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Crimean-Congo hemorrhagic fever virus
Virus classification
Group: Group V ((-)ssRNA)
Family: Bunyaviridae
Genus: Nairovirus
Species: Crimean-Congo hemorrhagic fever virus
Crimean-Congo hemorrhagic fever
Classification and external resources
ICD-10 A98.0
ICD-9 065.0
DiseasesDB 31969

Crimean-Congo hemorrhagic fever (CCHF) is a widespread tick-borne viral disease, a zoonosis of domestic animals and wild animals, that may affect humans. The pathogenic virus, especially common in East and West Africa, is a member of the Bunyaviridae family of RNA viruses. Clinical disease is rare in infected mammals, but commonly severe in infected humans, with a 30% mortality rate. Outbreaks of illness are usually attributable to handling infected animals or people.

Contents

Virology

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Life cycle

Typically, after a 1–3 day incubation period following a tick bite (5–6 days after exposure to infected blood or tissues), flu-like symptoms appear, which may resolve after one week. In up to 75% of cases, however, signs of hemorrhage appear within 3–5 days of the onset of illness in case of bad containment of the first symptoms: first mood instability, agitation, mental confusion and throat petechiae, then soon nosebleeds, bloody urine and vomiting, and black stools. The liver becomes swollen and painful. Disseminated intravascular coagulation may occur as well as acute kidney failure and shock, and sometimes acute respiratory distress syndrome.

Patients usually begin to recover after 9–10 days from symptom onset, but 30% die in the second week of illness.

Prevention

Where mammal and tick infection is common agricultural regulations require de-ticking farm animals before transportation or delivery for slaughter. Personal tick avoidance measures are recommended, such as use of insect repellents, adequate clothing and body inspection for adherent ticks.

When feverish patients with evidence of bleeding require resuscitation or intensive care, body substance isolation precautions should be taken.

The United States armed forces maintain special stocks of ribavirin to protect personnel deployed to Afghanistan and Iraq from CCHF.

Treatment

Treatment is primarily symptomatic and supportive, as there is no established specific treatment. Ribavirin is effective in vitro[1] and has been used during outbreaks,[2] but there is no trial evidence to support its use.

Epidemiology

Vectors

Hyalomma tick

Sporadic infection of people is usually caused by Hyalomma tick bite. Clusters of illness typically appear after people treat, butcher or eat infected livestock, particularly ruminants and ostriches. Outbreaks have occurred in clinical facilities where health workers have been exposed to infected. blood and fomites.

The causative organism is found in Asia, Eastern Europe, the Middle East, a belt across central Africa and South Africa and Madagascar (see map [3]) The main environmental reservoir for the virus is small mammals (particularly European hare, Middle-African hedgehogs and multimammate rats). Ticks carry the virus to domestic animal stock. Sheep, goats and cattle develop high titers of virus in blood, but tend not to fall ill. Birds are generally resistant with the exception of ostriches.

Outbreaks

Isolated male patient diagnosed with Crimean-Congo hemorrhagic fever

During the summers of 1944 and 1945 over 200 cases of an acute, hemorrhagic, febrile illness occurred in Soviet troops rescuing the harvest following the ethnic cleansing of the Crimean Tatars. Virus was discovered by Mikhail Chumakov and his colleagues in blood samples of patients and in the tick Hyalomma marginatum marginatum. Researchers soon recognized that a similar disease had been occurring in the Central Asian Republics. In 1969 analysis of a preserved blood sample collected from a febrile child in Zaire in 1956 showed the same virus. This finding gave rise to the present name of the disease.

On July 28, 2005 authorities reported 41 cases of CCHF in Turkey's Yozgat Province, with one death. As of August 2008, a total of 50 people were reported to have lost their lives in various cities in Turkey due to CCHF. 3128 Crimean-Congo hemorrhagic fever cases with 5% of case-fatality rate have been reported by the Ministry of Health of Turkey between 2002-2008.

