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The article discusses the presence of antibodies against Crimean-Congo haemorrhagic fever virus in various livestock species in Nigeria. The study found a seroprevalence of 37.7% in domestic animals, with the highest prevalence observed in camels from Kano State. The detection of these antibodies highlights the potential risk of human infection and emphasizes the need for further research and surveillance to prevent disease outbreaks. [Extracted from the article]

In this study, we aimed to evaluate the change in taurine levels in two diseases [Crimean-Congo hemorrhagic fever (CCHF) and novel coronavirus disease (COVID-19)], which have a significant impact on public health as they frequently cause mortality and morbidity.This observational, cross-sectional study was conducted between September 15, 2023, and November 30, 2023, at the Emergency Department, Sivas Cumhuriyet University Faculty of Medicine. There were three groups in our study. These groups were 35 COVID-19 patients with confirmed diagnosis, 35 CCHF patients, and a control group consisting of 35 healthy volunteers who were similar to these patient groups in terms of age and gender. Plasma amino acid levels of taurine, β-alanine, arginine, carnosine, cystine, histidine, lysine, and methionine were measured and compared in these three groups.In the pairwise comparison of the groups, the increase in taurine plasma levels in CCHF (p<0.001) and COVID-19 (p=0.002) patients compared to the control group was statistically significant, whereas the difference between CCHF and COVID-19 patient groups was not significant (p=0.303). Multinomial logistic regression analysis revealed that taurine, β-alanine, arginine, and lysine levels were significant predictors in differentiating patients with CCHF and COVID-19 from healthy individuals.We concluded that it may be important to determine taurine levels during the treatment and observation processes of these two diseases, which seriously affect public health. This study will contribute to a better understanding of the pathogenesis of the CCHF and COVID-19 diseases. [ABSTRACT FROM AUTHOR]

Crimean-Congo hemorrhagic fever (CCHF) is a severe viral illness with a high fatality rate. The interferon response plays a crucial role in the antiviral defense against the CCHF virus (CCHFV). Interferon regulatory factors (IRFs) are essential for initiating and amplifying the interferon response. In this study, we aimed to evaluate the IRF response in CCHF patients for the first time.This study investigated the expression levels of various IRFs (IRF-1, 2, 3, 4, and 7) in CCHF patients and evaluated their potential association with disease prognosis. The research encompassed a cohort of 60 CCHF patients and 30 healthy volunteers. CCHF was diagnosed with CCHFV positivity using PCR method and/or IgM detection using ELISA method. The quantitative sandwich ELISA technique was employed to determine the levels of serum IRF-1, IRF-2, IRF-3, IRF-4, IRF-7, interferon (IFN)-alpha, and IFN-beta.There were statistically significant differences in the levels of serum IRF-1, IRF-2, IRF-3, IRF-4, IRF-7, IFN-alpha, and IFN-beta between the patient and healthy control groups. Patients showed elevated levels in all these factors except for IRF-1. However, no statistically significant differences were found in IRF-1, IRF-2, IRF-3, IRF-4, IRF-7, IFN-alpha, and IFN-beta levels between patients who survived and those who died.IFN-alpha and beta likely contribute to the immune response in CCHF. IRF-2, 3, 4, and 7 play crucial roles in IFN-alpha and beta expression, pivotal for the antiviral response in CCHF. Targeted interventions to modulate IRF-1 could alleviate disease severity and overall impact. [ABSTRACT FROM AUTHOR]

Crimean‐Congo hemorrhagic fever virus (CCHFV) causes a serious human tick‐borne disease. In animals, CCHFV infections are mainly subclinical. The circulation of the virus has received little attention in areas where the main vector (Hyalomma spp.) is not considered to be present or established (e.g., the Northern Iberian Peninsula). The presence of antibodies against CCHFV was evaluated in sera collected from 1190 wild boars, 36 red deer, and 36 roe deer in the Basque Country (Northern Iberian Peninsula) in 2014–2019. Antibodies were found in the three wild ungulate species with an overall prevalence of 2.5%. The highest seroprevalence was found in red deer (22.2%) and in the southwest province: Araba (8.6%). The presence of antibodies against CCHFV in wild ungulates reported in this study could be due to an underestimated presence of Hyalomma ticks, the sporadic exposure to infected Hyalomma ticks transported by animals (e.g., migratory birds), or the role of other tick species in the virus's circulation. The detection of exposed animals since 2014 suggests that the circulation of the virus beyond the southwestern regions of the Iberian Peninsula could have been more widespread than previously thought. [ABSTRACT FROM AUTHOR]

Abstract Crimean Congo hemorrhagic fever (CCHF) is a re-emerging tick-borne zoonosis that is caused by CCHF virus (CCHFV). The geographical distribution of the disease and factors that influence its occurrence are poorly known. We analysed historical records on its outbreaks in various countries across the sub-Saharan Africa (SSA) to identify hotspots and determine socioecological and demographicfactors associated with these outbreaks. We used data from historical outbreaks that were reported between 1981 and 2022 in various countries in SSA. To develop a common framework for merging the outbreak data and potential explanatory variables, we generated a common shapefile that combined Level 2 administrative units in all the countries. Several climatic, environmental, socioecological data were obtained from on-line GIS databases and extracted using the shapefile. The data were analysed using an approximate Bayesian hierarchical model using the R-INLA package. The outcome was a Boolean variable which indicated whether an administrative unit in the shapefile was affected in a given year or not. A neighborhood structure was also generated and used to account for spatial autocorrelation in the analysis. The final model that was obtained from the analysis was used to build a CCHF risk map. A total of 54 CCHF outbreaks were compiled across 414 districts in nine SSA countries. Factors that were positively associated with CCHF outbreaks included human population density, land area under grassland, bare soil cover and shrub cover. Conversely, high precipitation during wet months, elevated mean temperature and slope had negative effects. The risk map generated shows that CCHF occurrence risk is higher in arid and semi-arid land (ASAL) of West Africa, the Sahelian region, Central Africa, and the Eastern and Southern Africa region. The analysis identified ecological and demographic factors that are associated with CCHF outbreaks in SSA. This finding suggests the need to improve surveillance for the disease especially in the grasslands where the human population is increasing.

