Crimean-Congo hemorrhagic fever

History, epidemiology, pathogenesis, clinical syndrome and genetic diversity

Dennis Bente, Naomi L. Forrester, Douglas M. Watts, Alexander J. McAuley, Chris A. Whitehouse, Mike Bray

Research output: Contribution to journalArticle

244 Citations (Scopus)

Abstract

Crimean-Congo hemorrhagic fever (CCHF) is the most important tick-borne viral disease of humans, causing sporadic cases or outbreaks of severe illness across a huge geographic area, from western China to the Middle East and southeastern Europe and throughout most of Africa. CCHFV is maintained in vertical and horizontal transmission cycles involving ixodid ticks and a variety of wild and domestic vertebrates, which do not show signs of illness. The virus circulates in a number of tick genera, but Hyalomma ticks are the principal source of human infection, probably because both immature and adult forms actively seek hosts for the blood meals required at each stage of maturation. CCHF occurs most frequently among agricultural workers following the bite of an infected tick, and to a lesser extent among slaughterhouse workers exposed to the blood and tissues of infected livestock and medical personnel through contact with the body fluids of infected patients. CCHFV is the most genetically diverse of the arboviruses, with nucleotide sequence differences among isolates ranging from 20% for the viral S segment to 31% for the M segment. Viruses with diverse sequences can be found within the same geographic area, while closely related viruses have been isolated in far distant regions, suggesting that widespread dispersion of CCHFV has occurred at times in the past, possibly by ticks carried on migratory birds or through the international livestock trade. Reassortment among genome segments during co-infection of ticks or vertebrates appears to have played an important role in generating diversity, and represents a potential future source of novel viruses. In this article, we first review current knowledge of CCHFV, summarizing its molecular biology, maintenance and transmission, epidemiology and geographic range. We also include an extensive discussion of CCHFV genetic diversity, including maps of the range of the virus with superimposed phylogenetic trees. We then review the features of CCHF, including the clinical syndrome, diagnosis, treatment, pathogenesis, vaccine development and laboratory animal models of CCHF. The paper ends with a discussion of the possible future geographic range of the virus. For the benefit of researchers, we include a Supplementary Table listing all published reports of CCHF cases and outbreaks in the English-language literature, plus some principal articles in other languages, with total case numbers, case fatality rates and all CCHFV strains on GenBank.

Original languageEnglish (US)
Pages (from-to)159-189
Number of pages31
JournalAntiviral Research
Volume100
Issue number1
DOIs
StatePublished - 2013

Fingerprint

Crimean Hemorrhagic Fever
Congo
Ticks
Epidemiology
History
Viruses
Livestock
Disease Outbreaks
Vertebrates
Language
Tick-Borne Diseases
Tick Bites
Arboviruses
Abattoirs
Middle East
Nucleic Acid Databases
Body Fluids
Virus Diseases
Coinfection
Birds

Keywords

  • Arbovirus
  • Bunyavirus
  • Crimean-Congo hemorrhagic fever virus
  • Nairovirus
  • Tick-borne virus
  • Viral hemorrhagic fever

ASJC Scopus subject areas

  • Virology
  • Pharmacology

Cite this

Crimean-Congo hemorrhagic fever : History, epidemiology, pathogenesis, clinical syndrome and genetic diversity. / Bente, Dennis; Forrester, Naomi L.; Watts, Douglas M.; McAuley, Alexander J.; Whitehouse, Chris A.; Bray, Mike.

In: Antiviral Research, Vol. 100, No. 1, 2013, p. 159-189.

