RNA, Viral
- Sequence Analysis, DNA
- Serologic Tests
- Ticks/virology
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Vawda S, Goedhals D, Bester PA, Burt F. Seroepidemiologic Survey of Crimean-Congo Hemorrhagic Fever Virus in Selected Risk Groups, South Africa. Emerg Infect Dis 2019; 24:1360-1363. [PMID: 29912704 PMCID: PMC6038756 DOI: 10.3201/eid2407.172096] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Crimean Congo hemorrhagic fever virus (CCHFV) is endemic in South Africa, but whether mild undiagnosed cases occur is unclear. In a seroepidemiologic survey, only 2 of 387 adults considered at risk because of occupational or recreational activities had evidence of previous infection. Seroprevalence in South Africa remains low within the groups investigated.
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Aytekin FY, Barut HŞ, Rüstemoğlu A, Atay A, Günal Ö, Duygu F. Factors related to fatalities and clinical progression of Crimean-Congo hemorrhagic fever patients and the effects of IL 28-B gene polymorphism. Arch Virol 2019; 164:547-557. [PMID: 30478788 DOI: 10.1007/s00705-018-4106-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 11/05/2018] [Indexed: 02/06/2023]
Abstract
Mortality rates of Crimean-Congo hemorrhagic fever (CCHF) vary from 5% to 80%. However, there is no clear information available about why this disease is fatal for some people while others recover. In this study, the factors related to fatalities and serious clinical progression of CCHF patients and the correlation between serious prognosis and IL 28-B gene polymorphism were investigated. The study included 107 patients with a preliminary diagnosis of CCHF, and the patients were found positive for CCHFV RNA based on polymerase chain reaction (PCR) analysis. The IL 28-B rs12979860 polymorphism was identified by PCR "restriction fragment length polymorphism" (PCR-RFLP) analysis using blood samples from the patients. In addition to the IL 28-B analysis results, a variety of data along with laboratory records obtained during the hospital stay were evaluated using statistical analysis. Of the 107 cases, nine were fatal (8.4%), while the other patients recovered and were discharged. Twenty-four patients had the CC genotype (22.43%), 64 had the CT genotype (59.81%), and 19 had the TT genotype (17.76%). Of the nine patients who died, three had the CC genotype (33.33%) and six had the CT genotype (66.67%). None of the patients who died had the TT genotype. Symptoms and findings of diarrhea, abdominal pain, hemorrhage, and rash were more common in fatal cases than in non-fatal cases. The IL 28-B rs12979860 polymorphism was not found to have a statistically significant correlation with fatality or symptoms indicating serious clinical progression in CCHF patients. As has been observed in previous studies, our study showed that leukocytosis, abdominal pain and diarrhea were more common in fatal cases.
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Affiliation(s)
- Feyza Yıldız Aytekin
- Department of Infectious Diseases and Clinical Microbiology, Ministry of Health-Giresun University Prof. Dr. A. Ilhan Özdemir Training and Research Hospital, Giresun, Turkey.
| | - Hüseyin Şener Barut
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - Aydın Rüstemoğlu
- Department of Medical Biology, Faculty of Medicine, Gaziosmanpasa University, Tokat, Turkey
| | - Ayfer Atay
- Department of Infectious Diseases and Clinical Microbiology, Bahçelievler State Hospital, Istanbul, Turkey
| | - Özgür Günal
- Department of Infectious Diseases and Clinical Microbiology, Samsun Training and Research Hospital, University of Health Science, Samsun, Turkey
| | - Fazilet Duygu
- Department of Infectious Diseases and Clinical Microbiology, Ankara Onkology Training and Research Hospital, University of Health Science, Ankara, Turkey
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Vakalova EV, Butenko AM, Vishnevskaya TV, Dorofeeva TE, Gitelman AK, Kulikova LN, Lvov DK, Alkhovsky SV. [Results of investigation of ticks in Volga river delta (Astrakhan region, 2017) for Crimean-Congo hemorrhagic fever virus (Nairoviridae, Orthonairovirus, CCHFV) and other tick-borne arboviruses.]. Vopr Virusol 2019; 64:221-228. [PMID: 32167687 DOI: 10.36233/0507-4088-2019-64-5-221-228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 11/28/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION There are natural foci of Crimean-Congo hemorrhagic fever (CCHF) that vectored by Hyalomma marginatum ticks in Volga river delta (Astrakhan region, South of Russia). The circulation of Dhori virus (DHOV) (Thogotovirus: Orthomyxoviridae) has been also shown here. We hypothesized that other tick-borne arboviruses are also likely to circulate in the region. In particular, Bhanja virus (Phlebovirus: Phenuiviridae), Wad Medani virus (Orbivirus: Reoviridae), and Tamdy virus (Orthonairovirus: Nairoviridae), which were found to circulate in neighboring regions and are vectored by Haemaphysalis spp., Dermacenter spp., and Hyalomma spp. ticks. OBJECTIVES The aim of the study was to examine ixodid ticks in Volga river delta for the presence of CCHFV, DHOV, Bhanja virus, Wad Medani virus, and Tamdy virus. MATERIAL AND METHODS Ticks were collected in Volga river delta in 2017. We used molecular genetic methods for the detection and analysis of nucleic acids (PCR, sequencing, phylogenetic analysis). RESULTS We detect CCHFV and DHOV RNA in H. marginatum ticks. The rate of infected H. marginatum ticks was 1.98% for CCHFV and 0.4% for DHOV. The results of genetic analysis showed that found DHOV strains are almost identical (99-100% in the M gene) and forms a separate genetic lineage alongside of Batken virus from Central Asia. At the same time, Bhanja virus, Wad Medani virus, and Tamdy virus were not found in ticks, collected in this region. CONCLUSIONS DHOV is circulating in the natural foci of CCHF in the Volga river delta. The ratio of infection of H. marginatum with CCHFV and DHOV was determined for the first time.