We report a fatal case of Crimean-Congo hemorrhagic fever in Portugal. An 83-year-old man, initially suspected of having Mediterranean spotted fever, was later confirmed to have Crimean-Congo hemorrhagic fever by the detection of viral genome in the patient's serum and the presence of specific IgM antibodies.

Abstract Background Crimean-Congo haemorrhagic fever (CCHF) is a lethal acute viral zoonosis with a case fatality rate of 5–50%. Due to the potential of human-to human transmission of the disease, healthcare workers (HCWs) are at risk of occupational exposure to CCHF virus. Little is known about CCHF virus route of transmission and risks in Iranian HCWs. Therefore this study was designed to identify the routes of exposure to the CCHF virus among Iranian HCWs. Methods From Oct 2000 to Feb 2023, 96 CCHF suspected healthcare workers referred to national reference laboratory were tested for CCHF virus infection by the use of RT-PCR and IgM Capture Enzyme-Linked Immunosorbent Assay (MAC-ELISA) and exposure history of cases were investigated to determine the CCHF virus routes of transmission in nosocomial settings. Results Twelve CCHF confirmed cases were identified including seven nurses and five physicians, with the median age of 32.5 years (range 23–53 years) and the median incubation period of 6.8 days (range from 1 to 22 days). None of the cases reported a history of tick bite or close contact with tissues or animal blood. The cases were from Razavi Khorasan (seven cases), Sistan and Baluchistan (two cases), Isfahan (one case), South Khorasan (one case) and Fars (one case). Percutaneous exposure (needle stick) (three cases), mucosal exposure (blood splash in to face) (three cases) and skin contact with blood (three cases) constituted the most prevalent routes of transmission. Since 2013, no CCHF cases have been identified among Iranian HCWs. Conclusions In healthcare settings, physicians and nurses are at risk of nosocomial CCHF virus infection. The routes of transmission mainly include direct exposures via needle-stick, mucosal or direct contact with the skin to infected blood. Continuous education and implementation of infection prevention and control measures are key factors to minimize the incidence of healthcare related CCHF.

Background: Crimean-Congo haemorrhagic fever (CCHF) is a lethal acute viral zoonosis with a case fatality rate of 5–50%. Due to the potential of human-to human transmission of the disease, healthcare workers (HCWs) are at risk of occupational exposure to CCHF virus. Little is known about CCHF virus route of transmission and risks in Iranian HCWs. Therefore this study was designed to identify the routes of exposure to the CCHF virus among Iranian HCWs. Methods: From Oct 2000 to Feb 2023, 96 CCHF suspected healthcare workers referred to national reference laboratory were tested for CCHF virus infection by the use of RT-PCR and IgM Capture Enzyme-Linked Immunosorbent Assay (MAC-ELISA) and exposure history of cases were investigated to determine the CCHF virus routes of transmission in nosocomial settings. Results: Twelve CCHF confirmed cases were identified including seven nurses and five physicians, with the median age of 32.5 years (range 23–53 years) and the median incubation period of 6.8 days (range from 1 to 22 days). None of the cases reported a history of tick bite or close contact with tissues or animal blood. The cases were from Razavi Khorasan (seven cases), Sistan and Baluchistan (two cases), Isfahan (one case), South Khorasan (one case) and Fars (one case). Percutaneous exposure (needle stick) (three cases), mucosal exposure (blood splash in to face) (three cases) and skin contact with blood (three cases) constituted the most prevalent routes of transmission. Since 2013, no CCHF cases have been identified among Iranian HCWs. Conclusions: In healthcare settings, physicians and nurses are at risk of nosocomial CCHF virus infection. The routes of transmission mainly include direct exposures via needle-stick, mucosal or direct contact with the skin to infected blood. Continuous education and implementation of infection prevention and control measures are key factors to minimize the incidence of healthcare related CCHF. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionCrimean-Congo hemorrhagic fever (CCHF), an acute viral hemorrhagic fever disease, has a high mortality rate among humans. Hemorrhagic propensity is caused by coagulation malfunction and increased capillary permeability brought on by the resultant vascular injury. Vascular endothelial growth factor (VEGF) and VEGF receptor-2, or KDR (kinase insert domain containing receptor), are effective in vasculogenesis and angiogenesis. CCHF was stated to have endothelial dysfunction. This study aimed to evaluate whether the VEGF and KDR gene variants contribute to the development of CCHF in the Turkish population.A total of 101 subjects, including 51 CCHF patients and 50 healthy controls, were included in the study. The polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) method was used to genotype VEGF 936 C > T (rs3025039) and KDR − 604 T > C (rs2071559) variants. The results were statistically analyzed.The VEGF 936 C > T genotype and allele distributions did differ significantly between the patients and the controls. The subjects carrying the C/C genotype and C allele had a higher risk of developing CCHF than the control group (p˂0.05). There was a statistically significant association between the controls and the patients in terms of VEGF 936 C > T C/C versus C/T + T/T (p˂0.05, OR:3.273, 95%Cl: 1.44–7.63). The KDR − 604 T > C variant’s allele and genotype distribution were not significantly different between the patients and controls.This study suggests the VEGF 936 C > T variant is a genetic marker of sensitivity to CCHF among the Turkish population and may help protect against the disease. [ABSTRACT FROM AUTHOR]

