Lessons of 10 years experience on CCHF in Iran

International audienceCrimean-Congo Hemorrhagic Fever (CCHF) is a viral zoonotic disease with high mortality rate in humans caused by CCHF virus (CCHFV) belonging to the genus Nairovirus, family Bunyaviridae, and congaing a three segment single-stranded RNA genome. The CCHFV is transmitted to humans by bite of infected ticks, by direct contact with blood or tissues of infected livestock and nosocomially. After Chaharmahal-va-Bakhtiari outbreak in 1999 whose serum samples was sent to South Africa for diagnosis, Arboviruses and Viral Hemorrhagic Fevers Laboratory (As National Reference Lab) was established in 2000 to precise and on time laboratory diagnosis of CCHF in the country. The Lab along with CDC of Iran (national health regulator) and Veterinary organization (control program of tick populations and livestock monitoring) are members of National Expert Committee on Viral Hemorrhagic Fevers (NECVHFs) for surveillance and control of CCHF in Ir

Serological and molecular epidemiology of crimean-congo hemorrhagic fever in Ghaemshahr county in Mazandaran province; Iran

Crimean-Congo Hemorrhagic Fever (CCHF) is a tick-borne viral hemorrhagic fever disease which is known as an endemic disease within some provinces of Iran. Ticks play an important role in transmission of the disease. As vector and reservoir, ticks transmit CCHF virus from livestock to human. The current study reports the presence of CCHFV in Ghaemshahr county of Mazandaran province, in north of Iran based on the evidences obtained from ELISA and RT- PCR. Based on our results, IgG antibodies against CCHFV were detected in 4(4.8) out of 84 sheep sera samples. Forty sera were obtained from people who were in close contact with the examined sheep, none of which had IgG antibodies against CCHFV. Using RT-PCR, we confirmed the existence of CCHFV genome in 1.7 of hard tick samples. Sequence analysis demonstrated that CCHFV genomes isolated from ticks were 100 identical to those isolated from the corresponding livestock. This study confirms the presence of the virus in this region; so people in close contact with livestock and health care workers should be alerted. © 2016, Malaysian Society for Parasitology. All rights reserved

Molecular assay on Crimean Congo Hemorrhagic Fever virus in ticks (Ixodidae) collected from Kermanshah Province, Western Iran

Background: Crimean-Congo Hemorrhagic Fever (CCHF) is a feverous and hemorrhagic disease endemic in some parts of Iran and caused by an arbovirus related to Bunyaviridae family and Nairovirusgenus. The main virus reservoir in the nature is ticks, however small vertebrates and a wide range of domestic and wild animals are regarded as reservoir hosts. This study was conducted to determine the infection rate of CCHF virus in hard ticks of Sarpole- Zahab County, Kermanshah province, west of Iran. Methods: From total number of 851 collected ticks from 8 villages, 131 ticks were selected randomlyand investigated for detection of CCHF virus using RT-PCR. Results: The virus was found in 3.8 of the tested ticks. Hyalommaanatolicum, H.asiaticum and Rhipicephalus sanguineus species were found to have viral infection, with the highest infection rate (11.11) in Rh. sanguineus. Conclusion: These findings provide epidemiological evidence for planning control strategies of the disease in the study area

Hyalomma anatolicum as the main infesting tick in an important livestock rearing region, central area of iran

Background: This study was carried out to determine the infestation of domestic ruminants to ticks in an important livestock-rearing region, located in central part of Iran. Methods: Ticks were collected from cattle, sheep, and goats and then were identified with appropriate identification keys to species level in two different ecological regions of plains and mountain in 4 seasons in 2015. Results: Totally 492 ticks from cattle, sheep, and goats in 34 herds were collected. Totally, 18.53 of domestic animals were infected by ticks. All ticks were belonged to family Ixodidae and classified into three genera and six species comprising Hyalomma anatolicum (38.83), Hy. Asiaticum (23.37), Hy. marginatum (2.85), Hy. sp. (3.45), Rhipicephalus sanguineus (14.02) and Haemaphysalis sulcata (10.98). Sex ratio of the collected specimens showed 241 (48.99) male, 219 (44.51) female and 32 (6.5) nymph Conclusion: Studied area is important for production of livestock and dairy products. Annually, many livestock products are exported to other parts from this region; therefore, it is very important to identify the infection rate of tick-borne diseases as well as safety factors on livestock. © 2018, Iranian Journal of Public Health. All rights reserved

Hyalomma anatolicum as the main infesting tick in an important livestock rearing region, central area of iran

Background: This study was carried out to determine the infestation of domestic ruminants to ticks in an important livestock-rearing region, located in central part of Iran. Methods: Ticks were collected from cattle, sheep, and goats and then were identified with appropriate identification keys to species level in two different ecological regions of plains and mountain in 4 seasons in 2015. Results: Totally 492 ticks from cattle, sheep, and goats in 34 herds were collected. Totally, 18.53 of domestic animals were infected by ticks. All ticks were belonged to family Ixodidae and classified into three genera and six species comprising Hyalomma anatolicum (38.83), Hy. Asiaticum (23.37), Hy. marginatum (2.85), Hy. sp. (3.45), Rhipicephalus sanguineus (14.02) and Haemaphysalis sulcata (10.98). Sex ratio of the collected specimens showed 241 (48.99) male, 219 (44.51) female and 32 (6.5) nymph Conclusion: Studied area is important for production of livestock and dairy products. Annually, many livestock products are exported to other parts from this region; therefore, it is very important to identify the infection rate of tick-borne diseases as well as safety factors on livestock. © 2018, Iranian Journal of Public Health. All rights reserved