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Affiliation(s)
- E V Vakalova
- Astrakhan Anti-plague Station, Astrakhan, 414024, Russia
- Astrakhan State Medical University, Astrakhan, 414011, Russia
- A.M. Nichogi Regional Infectious Clinical Hospital, Astrakhan, 414011, Russia
| | - A M Butenko
- D.I. Ivanovsky Institute of Virology National Research Centre for Epidemiology and Microbiology named after the honorary academician N.F. Gamaleya, Moscow, 123098, Russia
| | - T V Vishnevskaya
- D.I. Ivanovsky Institute of Virology National Research Centre for Epidemiology and Microbiology named after the honorary academician N.F. Gamaleya, Moscow, 123098, Russia
| | - T E Dorofeeva
- D.I. Ivanovsky Institute of Virology National Research Centre for Epidemiology and Microbiology named after the honorary academician N.F. Gamaleya, Moscow, 123098, Russia
| | - A K Gitelman
- D.I. Ivanovsky Institute of Virology National Research Centre for Epidemiology and Microbiology named after the honorary academician N.F. Gamaleya, Moscow, 123098, Russia
| | - L N Kulikova
- Center of Hygiene and Epidemiology in Astrakhan region, Astrakhan, 414057, Russia
| | - D K Lvov
- D.I. Ivanovsky Institute of Virology National Research Centre for Epidemiology and Microbiology named after the honorary academician N.F. Gamaleya, Moscow, 123098, Russia
| | - S V Alkhovsky
- D.I. Ivanovsky Institute of Virology National Research Centre for Epidemiology and Microbiology named after the honorary academician N.F. Gamaleya, Moscow, 123098, Russia
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Karakus N, Yigit S, Duygu F, Barut S, Rustemoglu A, Basol N. Effects of Paraoxonase-1 variants on course of severity and mortality of Crimean-Congo hemorrhagic fever. Gene 2018; 687:188-192. [PMID: 30465883 DOI: 10.1016/j.gene.2018.11.059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 10/30/2018] [Accepted: 11/17/2018] [Indexed: 11/13/2022]
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is an acute viral hemorrhagic fever caused by Crimean Congo hemorrhagic fever virus (CCHFV). Paraoxonase-1 (PON1) is a high density lipoprotein (HDL)-binding protein which defense the body against oxidative stress. To investigate the role of the PON1 gene in CCHF, we screened the genotypes of two single nucleotide polymorphisms (Q192R [rs662] and L55M [rs854560]) in CCHF patients stratified according to course of severity and mortality by using PCR-based RFLP assay. Overall, 132 patients diagnosed as CCHF were enrolled in this study. The frequencies of the three genotypes and two alleles of Q192R and L55M polymorphisms didn't show any statistically significant differences in terms of mortality and disease severity (p > 0.05). Any statistically significant differences were not found between severe and mild and fatal and non-fatal CCHF patients according to seven composite genotypes (p > 0.05). When we analyzed the clinical characteristics of CCHF patients stratified according to PON1gene polymorphisms, any statistically significant differences were not also observed (p > 0.05). Our study showed no possible association between genotypes of PON1 gene Q192R and L55M polymorphisms and CCHF.
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Affiliation(s)
- Nevin Karakus
- Faculty of Medicine, Tokat Gaziosmanpasa University, Department of Medical Biology, Tokat, Turkey.