References

  1. ^ Watts DM, Ussery MA, Nash D, Peters CJ. (1989). "Inhibition of Crimean-Congo hemorrhagic fever viral infectivity yields in vitro by ribavirin". Am J Trop Med Hyg. 41: 581–5. PMID 2510529.  
  2. ^ Ergönül Ö, Celikbas A, Dokuzoguz B, et al. (2004). "The chacteristics of Crimean-Congo hemorrhagic fever in a recent outbreak in Turkey and the impact of oral ribavirin therapy". Clin Infect Dis 39: 285–9. doi:10.1086/422000. PMID 15307042. http://www.journals.uchicago.edu/cgi-bin/resolve?CID32782.  
  3. ^ Map

External links


Crimean-Congo hemorrhagic fever virus
Virus classification
Group: Group V ((-)ssRNA)
Family: Bunyaviridae
Genus: Nairovirus
Species: Crimean-Congo hemorrhagic fever virus

Template:DiseaseDisorder infobox

Crimean-Congo hemorrhagic fever (CCHF) is a widespread tick-borne viral disease, a zoonosis of domestic animals and wild animals, that may affect humans. The pathogenic virus, especially common in East and West Africa, is a member of the Bunyaviridae family of RNA viruses. Clinical disease is rare in infected mammals, but commonly severe in infected humans, with a 30% mortality rate. Outbreaks of illness are usually attributable to handling infected animals or people.

Contents

Virology

Life cycle

Typically, after a 1–3 day incubation period following a tick bite (5–6 days after exposure to infected blood or tissues), flu-like symptoms appear, which may resolve after one week. In up to 75% of cases, however, signs of hemorrhage appear within 3–5 days of the onset of illness in case of bad containment of the first symptoms: first mood instability, agitation, mental confusion and throat petechiae, then soon nosebleeds, bloody urine and vomiting, and black stools. The liver becomes swollen and painful. Disseminated intravascular coagulation may occur as well as acute kidney failure and shock, and sometimes acute respiratory distress syndrome.

Patients usually begin to recover after 9–10 days from symptom onset, but 30% die in the second week of illness.

Prevention

Where mammal and tick infection is common agricultural regulations require de-ticking farm animals before transportation or delivery for slaughter. Personal tick avoidance measures are recommended, such as use of insect repellents, adequate clothing and body inspection for adherent ticks.

When feverish patients with evidence of bleeding require resuscitation or intensive care, body substance isolation precautions should be taken.

The United States armed forces maintain special stocks of ribavirin to protect personnel deployed to Afghanistan and Iraq from CCHF.

Treatment

Treatment is primarily symptomatic and supportive, as there is no established specific treatment. Ribavirin is effective in vitro[1] and has been used during outbreaks,[2] but there is no trial evidence to support its use.

Epidemiology

Vectors

Sporadic infection of people is usually caused by Hyalomma tick bite. Clusters of illness typically appear after people treat, butcher or eat infected livestock, particularly ruminants and ostriches. Outbreaks have occurred in clinical facilities where health workers have been exposed to infected. blood and fomites.

The causative organism is found in Asia, Eastern Europe, the Middle East, a belt across central Africa and South Africa and Madagascar (see map [3]) The main environmental reservoir for the virus is small mammals (particularly European hare, Middle-African hedgehogs and multimammate rats). Ticks carry the virus to domestic animal stock. Sheep, goats and cattle develop high titers of virus in blood, but tend not to fall ill. Birds are generally resistant with the exception of ostriches.

Outbreaks

During the summers of 1944 and 1945 over 200 cases of an acute, hemorrhagic, febrile illness occurred in Soviet troops rescuing the harvest following the ethnic cleansing of the Crimean Tatars. Virus was discovered in blood samples of patients and in the tick Hyalomma marginatum marginatum. Researchers soon recognized that a similar disease had been occurring in the Central Asian Republics. In 1969 analysis of a preserved blood sample collected from a febrile child in Zaire in 1956 showed the same virus. This finding gave rise to the present name of the disease.

On July 28, 2005 authorities reported 41 cases of CCHF in Turkey's Yozgat Province, with one death. As of August 2008, a total of 50 people were reported to have lost their lives in various cities in Turkey due to CCHF. 3128 Crimean-Congo hemorrhagic fever cases with 5% of case-fatality rate have been reported by the Ministry of Health of Turkey between 2002-2008.

References

  1. Watts DM, Ussery MA, Nash D, Peters CJ. (1989). "Inhibition of Crimean-Congo hemorrhagic fever viral infectivity yields in vitro by ribavirin". Am J Trop Med Hyg. 41: 581–5. PMID 2510529. 
  2. Ergönül Ö, Celikbas A, Dokuzoguz B, et al. (2004). "The chacteristics of Crimean-Congo hemorrhagic fever in a recent outbreak in Turkey and the impact of oral ribavirin therapy". Clin Infect Dis 39: 285–9. doi:10.1086/422000. PMID 15307042. http://www.journals.uchicago.edu/cgi-bin/resolve?CID32782. 
  3. Map

External links


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