Imported Crimean-Congo hemorrhagic fever cases in Istanbul

We described a series of imported cases of Crimean-Congo Hemorrhagic Fever (CCHF) in Istanbul and investigated the genetic diversity of the virus. All the suspected cases of CCHF, who were applied to the health centers in Istanbul, were screened for CCHF virus (CCHFv) infection by using semi-nested Polymerase Chain Reaction (PCR) following RT-PCR. Simultaneous blood samples were also sent to the national reference laboratory in Ankara for serologic investigation. In 10 out of 91 patients, CCHFv was detected by PCR, and among 9 out of 10, anti-CCHFv IgM antibodies were also positive. Clinical features were characterized by fever, myalgia, and hemorrhage. The levels of liver enzymes, creatinine phosphokinase, and lactate dehydrogenase were elevated, and bleeding markers were prolonged. All the cases were treated with ribavirin. There was no fatal case. All the strains clustered within the same group as other Europe/Turkey isolates

Crimean-Congo hemorrhagic fever: epidemiological trends and controversies in treatment

Crimean-Congo hemorrhagic fever (CCHF) virus has the widest geographic range of all tick-borne viruses and is endemic in more than 30 countries in Eurasia and Africa. Over the past decade, new foci have emerged or re-emerged in the Balkans and neighboring areas. Here we discuss the factors influencing CCHF incidence and focus on the main issue of the use of ribavirin for treating this infection. Given the dynamics of CCHF emergence in the past decade, development of new anti-viral drugs and a vaccine is urgently needed to treat and prevent this acute, life-threatening disease

Neglected Tropical Diseases of the Middle East and North Africa: Review of Their Prevalence, Distribution, and Opportunities for Control

The neglected tropical diseases (NTDs) are highly endemic but patchily distributed among the 20 countries and almost 400 million people of the Middle East and North Africa (MENA) region, and disproportionately affect an estimated 65 million people living on less than US$2 per day. Egypt has the largest number of people living in poverty of any MENA nation, while Yemen has the highest prevalence of people living in poverty. These two nations stand out for having suffered the highest rates of many NTDs, including the soil-transmitted nematode infections, filarial infections, schistosomiasis, fascioliasis, leprosy, and trachoma, although they should be recognized for recent measures aimed at NTD control. Leishmaniasis, especially cutaneous leishmaniasis, is endemic in Syria, Iran, Iraq, Libya, Morocco, and elsewhere in the region. Both zoonotic (Leishmania major) and anthroponotic (Leishmania tropica) forms are endemic in MENA in rural arid regions and urban regions, respectively. Other endemic zoonotic NTDs include cystic echinococcosis, fascioliasis, and brucellosis. Dengue is endemic in Saudi Arabia, where Rift Valley fever and Alkhurma hemorrhagic fever have also emerged. Great strides have been made towards elimination of several endemic NTDs, including lymphatic filariasis in Egypt and Yemen; schistosomiasis in Iran, Morocco, and Oman; and trachoma in Morocco, Algeria, Iran, Libya, Oman, Saudi Arabia, Tunisia, and the United Arab Emirates. A particularly noteworthy achievement is the long battle waged against schistosomiasis in Egypt, where prevalence has been brought down by regular praziquantel treatment. Conflict and human and animal migrations are key social determinants in preventing the control or elimination of NTDs in the MENA, while local political will, strengthened international and intersectoral cooperative efforts for surveillance, mass drug administration, and vaccination are essential for elimination

Biosafety standards for working with Crimean-Congo hemorrhagic fever virus

In countries from which Crimean-Congo haemorrhagic fever (CCHF) is absent, the causative virus CCHF virus (CCHFV) is classified as a hazard group 4 agent and handled in containment level 4. In contrast, most endemic countries out of necessity have had to perform diagnostic tests under biosafety level (BSL) 2 or 3 conditions. In particular, Turkey and several of the Balkan countries have safely processed more than 100000 samples over many years in BSL-2 laboratories. It is therefore advocated that biosafety requirements for CCHF diagnostic procedures should be revised, to allow the required tests to be performed under enhanced BSL-2 conditions with appropriate biosafety laboratory equipment and personal protective equipment used according to standardized protocols in the affected countries. Downgrading of CCHFV research work from Cl- 4,BSL-4 to Cl-3 ,BSL-3 should also be considered.Funding was received through CCH Fever Network (Collaborative Project) supported by the European Commission under the Health Cooperation Work Program of the 7th Framework Program (Grant agreement no. 260427) (http://www.cch-fever.eu/).http://vir.sgmjournals.orghb2017Veterinary Tropical Disease