Aim: Crimean-Congo Hemorrhagic Fever (CCHF) is a tick-borne viral disease, and Sensorineural Hearing Loss (SNHL) arises from pathologies in the cochlea or retrocochlear pathways. Viral infections, including Crimean-Congo hemorrhagic fever are considered possible etiological factors for Sensorineural hearing loss, as endothelial damage in Crimean-Congo hemorrhagic fever may impair inner ear blood flow. This study aimed to differentiate between cochlear and retrocochlear hearing loss in patients with Crimean- Congo hemorrhagic fever and assess the reliability of Auditory Steady-State Response (ASSR) testing by comparing its results with pure-tone audiometry. Materials and Methods: The study included 30 Crimean-Congo hemorrhagic fever patients (Group CCHF) and 30 healthy controls (Group C). Hearing measurements were conducted using pure tone audiometry, otoacoustic emissions, tympanometry, and Auditory steady-state response before the patients' discharge. Data were analyzed using SPSS 22.0. Results: The results showed no significant difference in audiometric thresholds between the right and left ears of Group CCHF at various frequencies. However, Auditory steady-state response results at 1000, 2000, and 4000 Hz in the right ear and at all tested frequencies in the left ear revealed significant differences between groups (p<0.05). Conclusion: While this study did not establish a clear link between Crimean-Congo hemorrhagic fever and Sensorineural hearing loss, it suggests the need for further research with larger samples and testing during both the active and recovery phases of Crimean-Congo hemorrhagic fever. [ABSTRACT FROM AUTHOR]

Crimean-Congo hemorrhagic fever (CCHF) is a widespread tick-borne viral disease. YKL-40 (also known as chitinase-3-like-1 protein) is an acute phase protein released by various immune cells. The purpose of this study was to investigate the relationship between YKL-40 level and the clinical course and prognosis of CCHF. The study included 78 patients who were admitted to our hospital between April 15 and 30 August 2022 and had a positive polymerase chain reaction test result for CCHF. The patients were divided into two groups, severe and non-severe. In addition, a control group consisting of 22 healthy people was established. Mean serum YKL-40 levels were significantly higher in patients than controls (106.8 ng/mL ± 91.2 and 47.1 ng/mL ± 35.3, respectively; p < 0.001). However, mean YKL-40 levels were also significantly higher in patients with severe CCHF compared to non-severe cases (173.3 ± 112.3 and 67.5 ± 41.7, respectively; p < 0.001). A comparison of the 10 exitus patients and the 68 survivors revealed significantly higher YKL-40 levels in the exitus group (mean: 214.0 ± 139.0 and 92.8 ± 73.6, respectively; p = 0.001). A receiver operating characteristic analysis for YKL-40 levels to distinguish between severe and non-severe patients found an area under the curve of 0.925. YKL-40 levels were measured with a sensitivity of 97% and a specificity of 84% with a cutoff value of 90.7 ng/mL. YKL-40 levels measured at the time of hospital presentation in patients with CCHF can be used as a biomarker for clinical course and prognosis. [ABSTRACT FROM AUTHOR]

AIM: This report aims to present the use of Coupled Plasma Filtration and Adsorption(CPFA) in CCHF patients. BACKGROUND: Crimean-Congo Hemorrhagic Fever(CCHF) is a viral hemorrhagic fever syndrome that can cause multi-organ failure with hyperactivation of the immune system. There is no proven treatment for CCHF,supportive care is essential for management.Extracorporeal depurative techniques have been used to remove inflammatory mediators from the bloodstream. RESULTS: We performed CPFA on three patients with CCHF, all of which were confirmed with PCR.A 35-year-old female was admitted one week after tick-exposure.Despite supportive treatment, patient developed mucosal and gastrointestinal bleeding due to disseminated intravascular coagulation(DIC).After CFPA,her clinic situation and laboratory results improved.A 54-year-old female was admitted to the Intensive Care Unite due to severe bleeding and had a history of tick bite nine-days-ago. She had multiple organ failure with DIC,we started CPFA.Patient didn't respond to the treatment and died.A 69-year-old male was admitted to the hospital on the seventh-day of exposure to tick. He had diabetes, hypertension and coronary artery disease.Next day,patient developed alveolar hemorrhage and his liver enzymes,coagulation parameters deteriorated.We performed CFPA,however,the patient didn't respond to treatment and died. CONCLUSION: We suggested that CPFA may have positive effects on the outcome and prognosis of critically ill CCHF patients.Only one patient responded well which can be a result of being young, early admission to the hospital and lack of comorbidity.CPFA may be an option to treat severe CCHF infection with cytokine storm.However,there is a need for further studies on when we should apply this treatment and whether early application prevents mortality.

Little is known about using noninvasive samples for diagnosing Crimean-Congo hemorrhagic fever (CCHF). We investigated detection of CCHF virus in serum, saliva, and urine samples. Our results indicate that serum is the best sample type for CCHF diagnosis; saliva can be used for noninvasive sampling.

Crimean-Congo hemorrhagic fever (CCHF) is a lethal viral disease that has severe public health effects throughout Africa and a case fatality rate of 10%–40%. CCHF virus was first discovered in Crimea in 1944 and has since caused a substantial disease burden in Africa. The shortage of diagnostic tools, ineffective tick control efforts, slow adoption of preventive measures, and cultural hurdles to public education are among the problems associated with continued CCHF virus transmission. Progress in preventing virus spread is also hampered by the dearth of effective serodiagnostic testing for animals and absence of precise surveillance protocols. Intergovernmental coordination, creation of regional reference laboratories, multiinstitutional public education partnerships, investments in healthcare infrastructure, vaccine development, and a One Health approach are strategic methods for solving prevention challenges. Coordinated efforts and financial commitments are needed to combat Crimean-Congo hemorrhagic fever and improve all-around readiness for newly developing infectious illnesses in Africa.