| | - Serbulent Yigit
- Faculty of Medicine, Tokat Gaziosmanpasa University, Department of Medical Biology, Tokat, Turkey
| | - Fazilet Duygu
- Department of Infectious Diseases and Clinical Microbiology, Saglik Bilimleri University, Dr. Abdurrahman Yurtaslan Ankara Oncology Training & Research Hospital, Ankara, Turkey
| | - Sener Barut
- Faculty of Medicine, Tokat Gaziosmanpasa University, Department of Infectious Diseases and Clinical Microbiology, Tokat, Turkey
| | - Aydin Rustemoglu
- Faculty of Medicine, Tokat Gaziosmanpasa University, Department of Medical Biology, Tokat, Turkey
| | - Nursah Basol
- Faculty of Medicine, Tokat Gaziosmanpasa University, Department of Emergency Medicine, Tokat, Turkey
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40
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Zivcec M, Safronetz D, Scott DP, Robertson S, Feldmann H. Nucleocapsid protein-based vaccine provides protection in mice against lethal Crimean-Congo hemorrhagic fever virus challenge. PLoS Negl Trop Dis 2018; 12:e0006628. [PMID: 30011277 PMCID: PMC6062107 DOI: 10.1371/journal.pntd.0006628] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 07/26/2018] [Accepted: 06/24/2018] [Indexed: 01/11/2023] Open
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is an acute, often fatal viral disease characterized by rapid onset of febrile symptoms followed by hemorrhagic manifestations. The etiologic agent, CCHF orthonairovirus (CCHFV), can infect several mammals in nature but only seems to cause clinical disease in humans. Over the past two decades there has been an increase in total number of CCHF case reports, including imported CCHF patients, and an expansion of CCHF endemic areas. Despite its increased public health burden there are currently no licensed vaccines or treatments to prevent CCHF. We here report the development and assessment of the protective efficacy of an adenovirus (Ad)-based vaccine expressing the nucleocapsid protein (N) of CCHFV (Ad-N) in a lethal immunocompromised mouse model of CCHF. The results show that Ad-N can protect mice from CCHF mortality and that this platform should be considered for future CCHFV vaccine strategies. Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease that can manifest as a viral hemorrhagic fever syndrome. The CCHF virus is widely spread throughout the African continent, the Balkans, the Middle East, Southern Russia and Western Asia where it remains a serious public health concern. Currently, there are no licensed treatments or vaccines available, and medical countermeasures are urgently needed. We developed an adenovirus vector vaccine based on the conserved structural nucleoprotein (N) as the antigen. A prime-boost approach showed promising efficacy in the most widely used immunocompromised mouse model. This vaccine approach demonstrates a role for N in protection and suggests its consideration for future CCHFV vaccine strategies.
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Affiliation(s)
- Marko Zivcec
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Disease, National Institutes of Health, Hamilton, Montana, United States of America
| | - David Safronetz
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Disease, National Institutes of Health, Hamilton, Montana, United States of America
| | - Dana P. Scott
- Rocky Mountain Veterinary Branch, Division of Intramural Research, National Institute of Allergy and Infectious Disease, National Institutes of Health, Hamilton, Montana, United States of America
| | - Shelly Robertson
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Disease, National Institutes of Health, Hamilton, Montana, United States of America
| | - Heinz Feldmann
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, Manitoba, Canada
- Laboratory of Virology, Division of Intramural Research, National Institute of Allergy and Infectious Disease, National Institutes of Health, Hamilton, Montana, United States of America
- * E-mail:
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Fritzen A, Risinger C, Korukluoglu G, Christova I, Corli Hitzeroth A, Viljoen N, Burt FJ, Mirazimi A, Blixt O. Epitope-mapping of the glycoprotein from Crimean-Congo hemorrhagic fever virus using a microarray approach. PLoS Negl Trop Dis 2018; 12:e0006598. [PMID: 29985929 PMCID: PMC6053253 DOI: 10.1371/journal.pntd.0006598] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 07/19/2018] [Accepted: 06/08/2018] [Indexed: 12/19/2022] Open
Abstract
Crimean-Congo hemorrhagic fever virus (CCHFV) causes severe acute human disease with lethal outcome. The knowledge about the immune response for this human health threat is highly limited. In this study, we have screened the glycoprotein of CCHFV for novel linear B-cell epitopic regions using a microarray approach. The peptide library consisted of 168 synthesized 20mer peptides with 10 amino acid overlap covering the entire glycoprotein. Using both pooled and individual human sera from survivors of CCHF disease in Turkey five peptide epitopes situated in the mucin-like region and GP 38 (G15-515) and GN G516-1037 region of the glycoprotein were identified as epitopes for a CCHF immune response. An epitope walk of the five peptides revealed a peptide sequence located in the GN region with high specificity and sensitivity. This peptide sequence, and a sequence downstream, reacted also against sera from survivors of CCHF disease in South Africa. The cross reactivity of these peptides with samples from a geographically distinct region where genetically diverse strains of the virus circulate, enabled the identification of unique peptide epitopes from the CCHF glycoprotein that could have application in development of diagnostic tools. In this study clinical samples from geographically distinct regions were used to identify conserved linear epitopic regions of the glycoprotein of CCHF. Crimean-Congo hemorrhagic fever (CCHF) is a widespread disease caused by a tick-borne virus belonging to the genus Orthonairovirus of the Nairoviridae family. The virus is responsible for outbreaks of severe viral hemorrhagic fever with a case fatality rate of approximately 30%. The CCHF virus is transmitted to people either by tick bites or through contact with infected animal blood or tissues. A mouse brain-derived vaccine against CCHF has been developed (included in this study) and used on a small scale in eastern Europe. There is no safe and effective vaccine widely available for human use. Currently, there are a limited number of serological assays commercially available for testing for CCHFV specific IgG and IgM. There are enzyme linked immunosorbent assays (ELISA) and imunnofluorescent assays (IFA) designed for screening human samples for diagnostic purposes however they are not cost effective for surveillance studies. The limiting factor for the replication of these protocols in other laboratories is the availability of antigens and (where relevant) specified monoclonal antibodies. To contribute to the improvement of the diagnostic methods for CCHFV, we aimed to identify and characterize new synthetic antigens that were more sensitive and specific and could be applied in epidemiologic surveys.