Objective. To identify specific features of the clinical course of Congo-Crimean hemorrhagic fever (CCHF) in children in order to optimize early and differential diagnosis, management tactics and treatment of pediatric patients Materials and Methods. A retrospective analysis of 159 probable and confirmed cases of Congo-Crimean hemorrhagic fever was carried out in patients admitted to the infectious diseases departments of Shymkent, district hospitals of Turkestan region for the period 2013–2022, of which 39 (24.5%) were children aged 1 to 18 years. Results. Of the 39 cases of CCHF in children, 9 (23.07%) were reported as confirmed, 5 (12.8%) as probable and 25 (64.1%) as suspected cases. In the epidemiological history, tick bite was noted in 25 (64.1%) cases. The incubation period in children and adolescents ranged from 1 to 14 days, on average – 9–8 days. Two children developed a severe complication of CCHF – hemoperitoneum. Conclusions. The probability of CCHF infection in children increases during the season of tick vector activity. The clinical picture of CCHF in children may be similar to manifestations of this infection in adults. Among the rare severe forms of CCHF, children may develop hemoperitoneum.

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Aim: This study aimed to investigate acute promyelocytic leukemia (APL) with an abnormal fusion gene in suspected Crimean-Congo hemorrhagic fever (CCHF) cases that were CCHF virus PCR/IgM negative. Materials & methods: A total of 102 serum samples from CCHF suspected cases were included. A TaqMan Real-Time PCR assay was used to detect the APL associated abnormal gene fusion. Results: Totally, the APL was detected in 2 (1.96%) serum samples, both of them were from fetal female cases. No statistically significant association was found between APL and demographic, clinical and laboratory data. Conclusion: Recognizing APL in CCHF-suspected individuals is crucial for accurate differential diagnosis due to shared clinical symptoms and the necessity of its emergency diagnosis, especially in endemic areas Plain Language Summary In this study, we investigated whether suspected cases of the viral disease Crimean-Congo hemorrhagic fever (CCHF) were actually a type of blood cancer, acute promyelocytic leukemia (APL). These conditions have some similar symptoms. We used a genetic test to detect APL and found that 2 of 102 samples showed a marker of APL. Our findings show the importance of testing for APL as a different diagnosis of CCHF to stop misdiagnosis and giving patients the wrong treatments. Article highlights Crimean-Congo hemorrhagic fever is a fatal viral zoonotic disease transmitted by ticks and caused by the CCHFV. Crimean-Congo hemorrhagic fever (CCHF) and Acute Promyelocytic Leukemia (APL) share clinical features, emphasizing the need for accurate differential diagnosis. The study focused on identifying the PML-RARA abnormal fusion, a common form of APL, in patients initially suspected of CCHF, highlighting the potential overlap in symptoms and the necessity for precise differential diagnosis. Importance of accurate diagnosis Accurate identification of PML-RARA in suspected CCHF cases is critical to ensure timely and appropriate treatment, preventing potential complications associated with misdiagnosis. The research highlights a specific case where initial suspicion of CCHF led to ribavirin treatment, illustrating the challenges in distinguishing between CCHF and hematological malignancies with overlapping symptoms. The prevalence of PML-RARA fusion among young individuals underscores the importance of considering age as a factor in the incidence of APL, providing valuable information for disease management. Recognizing the overlap between CCHF and APL is crucial for effective diagnosis and treatment. Improved awareness and diagnostic strategies are essential to prevent misdiagnosis and ensure appropriate management of both conditions in endemic regions. [ABSTRACT FROM AUTHOR]

Crimean-Congo hemorrhagic fever (CCHF) and Rift Valley fever (RVF) are among the list of emerging zoonotic diseases that require special attention and priority. RVF is one of the six priority diseases selected by the Senegalese government. Repeated epidemic episodes and sporadic cases of CCHF and RVF in Senegal motivated this study, involving a national cross-sectional serological survey to assess the distribution of the two diseases in this country throughout the small ruminant population. A total of 2127 sera from small ruminants (goat and sheep) were collected in all regions of Senegal. The overall seroprevalence of CCHF and RVF was 14.1% (IC 95%: 12.5–15.5) and 4.4% (95% CI: 3.5–5.3), respectively. The regions of Saint-Louis (38.4%; 95% CI: 30.4–46.2), Kolda (28.3%; 95% CI: 20.9–35.7), Tambacounda (22.2%; 95% CI: 15.8–28.6) and Kédougou (20.9%; 95% CI: 14.4–27.4) were the most affected areas. The risk factors identified during this study show that the age, species and sex of the animals are key factors in determining exposure to these two viruses. This study confirms the active circulation of CCHF in Senegal and provides important and consistent data that can be used to improve the surveillance strategy of a two-in-one health approach to zoonoses. [ABSTRACT FROM AUTHOR]

(1) Background: Crimean–Congo hemorrhagic fever (CCHF) is an emerging tick-borne disease endemic in Africa, Asia, the Middle East, and the Balkan and Mediterranean regions of Europe. Although no human CCHF cases have been reported, based on vector presence, serological evidence among small vertebrates, and the general human population, Hungary lies within high evidence consensus for potential CCHF introduction and future human infection. Thus, the aim of our pilot serosurvey was to assess CCHF seropositivity among cattle and sheep as indicator animals for virus circulation in the country. (2) Methods: In total, 1905 serum samples taken from free-range cattle and sheep in 2017 were tested for the presence of anti-CCHF virus IgG antibodies using commercial ELISA and commercial and in-house immunofluorescent assays. (3) Results: We found a total of eleven reactive samples (0.58%) from five administrative districts of Hungary comprising 8 cattle and 3 sheep. The most affected regions were the south–central and northwestern parts of the country. (4) Conclusions: Based on these results, more extended surveillance is advised, especially in the affected areas, and there should be greater awareness among clinicians and other high-risk populations of the emerging threat of CCHF in Hungary and Central Europe. [ABSTRACT FROM AUTHOR]

Crimean–Congo hemorrhagic fever (CCHF) is a zoonotic tick-borne disease, caused by an arbovirus of the genus Orthonairovirus and the family Nairoviridae. Crimean–Congo hemorrhagic fever virus (CCHFV) is widespread in several regions of the world. While the virus is not pathogenic to all susceptible livestock and wild mammals, it can lead to severe hemorrhagic fever in humans. In this review, we compiled published data on CCHFV infections in humans, animals, and ticks in Tunisia. Based on that, we discussed the epidemiology and the distribution patterns of CCHFV infections highlighting the risk factors for this virus in the country. CCHF infection prevalence in humans was estimated to 2.76% (5/181) and 5% (2/38) in Tunisian febrile patients and Tunisian slaughterhouse workers, respectively. Concurrently, seroprevalence in domestic ungulates (sheep, goats, cattle, and dromedaries) ranged from zero to 89.7%, and only one Hyalomma impeltatum tick specimen collected from dromedaries in southern Tunisian was positive for CCHFV by reverse transcriptase–polymerase chain reaction (0.6%; 1/165). As Tunisian studies on CCHFV are geographically scattered and limited due to very small sample sizes, further studies are needed to improve the knowledge on the epidemiology of CCHF in Tunisia. [ABSTRACT FROM AUTHOR]

Background and Aims: Crimean‐Congo hemorrhagic fever (CCHF) is a severe and potentially lethal illness. Tick bites of the Hyalomma genus are the primary source of transmission of CCHF to humans. The virus responsible for CCHF is the CCHF virus (CCHFV). It is a single‐stranded negative sensed RNA virus. The virus belongs to the Orthonairoviridae genus within the Nairoviridae family. It occurs in an extensive geographical area spanning the Middle East, western China, southern Asia, southeastern Europe, and much of Africa. The current study aimed to evaluate the pathogenicity and potential risk of CCHFV to cause a public health emergency of international concern. Methods: We searched updated relevant information from PubMed, Google Scholar, and Scopus databases using Crimean‐Congo hemorrhagic fever, tick‐borne virus, and Nairovirus as keywords. Results: The case fatality rate (CFR) varies by region. It can be more than 30% in some cases. Three segments in the genome of CCHFV (L, M, and S) are different in size and function. It is unknown whether the pathogenicity of CCHFV varied based on the genomic diversity. CCHFV can be transmitted through tick bites, handling of infected ticks, contact with infected humans, contaminated body fluids, and so on. A wide range of severity is associated with CCHF, ranging from a moderate fever with no apparent cause to increased vascular permeability, failure of several organs, bleeding, and shock. Hospitals with high‐level isolation units should be the first choice for treating CCHF patients. Individual safety equipment is crucial in healthcare to prevent the spread of the virus. In the farm environment, using integrated pest management techniques, minimizing activity in tick‐infested regions, and dressing appropriately in long sleeves and pants will help to reduce the risk of CCHFV infection via tick bites. Conclusion: There are no approved vaccinations or therapeutics for CCHF except supportive therapeutic approaches. Therefore, scientists recommend early ribavirin therapy for cases of high‐risk exposures. [ABSTRACT FROM AUTHOR]

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.

Crimean-Congo hemorrhagic fever virus (CCHFV) is the most geographically widespread tickborne viral infection worldwide and has a fatality rate of up to 62%. Despite its widespread range and high fatality rate, no vaccines or treatments are currently approved by regulatory agencies in the United States or Europe. Supportive treatment remains the standard of care, but the use of antiviral medications developed for other viral infections have been considered. We reviewed published literature to summarize the main aspects of CCHFV infection in humans. We provide an overview of diagnostic testing and management and medical countermeasures, including investigational vaccines and limited therapeutics. CCHFV continues to pose a public health threat because of its wide geographic distribution, potential to spread to new regions, propensity for genetic variability, potential for severe and fatal illness, and limited medical countermeasures for prophylaxis and treatment. Clinicians should become familiar with available diagnostic and management tools for CCHFV infections in humans.

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.

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.

To estimate the determinants of spatial variation in Crimean-Congo hemorrhagic fever virus (CCHFV) transmission and to create a risk map as a preventive public health tool, we designed a survey of small domestic ruminants in Andalusia, Spain. To assess CCHFV exposure spatial distribution, we analyzed serum from 2,440 sheep and goats by using a double-antigen ELISA and modeled exposure probability with environmental predictors by using generalized linear mixed models. CCHFV antibodies detected in 84 samples confirmed low CCHFV prevalence in small domestic ruminants in the region. The best-fitted statistical model indicated that the most significant predictors of virus exposure risk were cattle/horse density and the normalized difference vegetation index. Model validation showed 99.7% specificity and 10.2% sensitivity for identifying CCHFV circulation areas. To map CCHFV exposure risk, we projected the model at a 1 × 1-km spatial resolution. Our study provides insight into CCHFV ecology that is useful for preventing virus transmission.