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Affiliation(s)
- Amanda Fritzen
- Department of Chemistry, University of Copenhagen, Frederiksberg, Denmark
| | - Christian Risinger
- Department of Chemistry, University of Copenhagen, Frederiksberg, Denmark
| | | | - Iva Christova
- National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Arina Corli Hitzeroth
- Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein, Republic of South Africa
| | - Natalie Viljoen
- Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein, Republic of South Africa
| | - Felicity Jane Burt
- Division of Virology, Faculty of Health Sciences, University of the Free State, Bloemfontein, Republic of South Africa
- Division of Virology, NHLS Universitas, Bloemfontein, Republic of South Africa
| | - Ali Mirazimi
- Folkhälsomyndigheten, Solna, Stockholm, Sweden
- Department for Laboratory Medicine, Karolinska Institute and Karolinska Hospital University, Solna, Sweden
- National Veterinary Institute, Uppsala, Sweden
- * E-mail: (AM); (OB)
| | - Ola Blixt
- Department of Chemistry, University of Copenhagen, Frederiksberg, Denmark
- Department for Laboratory Medicine, Karolinska Institute and Karolinska Hospital University, Solna, Sweden
- * E-mail: (AM); (OB)
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Ramírez de Arellano E, Hernández L, Goyanes MJ, Arsuaga M, Cruz AF, Negredo A, Sánchez-Seco MP. Phylogenetic Characterization of Crimean-Congo Hemorrhagic Fever Virus, Spain. Emerg Infect Dis 2018; 23:2078-2080. [PMID: 29148370 PMCID: PMC5708233 DOI: 10.3201/eid2312.171002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Two cases of Crimean-Congo hemorrhagic fever were reported in Spain during 2016. We obtained the virus from a patient sample and characterized its full genomic sequence. Phylogenetic analysis indicated that the virus corresponds to the African genotype III, which includes viruses previously found in West and South Africa.
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MESH Headings
- Animals
- Arachnid Vectors/virology
- Genome, Viral
- Hemorrhagic Fever Virus, Crimean-Congo/classification
- Hemorrhagic Fever Virus, Crimean-Congo/genetics
- Hemorrhagic Fever Virus, Crimean-Congo/isolation & purification
- Hemorrhagic Fever Virus, Crimean-Congo/pathogenicity
- Hemorrhagic Fever, Crimean/diagnosis
- Hemorrhagic Fever, Crimean/pathology
- Hemorrhagic Fever, Crimean/transmission
- Hemorrhagic Fever, Crimean/virology
- Humans
- Phylogeny
- RNA, Viral/genetics
- South Africa
- Spain
- Ticks/virology
- Whole Genome Sequencing
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Christova I, Panayotova E, Groschup MH, Trifonova I, Tchakarova S, Sas MA. High seroprevalence for Crimean-Congo haemorrhagic fever virus in ruminants in the absence of reported human cases in many regions of Bulgaria. Exp Appl Acarol 2018; 75:227-234. [PMID: 29713918 DOI: 10.1007/s10493-018-0258-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 04/19/2018] [Indexed: 06/08/2023]
Abstract
Crimean-Congo haemorrhagic fever (CCHF) is a severe tick-borne zoonotic disease in humans caused by CCHF virus. It has been observed in Bulgaria since 1952 and over the years more than 1600 cases have been reported in the country. Close contact with viraemic livestock was shown as one of the main causes of the infection. Detection of CCHF virus specific antibodies in livestock can be used as an indicator for virus circulation and risk assessment. CCHF seroprevalence was investigated in 843 cattle, 88 goats and 130 sheep, originating from all 28 districts of Bulgaria. CCHF virus-specific IgG antibodies were observed in 165 cattle (19.6, 95% CI 17.0-22.4%), in 20 goats (22.7, 95% CI 15.2-32.5%) and in 10 sheep (7.7, 95% CI 4.2-13.6%). The highest seroprevalence was detected in the district of Kardzhali, South Bulgaria (86.7, 95% CI 73.8-93.7%), a well-known focus of CCHF in humans. The other two districts with human CCHF cases, Blagoevgrad and Burgas, located in southwest and southeast Bulgaria, showed overall seroprevalences in livestock of 41.9% (95% CI 28.4-56.7%) and 31.3% (95% CI 22.2-42.1%), respectively. Seroprevalences in districts with no history of human CCHF cases varied between 55% (95% CI 39.8-69.3%) and 22.5% (95% CI 12.3-37.5%). These results suggest frequent CCHF virus infections even in regions without human CCHF cases and an enhanced risk of infection for humans in close contact with the infected livestock.