The review provides the summarized and updated information on the current distribution of the tick Hyalomma marginatum in the natural Crimean hemorrhagic fever (CHF) focus in Russia. The work is based on the analysis of numerous literature sources, as well as the evidence from the personal collecting of ticks during long-term field research. In addition, the collection of ticks of the Stavropol Research Anti-Plague Institute of the Rospotrebnadzor and the database of H. marginatum collections in various regions of southern Russia were used. When delineating the boundaries of the H. marginatum areal and the CHF focus, we also deployed maps of the epidemiological survey of the focus, weekly and annual final reports on the CHF incidence from the Rospotrebnadzor Administrations. H. marginatum inhabits all regions of the Southern Federal District and the North-Caucasian Federal District, as well as the Crimean Peninsula and the south of the Saratov Region. The northern border of the areal reaches the Lugansk People’s Republic, Rostov, Volgograd, and Saratov Regions. H. marginatum is widely disseminated in the territory of Kalmykia and the Astrakhan Region. In the North Caucasus, it inhabits the entire flatland up to the foothills of the Greater Caucasus. The tick is widely distributed in the Stavropol Territory, populating the entire region. In the mountainous part of the Krasnodar Territory, this species is absent, but common in the rest of the areas. Beyond that, it is found on the Black Sea coast. In Karachay-Cherkessia, Kabardino-Balkaria, North Ossetia and Ingushetia, the tick lives in the northern steppe regions of the republics, in some places it invades the foothills. In Chechnya and Dagestan, the species widely inhabits the steppes and semi-deserts of the Terek-Kuma Interfluve. Moreover, in Dagestan, H. marginatum lives across the plain and foothill territory of the republic and even reaches the highlands up to a height of more than 2000 m above sea level. In addition, it is widely disseminated on the Crimean peninsula, both the flatland and the mountainous part.

The review features the situation on Crimean-Congo hemorrhagic fever (CCHF) in the world and the analysis of the epidemiological and epizootiological situation in the Russian Federation in 2023. The number of CCHF cases (26) in Russia was 2.3 times less than in 2022, and 71.6 % lower than the long-term average (in 2013–2022 – an average of 88.8 cases per year, mortality (8 %) is 2.4 times higher than the long-term average (3.3 %). The epidemically significant indicator of the abundance of the main vector of the CCHF virus, ticks Hyalomma marginatum, was 5 times higher than the threshold value (abundance index for cattle – 15.5) at long-term observation points in April. For the first time, one case of CCHF disease was registered in a new epidemically active territory – in the Botlikh and Novolaksky districts of the Republic of Dagestan. For the first time in the Zaporozhye Region, RNA of the CCHF virus was detected in ticks H. marginatum and Rhipicephalus rossicus. Markers of CCHF virus were found in 0.67–18.27 % of samples, CCHF virus variants of the genetic line Europe 1 were circulating on the territory of Russia in 2023. According to the forecast of the epidemic situation for 2024, CCHF morbidity is likely to increase in the south of the European part of Russia. The recommendations for undertaking preventive measures have been provided.

This study investigated the intricate interplay between Crimean‐Congo hemorrhagic fever virus (CCHFV) infection and alterations in amino acid metabolism. Our 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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The World Health Organization classified Crimean–Congo hemorrhagic fever (CCHF) as a high‐priority infectious disease and emphasized the performance of research studies and product development against it. Little information is available about the immune response due to natural CCHF virus (CCHFV) infection in humans. Here, we investigated the persistence of IgG and neutralizing antibodies in serum samples collected from 61 Iranian CCHF survivors with various time points after recovery (<12, 12−60, and >60 months after disease). The ELISA results showed IgG seropositivity in all samples while a pseudotyped based neutralization assay findings revealed the presence of neutralizing antibody in 29 samples (46.77%). For both IgG and neutralizing antibodies, a decreasing trend of titer was observed with the increase in the time after recovery. Not only the mean titer of IgG (772.80 U/mL) was higher than mean neutralizing antibody (25.64) but also the IgG persistence was longer. In conclusion, our findings provide valuable information about the long‐term persistence of humoral immune response in CCHF survivors indicating that IgG antibody can be detected at least 8 years after recovery and low titers of neutralizing antibody can be detected in CCHF survivors. [ABSTRACT FROM AUTHOR]

Objective: This review examines the link between the COVID-19 pandemic and the outbreak of Crimean-Congo Hemorrhagic Fever (CCHF) in Iraq. Methods: We reviewed literature and data to explore potential associations between the two diseases. Results: No direct causative link between COVID-19 and increased CCHF cases in Iraq was found. However, changes in healthcare, agriculture, and human-animal interactions during the pandemic may have indirectly affected CCHF transmission. Conclusion: This review highlights the need for further research to confirm any connections between the COVID-19 pandemic and CCHF outbreaks in Iraq. Understanding these links is crucial for effective public health responses to emerging infectious diseases. [ABSTRACT FROM AUTHOR]

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We report an imported Crimean-Congo hemorrhagic fever case in Senegal. The patient received PCR confirmation of virus infection 10 days after symptom onset. We identified 46 patient contacts in Senegal; 87.7% were healthcare professionals. Strengthening border crossing and community surveillance systems can help reduce the risks of infectious disease transmission.

Objective: Crimean-Congo hemorrhagic fever (CCHF) is the most common tick-borne viral hemorrhagic fever in our country and the world. While investigating the etiology of fever, tick contact should be questioned, especially in rural areas, and CCHF should be remembered. This study aimed to review the characteristics of the cases detected in Bayburt, one of the cities where CCHF is endemic. Methods: A total of 100 patients aged 16 years and older who were diagnosed with CCHF in our clinic between April 2020 and October 2022 were included in the study. Demographic, epidemiological, and clinical characteristics, treatments, and prognoses of the patients were reviewed retrospectively through the hospital automation system and CCHF information system of The Ministry of Health. Results: Sixty one (61%) of the patients included in the study were male, and their primary age (± standard deviation) was 50.4±15.7. 77% of the patients engaged in farming and or animal husbandry, and 71% were living in rural areas. The highest number of cases was in June and July. 63% of the patients had a history of a tick bite. At the first presentation, there were complaints of fatigue (95%), generalized body pain (84%), headache (67%), and fever (65%), in order of frequency. Ribavirin was started in 52 (52%) patients. One patient admitted in the late period died, and 99 patients were discharged with good recovery. Conclusion: CCHF is an important public health problem that has been causing seasonal epidemics in our country for nearly two decades. Although sporadic cases have been reported from almost every region, the disease is endemic in some areas. Since signs and symptoms are not specific, the disease can be easily missed when tick contact is not questioned. Therefore CCHF should be considered in patients presenting with fever and thrombocytopenia in rural areas, especially in the spring and summer months.