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Affiliation(s)
- Iva Christova
- National Reference Laboratory on Vector-Borne Pathogens, Leptospira and Listeria, Microbiology Department, National Center of Infectious and Parasitic Diseases, Blvd. Yanko Sakazov 26, 1504, Sofia, Bulgaria.
| | - Elitsa Panayotova
- National Reference Laboratory on Vector-Borne Pathogens, Leptospira and Listeria, Microbiology Department, National Center of Infectious and Parasitic Diseases, Blvd. Yanko Sakazov 26, 1504, Sofia, Bulgaria
| | - Martin H Groschup
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Südufer 10, 17483, Greifswald-Insel Riems, Germany
| | - Iva Trifonova
- National Reference Laboratory on Vector-Borne Pathogens, Leptospira and Listeria, Microbiology Department, National Center of Infectious and Parasitic Diseases, Blvd. Yanko Sakazov 26, 1504, Sofia, Bulgaria
| | - Simona Tchakarova
- National Diagnostic and Research Veterinarian Medical Institute, Bulgarian Food Safety Agency, Blvd. Pencho Slavejkov 15, Sofia, Bulgaria
| | - Miriam Andrada Sas
- Institute of Novel and Emerging Infectious Diseases, Friedrich-Loeffler-Institut, Südufer 10, 17483, Greifswald-Insel Riems, Germany
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Abstract
In January 2016, a migrant worker who returned home to India after becoming ill in Oman was confirmed to have Crimean-Congo hemorrhagic fever (CCHF). Physicians should include CCHF in the differential diagnosis for patients with hemorrhagic signs and a history of recent travel to any area where CCHF is endemic or prevalent.
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Spengler JR, Estrada-Peña A. Host preferences support the prominent role of Hyalomma ticks in the ecology of Crimean-Congo hemorrhagic fever. PLoS Negl Trop Dis 2018; 12:e0006248. [PMID: 29420542 PMCID: PMC5821391 DOI: 10.1371/journal.pntd.0006248] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2017] [Revised: 02/21/2018] [Accepted: 01/18/2018] [Indexed: 11/18/2022] Open
Abstract
Crimean-Congo hemorrhagic fever virus (CCHFV) is a tick-borne zoonotic agent that is maintained in nature in an enzootic vertebrate-tick-vertebrate cycle. Hyalomma genus ticks have been implicated as the main CCHFV vector and are key in maintaining silent endemic foci. However, what contributes to their central role in CCHFV ecology is unclear. To assess the significance of host preferences of ticks in CCHFV ecology, we performed comparative analyses of hosts exploited by 133 species of ticks; these species represent 5 genera with reported geographical distribution over the range of CCHFV. We found that the composition of vertebrate hosts on which Hyalomma spp. feed is different than for other tick genera. Immatures of the genus Hyalomma feed preferentially on species of the orders Rodentia, Lagomorpha, and the class Aves, while adults concentrate mainly on the family Bovidae. With the exception of Aves, these hosts include the majority of the vertebrates consistently reported to be viremic upon CCHFV infection. While other tick genera also feed on these hosts, Hyalomma spp. almost completely concentrate their populations on them. Hyalomma spp. feed on less phylogenetically diverse hosts than any other tick genus, implying that this network of hosts has a low resilience. Indeed, removing the most prominent hosts quickly collapsed the network of parasitic interactions. These results support the intermittent activity of CCHFV foci: likely, populations of infected Hyalomma spp. ticks exceed the threshold of contact with humans only when these critical hosts reach adequate population density, accounting for the sporadic occurence of clinical tick-transmitted cases. Our data describe the association of vertebrate host preferences with the role of Hyalomma spp. ticks in maintaining endemic CCHFV foci, and highlight the importance of host-tick dynamics in pathogen ecology.
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Affiliation(s)
- Jessica R. Spengler
- Viral Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States of America
| | - Agustin Estrada-Peña
- Department of Animal Health, Faculty of Veterinary Medicine, University of Zaragoza, Zaragoza, Spain
- * E-mail:
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Spengler JR, Kelly Keating M, McElroy AK, Zivcec M, Coleman-McCray JD, Harmon JR, Bollweg BC, Goldsmith CS, Bergeron É, Keck JG, Zaki SR, Nichol ST, Spiropoulou CF. Crimean-Congo Hemorrhagic Fever in Humanized Mice Reveals Glial Cells as Primary Targets of Neurological Infection. J Infect Dis 2017; 216:1386-1397. [PMID: 28482001 PMCID: PMC5853341 DOI: 10.1093/infdis/jix215] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Accepted: 05/02/2017] [Indexed: 12/21/2022] Open
Abstract
Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral hemorrhagic disease seen exclusively in humans. Central nervous system (CNS) infection and neurological involvement have also been reported in CCHF. In the current study, we inoculated NSG-SGM3 mice engrafted with human hematopoietic CD34+ stem cells with low-passage CCHF virus strains isolated from human patients. In humanized mice, lethal disease develops, characterized by histopathological change in the liver and brain. To date, targets of neurological infection and disease have not been investigated in CCHF. CNS disease in humanized mice was characterized by gliosis, meningitis, and meningoencephalitis, and glial cells were identified as principal targets of infection. Humanized mice represent a novel lethal model for studies of CCHF countermeasures, and CCHF-associated CNS disease. Our data suggest a role for astrocyte dysfunction in neurological disease and identify key regions of infection in the CNS for future investigations of CCHF.
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Affiliation(s)
- Jessica R Spengler
- Viral Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - M Kelly Keating
- Infectious Diseases Pathology Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Anita K McElroy
- Viral Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
- Division of Pediatric Infectious Diseases, Emory University, Atlanta, Georgia
| | - Marko Zivcec
- Viral Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - JoAnn D Coleman-McCray
- Viral Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Jessica R Harmon
- Viral Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brigid C Bollweg
- Infectious Diseases Pathology Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cynthia S Goldsmith
- Infectious Diseases Pathology Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Éric Bergeron
- Viral Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - James G Keck
- In Vivo Services, The Jackson Laboratory, Sacramento, California
| | - Sherif R Zaki
- Infectious Diseases Pathology Branch, Division of High Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Stuart T Nichol
- Viral Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Christina F Spiropoulou
- Viral Special Pathogens Branch, Centers for Disease Control and Prevention, Atlanta, Georgia
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Goedhals D, Paweska JT, Burt FJ. Long-lived CD8+ T cell responses following Crimean-Congo haemorrhagic fever virus infection. PLoS Negl Trop Dis 2017; 11:e0006149. [PMID: 29261651 PMCID: PMC5752039 DOI: 10.1371/journal.pntd.0006149] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 01/03/2018] [Accepted: 12/02/2017] [Indexed: 12/11/2022] Open
Abstract
Crimean-Congo haemorrhagic fever virus (CCHFV) is a member of the Orthonairovirus genus of the Nairoviridae family and is associated with haemorrhagic fever in humans. Although T lymphocyte responses are known to play a role in protection from and clearance of viral infections, specific T cell epitopes have yet to be identified for CCHFV following infection. A panel of overlapping peptides covering the CCHFV nucleoprotein and the structural glycoproteins, GN and GC, were screened by ELISpot assay to detect interferon gamma (IFN-γ) production in vitro by peripheral blood mononuclear cells from eleven survivors with previous laboratory confirmed CCHFV infection. Reactive peptides were located predominantly on the nucleoprotein, with only one survivor reacting to two peptides from the glycoprotein GC. No single epitope was immunodominant, however all but one survivor showed reactivity to at least one T cell epitope. The responses were present at high frequency and detectable several years after the acute infection despite the absence of continued antigenic stimulation. T cell depletion studies confirmed that IFN-γ production as detected using the ELISpot assay was mediated chiefly by CD8+ T cells. This is the first description of CD8+ T cell epitopic regions for CCHFV and provides confirmation of long-lived T cell responses in survivors of CCHFV infection.
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Affiliation(s)
- Dominique Goedhals
- Division of Virology, National Health Laboratory Service/University of the Free State, Bloemfontein, South Africa
| | - Janusz T. Paweska
- Center for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
- School of Pathology, Faculty of Health Sciences, University of the Witswatersrand, Johannesburg, South Africa
| | - Felicity J. Burt
- Division of Virology, National Health Laboratory Service/University of the Free State, Bloemfontein, South Africa
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48
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Bonney LC, Watson RJ, Afrough B, Mullojonova M, Dzhuraeva V, Tishkova F, Hewson R. A recombinase polymerase amplification assay for rapid detection of Crimean-Congo Haemorrhagic fever Virus infection. PLoS Negl Trop Dis 2017; 11:e0006013. [PMID: 29028804 PMCID: PMC5656326 DOI: 10.1371/journal.pntd.0006013] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 10/25/2017] [Accepted: 10/04/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Crimean-Congo Haemorrhagic fever Virus (CCHFV) is a rapidly emerging vector-borne pathogen and the cause of a virulent haemorrhagic fever affecting large parts of Europe, Africa, the Middle East and Asia. METHODOLOGY/PRINCIPLE FINDINGS An isothermal recombinase polymerase amplification (RPA) assay was successfully developed for molecular detection of CCHFV. The assay showed rapid (under 10 minutes) detection of viral extracts/synthetic virus RNA of all 7 S-segment clades of CCHFV, with high target specificity. The assay was shown to tolerate the presence of inhibitors in crude preparations of mock field samples, indicating that this assay may be suitable for use in the field with minimal sample preparation. The CCHFV RPA was successfully used to screen and detect CCHFV positives from a panel of clinical samples from Tajikistan. CONCLUSIONS/SIGNIFICANCE The assay is a rapid, isothermal, simple-to-perform molecular diagnostic, which can be performed on a light, portable real-time detection device. It is ideally placed therefore for use as a field-diagnostic or in-low resource laboratories, for monitoring of CCHF outbreaks at the point-of-need, such as in remote rural regions in affected countries.