Abstract Congo virus, or Crimean–Congo hemorrhagic fever (CCHF), is a tick-borne disease caused by a single-stranded RNA virus (genus nairovirus, Bunyaviridae family). It spreads through infected ticks' bites or contact with viremic individuals or livestock. Factors supporting its spread include hot, humid climates, limited pesticide use, poor animal control, inadequate irrigation during monsoons, and vector control deficiencies. Nosocomial transmission in under-resourced hospitals poses a threat to healthcare workers. Decades of CCHF cases persist in Pakistan due to these factors, with six deaths reported by June 2023. To combat the epidemic, Pakistan should raise awareness, improve irrigation, establish surveillance systems, and implement livestock quarantine and vaccination.

Aim:To evaluate the power of the systemic immune-inflammation index (SII) in the prediction of mortality in patients with Crimean-Congo hemorrhagic fever (CCHF) presenting at the emergency department (ED).Materials and Methods:The study included patients who presented at the ED between April 2020 and November 2022 and were hospitalized for treatment in the Infectious Diseases Department. The demographic data, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and SII were recorded. Categorical data were analyzed with the chi-square test and continuous data with the Mann-Whitney U test. Receiver operating characteristic (ROC) curve analysis was performed to determine the factors predicting the risk of mortality.Results:The SII value (p=0.010) and NLR (p

Crimean-Congo hemorrhagic fever (CCHF) is a viral hemorrhagic fever syndrome that can cause multi-organ failure with hyperactivation of the immune system. There is no proven treatment for CCHF, supportive care is essential for management. Extracorporeal depurative techniques have been used to remove inflammatory mediators from the bloodstream. This report aims to present the use of coupled plasma filtration and adsorption (CPFA) in CCHF patients. We performed CPFA on three patients with CCHF, all of which were confirmed with polymerase chain reaction. A 35-year-old female was admitted one week after tick-exposure. Despite supportive treatment, patient developed mucosal and gastrointestinal bleeding due to disseminated intravascular coagulation (DIC). After CFPA, her clinic situation and laboratory results improved. A 54-year-old female was admitted to the intensive care unit due to severe bleeding and had a history of tick bite nine-days-ago. She had multiple organ failure with DIC, we started CPFA. Patient didn’t respond to the treatment and died. A 69-year-old male was admitted to the hospital on the seventh-day of exposure to tick. He had diabetes, hypertension and coronary artery disease. Next day, patient developed alveolar hemorrhage and his liver enzymes, coagulation parameters deteriorated. We performed CFPA, however, the patient didn’t respond to treatment and died. We suggested that CPFA may have positive effects on the outcome and prognosis of critically ill CCHF patients. Only one patient responded well which can be a result of being young, early admission to the hospital and lack of comorbidity. CPFA may be an option to treat severe CCHF infection with cytokine storm. However,there is a need for further studies on when we should apply this treatment and whether early application prevents mortality.

Background and purpose: Crimean-Congo hemorrhagic fever (CCHF) is one of the viral hemorrhagic fevers caused by Nairovirus group. Epidemiological investigation and clinical symptoms of the disease in each region can help to identify disease-prone foci and early diagnosis of the disease in epidemic cases. Therefore, the purpose of this study was to investigate the clinical, epidemiological, and laboratory symptoms of patients with CCHF in Mazandaran province in 2014-2018. Materials and methods: In this cross-sectional epidemiological survey, 135 patients with proven CCHF in Mazandaran province were enrolled in a census manner. The clinical, epidemiological, and laboratory findings in these patients were determined. Results: In this study, 23% were younger than 30 years of age and 80.7% were men. In hospitalized patients, 33.3% had high risk jobs linked to the disease and 39.3% had livestock exposure. The patients were most affected in spring (45.9%) and summer (42.2%) and less during fall (5.9%), and winter (5.9%). Clinical manifestations, including fever, rash, abdominal pain, bleeding, epistaxis, headache, musculoskeletal pain, cough, and menorrhagia were observed in 88.1%, 11.1%, 23%, 28.9%, 7.4%, 52.6%, 69.7%, 0%, and 0% of the infected subjects, respectively. Thrombocytopenia were seen in 51.9% of the patients and about other laboratory results there were no any specific findings in 29.6%. According to laboratory findings, LFT raise, anemia, leukopenia, leukocytosis, LTF raise plus anemia, and LFT raise plus leukopenia were seen in 13.3%, 5.2%, 27.4%, 9.6%, 3.7%, and 11.1%, respectively. Conclusion: According to the present study, although the clinical, epidemiological, and laboratory findings in CCHF cases in Mazandaran province are similar to other studies worldwide, so, the regular analysis of CCHF patients is highly recommended.