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Affiliation(s)
- Laura C. Bonney
- National Infection Service, Public Health England, Porton Down, Salisbury, United Kingdom
- * E-mail:
| | - Robert J. Watson
- National Infection Service, Public Health England, Porton Down, Salisbury, United Kingdom
| | - Babak Afrough
- National Infection Service, Public Health England, Porton Down, Salisbury, United Kingdom
| | - Manija Mullojonova
- Department of Virology, Tajik Research Institute of Preventive Medicine of the Ministry of Health of the Republic of Tajikistan, Dushanbe, Republic of Tajikistan
| | - Viktoriya Dzhuraeva
- Department of Virology, Tajik Research Institute of Preventive Medicine of the Ministry of Health of the Republic of Tajikistan, Dushanbe, Republic of Tajikistan
| | - Farida Tishkova
- Department of Virology, Tajik Research Institute of Preventive Medicine of the Ministry of Health of the Republic of Tajikistan, Dushanbe, Republic of Tajikistan
| | - Roger Hewson
- National Infection Service, Public Health England, Porton Down, Salisbury, United Kingdom
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Garrison AR, Shoemaker CJ, Golden JW, Fitzpatrick CJ, Suschak JJ, Richards MJ, Badger CV, Six CM, Martin JD, Hannaman D, Zivcec M, Bergeron E, Koehler JW, Schmaljohn CS. A DNA vaccine for Crimean-Congo hemorrhagic fever protects against disease and death in two lethal mouse models. PLoS Negl Trop Dis 2017; 11:e0005908. [PMID: 28922426 PMCID: PMC5619839 DOI: 10.1371/journal.pntd.0005908] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 09/28/2017] [Accepted: 08/27/2017] [Indexed: 12/31/2022] Open
Abstract
Crimean-Congo hemorrhagic fever virus (CCHFV) is a tick-borne virus capable of causing a severe hemorrhagic fever disease in humans. There are currently no licensed vaccines to prevent CCHFV-associated disease. We developed a DNA vaccine expressing the M-segment glycoprotein precursor gene of CCHFV and assessed its immunogenicity and protective efficacy in two lethal mouse models of disease: type I interferon receptor knockout (IFNAR-/-) mice; and a novel transiently immune suppressed (IS) mouse model. Vaccination of mice by muscle electroporation of the M-segment DNA vaccine elicited strong antigen-specific humoral immune responses with neutralizing titers after three vaccinations in both IFNAR-/- and IS mouse models. To compare the protective efficacy of the vaccine in the two models, groups of vaccinated mice (7–10 per group) were intraperitoneally (IP) challenged with a lethal dose of CCHFV strain IbAr 10200. Weight loss was markedly reduced in CCHFV DNA-vaccinated mice as compared to controls. Furthermore, whereas all vector-control vaccinated mice succumbed to disease by day 5, the DNA vaccine protected >60% of the animals from lethal disease. Mice from both models developed comparable levels of antibodies, but the IS mice had a more balanced Th1/Th2 response to vaccination. There were no statistical differences in the protective efficacies of the vaccine in the two models. Our results provide the first comparison of these two mouse models for assessing a vaccine against CCHFV and offer supportive data indicating that a DNA vaccine expressing the glycoprotein genes of CCHFV elicits protective immunity against CCHFV. Crimean-Congo hemorrhagic Fever Virus (CCHFV) is a tick-borne virus capable of causing lethal human disease against which there are currently no approved vaccines. In this study, we compared the immunogenicity and protective efficacy of a candidate DNA vaccine expressing the glycoprotein precursor gene of CCHFV in two mouse models. In addition to the recently established IFNAR-/- mouse pathogenesis model, we also tested the vaccine in a novel murine system in which the interferon (IFN) α/β signaling response of immunocompetent mice is transiently suppressed. We found that the DNA vaccine elicited high humoral immune responses and provided significant protection against challenge with CCHFV in both mouse models. These findings further our understanding of the requirements for a CCHFV vaccine and provide a new mouse model for the development of CCHFV countermeasures.
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MESH Headings
- Animals
- Antibodies, Neutralizing/blood
- Antibodies, Viral/blood
- Disease Models, Animal
- Glycoproteins/genetics
- Glycoproteins/immunology
- Hemorrhagic Fever Virus, Crimean-Congo/genetics
- Hemorrhagic Fever Virus, Crimean-Congo/immunology
- Hemorrhagic Fever Virus, Crimean-Congo/isolation & purification
- Hemorrhagic Fever, Crimean/immunology
- Hemorrhagic Fever, Crimean/prevention & control
- Hemorrhagic Fever, Crimean/virology
- Humans
- Immunity, Humoral
- Immunocompromised Host
- Immunogenicity, Vaccine
- Mice
- Mice, Knockout
- Receptor, Interferon alpha-beta/deficiency
- Receptor, Interferon alpha-beta/genetics
- Th1 Cells/immunology
- Th2 Cells/immunology
- Vaccination
- Vaccines, DNA/administration & dosage
- Vaccines, DNA/immunology
- Viral Proteins/genetics
- Viral Proteins/immunology
- Viral Vaccines/administration & dosage
- Viral Vaccines/immunology
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Affiliation(s)
- Aura R. Garrison
- Virology Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, United States of America
- * E-mail: (CSS); (ARG)
| | - Charles J. Shoemaker
- Virology Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, United States of America
| | - Joseph W. Golden
- Virology Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, United States of America
| | - Collin J. Fitzpatrick
- Virology Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, United States of America
| | - John J. Suschak
- Virology Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, United States of America
| | - Michelle J. Richards
- Virology Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, United States of America
| | - Catherine V. Badger
- Virology Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, United States of America
| | - Carolyn M. Six
- Virology Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, United States of America
| | - Jacqueline D. Martin
- Virology Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, United States of America
| | - Drew Hannaman
- Ichor Medical Systems, Inc., San Diego, California, United States of America
| | - Marko Zivcec
- Viral Special Pathogens Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Eric Bergeron
- Viral Special Pathogens Branch, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Jeffrey W. Koehler
- Diagnostics Systems Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, United States of America
| | - Connie S. Schmaljohn
- Headquarters Division, United States Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, United States of America
- * E-mail: (CSS); (ARG)
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50
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Fletcher TE, Gulzhan A, Ahmeti S, Al-Abri SS, Asik Z, Atilla A, Beeching NJ, Bilek H, Bozkurt I, Christova I, Duygu F, Esen S, Khanna A, Kader Ç, Mardani M, Mahmood F, Mamuchishvili N, Pshenichnaya N, Sunbul M, Yalcin TY, Leblebicioglu H. Infection prevention and control practice for Crimean-Congo hemorrhagic fever-A multi-center cross-sectional survey in Eurasia. PLoS One 2017; 12:e0182315. [PMID: 28886039 PMCID: PMC5590734 DOI: 10.1371/journal.pone.0182315] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 07/16/2017] [Indexed: 11/30/2022] Open
Abstract
Background Crimean Congo Hemorrhagic Fever (CCHF) is a life threatening acute viral infection that presents significant risk of nosocomial transmission to healthcare workers. Aim Evaluation of CCHF infection prevention and control (IP&C) practices in healthcare facilities that routinely manage CCHF cases in Eurasia. Methods A cross-sectional CCHF IP&C survey was designed and distributed to CCHF centers in 10 endemic Eurasian countries in 2016. Results Twenty-three responses were received from centers in Turkey, Pakistan, Russia, Georgia, Kosovo, Bulgaria, Oman, Iran, India and Kazakhstan. All units had dedicated isolation rooms for CCHF, with cohorting of confirmed cases in 15/23 centers and cohorting of suspect and confirmed cases in 9/23 centers. There was adequate personal protective equipment (PPE) in 22/23 facilities, with 21/23 facilities reporting routine use of PPE for CCHF patients. Adequate staffing levels to provide care reported in 14/23 locations. All centers reported having a high risk CCHFV nosocomial exposure in last five years, with 5 centers reporting more than 5 exposures. Education was provided annually in most centers (13/23), with additional training requested in PPE use (11/23), PPE donning/doffing (12/23), environmental disinfection (12/23) and waste management (14/23). Conclusions Staff and patient safety must be improved and healthcare associated CCHF exposure and transmission eliminated. Improvements are recommended in isolation capacity in healthcare facilities, use of PPE and maintenance of adequate staffing levels. We recommend further audit of IP&C practice at individual units in endemic areas, as part of national quality assurance programs.
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Affiliation(s)
- Tom E. Fletcher
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- Department of Clinical Microbiology and Infectious Diseases, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Abuova Gulzhan
- South-Kazakhstan State Pharmaceutical Academy, Shymkent, Republic of Kazakhstan
| | - Salih Ahmeti
- Infectious Disease Clinic, University of Prishtina "Hasan Prishtina", Medical Faculty, Prishtina, Kosovo
| | | | - Zahide Asik
- Infectious Diseases and Clinical Microbiology, Tokat State Hospital, Tokat, Turkey
| | - Aynur Atilla
- Department of Infectious Diseases and Clinical Microbiology, Samsun Research and Training Hospital, Samsun, Turkey
| | - Nick J. Beeching
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Heval Bilek
- Department of Infectious Diseases, Siirt State Hospital, Siirt, Turkey
| | - Ilkay Bozkurt
- Department of Clinical Microbiology and Infectious Diseases, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Iva Christova
- Department of Microbiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Fazilet Duygu
- Department of Infectious Diseases, AY Ankara Oncology Research and Training Hospital, Ankara, Turkey
| | - Saban Esen
- Department of Clinical Microbiology and Infectious Diseases, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Arjun Khanna
- Metro Centre for Respiratory Diseases, Metro Multispeciality Hospital, Noida, Uttar Pradesh, India
| | - Çiğdem Kader
- Department of Infectious Diseases and Clinical Microbiology, Bozok University, Yozgat, Turkey
| | - Masoud Mardani
- Infectious Diseases Department, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Faisal Mahmood
- Infectious Diseases, Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | | | - Natalia Pshenichnaya
- Department of Infectious Diseases, Rostov State Medical University, Rostov-on-Don, Russia
| | - Mustafa Sunbul
- Department of Clinical Microbiology and Infectious Diseases, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Tuğba Y. Yalcin
- Department of Infectious Diseases, Sivas Numune Hospital, Sivas, Turkey
| | - Hakan Leblebicioglu
- Department of Clinical Microbiology and Infectious Diseases, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
- * E-mail:
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