Crimean-Congo hemorrhagic fever (CCHF) is an important zoonotic disease that can cause severe complications in human, especially among residents of rural areas. In this experimental study, 80 rural women were selected in Iran, by multi-stage cluster sampling method and randomly assigned into two intervention (n = 40) and control (n = 40) groups. A CCHF prevention education program was developed and implemented for the intervention group. Data were collected in both pretest and posttest groups (3 months after intervention), using a researcher-made questionnaire to measure knowledge, attitudes and practices effective in the prevention of CCHF. The data were analyzed in SPSS-27 software test at a significance level of 0.05. The mean age of participants was 32.5 ± 7.76 year. Based on the pretest results, the average knowledge (P =.001) and attitude (P =.001) in the control group was significantly higher than those of the intervention group, but the difference was not significant for the practice (P =.210). After 3 months of follow-up, the mean of knowledge, attitude and practice in the intervention group increased significantly, compared to that of the control group (P =.001). Educational interventions can improve the rural women's preventive behaviors toward CCHF. It is suggested to design and implement similar extensive educational interventions to empower rural women's first, and then whole society. [ABSTRACT FROM AUTHOR]

Crimean-Congo hemorrhagic fever virus (CCHFV) is endemic in Asia, infecting many animal hosts, but CCHFV has not been reported in Myanmar. We conducted a seroepidemiologic survey of logging communities in Myanmar and found CCHFV exposure was common (9.8%) and exposure to wild animal blood and body fluids was associated with seropositivity.

The review presents an analysis of the epidemiological and epizootiological situation on Crimean-Congo hemorrhagic fever (CCHF) in the Russian Federation in 2022. The incidence rate of CCHF registered in 2022 (59 cases) was 1.2 times higher as compared to 2021, however, below the long-term average annual values. The mortality rate was 10.2 %, which exceeds the indicators of long-term observations (in 2012–2021 – 3.2 %). Following epizootiological survey of stationary observation points, it was found that the number of Hyalomma marginatum imago in 2022, in general, corresponded to the average long-term indicators. CCHF virus isolates circulating in Russia in 2017–2022 belonged to the genetic lines “Europe-1” (V), “Europe-2” (VI), and “Europe-3” (VII). The ratio of CCHF virus genovariants in the population on the territory of the Russian Federation in 2017–2022 didn’t change. Based on the analysis of naturalclimatic factors, the forecast for the incidence of CCHF in the Russian Federation for 2023 has been made.

Ahmad Shekaib Rasikh,1 Mohammad Maroof Aram,2 Abdul Tawab Noory1 1Department of Infectious Diseases, Ali Abad Teaching Hospital, Kabul University of Medical Sciences, Kabul, Afghanistan; 2Department of Internal Medicine, Ali Abad Teaching Hospital, Kabul University of Medical Sciences, Kabul, AfghanistanCorrespondence: Ahmad Shekaib Rasikh, Tel +93 791906514, Email shekaib.rasikh@gmail.comObjective: Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic disease associated with a high fatality rate. CCHF is endemic in Afghanistan, and its morbidity and mortality have increased recently but there is limited data about the characteristics of fatal cases. We aimed to report the clinical and epidemiological features of fatal CCHF cases who were admitted to Kabul Referral Infectious Diseases (Antani) Hospital.Methods: This is a retrospective cross-sectional study. The demographic and presenting clinical and laboratory features of 30 fatal CCHF cases diagnosed by reverse transcription polymerase chain reaction (RT-PCR) or enzyme-linked immunosorbent assay (ELISA) tests were collected from the patients’ records between March 2021 and March 2023.Results: During the study period, a total of 118 laboratory-confirmed CCHF patients were admitted to Kabul Antani Hospital of whom 30 patients (25 males, 5 females) consequently died, indicating a 25.4% case fatality rate (CFR). The age of the fatal cases ranged from 15 to 62 years and their mean age was 36.6 ± 11.7 years. Concerning occupation, the patients were butchers (23.3%), animal dealers (20%), shepherds (16.6%), housewives (16.6%), farmers (10%), student (3.3%), and others (10%). The clinical symptoms of the patients on admission were fever (100%), generalized body pain (100%), fatigue (90%), bleeding (any type) (86.6%), headache (80%), nausea/vomiting (73.3%), and diarrhea (70%). The initial abnormal laboratory findings were leukopenia (80%), leukocytosis (6.6%), anemia (73.3%), and thrombocytopenia (100%), raised hepatic enzymes (ALT & AST) (96.6%) and prolonged prothrombin time/international normalized ratio (PT/INR) (100%).Conclusion: The hemorrhagic manifestations associated with low platelet and raised PT/INR levels are linked with fatal outcomes. A high index of clinical suspicion is required to recognize the disease at an early stage and to begin the treatment promptly for reducing mortality.Keywords: Afghanistan, Crimean-Congo hemorrhagic fever, fatal, thrombocytopenia

Crimean-Congo hemorrhagic fever (CCHF) and Rift Valley fever (RVF) are among the list of emerging zoonotic diseases that require special attention and priority. RVF is one of the six priority diseases selected by the Senegalese government. Repeated epidemic episodes and sporadic cases of CCHF and RVF in Senegal motivated this study, involving a national cross-sectional serological survey to assess the distribution of the two diseases in this country throughout the small ruminant population. A total of 2127 sera from small ruminants (goat and sheep) were collected in all regions of Senegal. The overall seroprevalence of CCHF and RVF was 14.1% (IC 95%: 12.5–15.5) and 4.4% (95% CI: 3.5–5.3), respectively. The regions of Saint-Louis (38.4%; 95% CI: 30.4–46.2), Kolda (28.3%; 95% CI: 20.9–35.7), Tambacounda (22.2%; 95% CI: 15.8–28.6) and Kédougou (20.9%; 95% CI: 14.4–27.4) were the most affected areas. The risk factors identified during this study show that the age, species and sex of the animals are key factors in determining exposure to these two viruses. This study confirms the active circulation of CCHF in Senegal and provides important and consistent data that can be used to improve the surveillance strategy of a two-in-one health approach to zoonoses.