Research output: Contribution to journalArticle

Bente, Dennis ; Forrester, Naomi L. ; Watts, Douglas M. ; McAuley, Alexander J. ; Whitehouse, Chris A. ; Bray, Mike. / Crimean-Congo hemorrhagic fever : History, epidemiology, pathogenesis, clinical syndrome and genetic diversity. In: Antiviral Research. 2013 ; Vol. 100, No. 1. pp. 159-189.
@article{bb142a696f9249ac85f69266c07aa35a,
title = "Crimean-Congo hemorrhagic fever: History, epidemiology, pathogenesis, clinical syndrome and genetic diversity",
abstract = "Crimean-Congo hemorrhagic fever (CCHF) is the most important tick-borne viral disease of humans, causing sporadic cases or outbreaks of severe illness across a huge geographic area, from western China to the Middle East and southeastern Europe and throughout most of Africa. CCHFV is maintained in vertical and horizontal transmission cycles involving ixodid ticks and a variety of wild and domestic vertebrates, which do not show signs of illness. The virus circulates in a number of tick genera, but Hyalomma ticks are the principal source of human infection, probably because both immature and adult forms actively seek hosts for the blood meals required at each stage of maturation. CCHF occurs most frequently among agricultural workers following the bite of an infected tick, and to a lesser extent among slaughterhouse workers exposed to the blood and tissues of infected livestock and medical personnel through contact with the body fluids of infected patients. CCHFV is the most genetically diverse of the arboviruses, with nucleotide sequence differences among isolates ranging from 20{\%} for the viral S segment to 31{\%} for the M segment. Viruses with diverse sequences can be found within the same geographic area, while closely related viruses have been isolated in far distant regions, suggesting that widespread dispersion of CCHFV has occurred at times in the past, possibly by ticks carried on migratory birds or through the international livestock trade. Reassortment among genome segments during co-infection of ticks or vertebrates appears to have played an important role in generating diversity, and represents a potential future source of novel viruses. In this article, we first review current knowledge of CCHFV, summarizing its molecular biology, maintenance and transmission, epidemiology and geographic range. We also include an extensive discussion of CCHFV genetic diversity, including maps of the range of the virus with superimposed phylogenetic trees. We then review the features of CCHF, including the clinical syndrome, diagnosis, treatment, pathogenesis, vaccine development and laboratory animal models of CCHF. The paper ends with a discussion of the possible future geographic range of the virus. For the benefit of researchers, we include a Supplementary Table listing all published reports of CCHF cases and outbreaks in the English-language literature, plus some principal articles in other languages, with total case numbers, case fatality rates and all CCHFV strains on GenBank.",
keywords = "Arbovirus, Bunyavirus, Crimean-Congo hemorrhagic fever virus, Nairovirus, Tick-borne virus, Viral hemorrhagic fever",
author = "Dennis Bente and Forrester, {Naomi L.} and Watts, {Douglas M.} and McAuley, {Alexander J.} and Whitehouse, {Chris A.} and Mike Bray",
year = "2013",
doi = "10.1016/j.antiviral.2013.07.006",
language = "English (US)",
volume = "100",
pages = "159--189",
journal = "Antiviral Research",
issn = "0166-3542",
publisher = "Elsevier",
number = "1",

}

TY - JOUR

T1 - Crimean-Congo hemorrhagic fever

T2 - History, epidemiology, pathogenesis, clinical syndrome and genetic diversity

AU - Bente, Dennis

AU - Forrester, Naomi L.

AU - Watts, Douglas M.

AU - McAuley, Alexander J.

AU - Whitehouse, Chris A.

AU - Bray, Mike

PY - 2013

Y1 - 2013

N2 - Crimean-Congo hemorrhagic fever (CCHF) is the most important tick-borne viral disease of humans, causing sporadic cases or outbreaks of severe illness across a huge geographic area, from western China to the Middle East and southeastern Europe and throughout most of Africa. CCHFV is maintained in vertical and horizontal transmission cycles involving ixodid ticks and a variety of wild and domestic vertebrates, which do not show signs of illness. The virus circulates in a number of tick genera, but Hyalomma ticks are the principal source of human infection, probably because both immature and adult forms actively seek hosts for the blood meals required at each stage of maturation. CCHF occurs most frequently among agricultural workers following the bite of an infected tick, and to a lesser extent among slaughterhouse workers exposed to the blood and tissues of infected livestock and medical personnel through contact with the body fluids of infected patients. CCHFV is the most genetically diverse of the arboviruses, with nucleotide sequence differences among isolates ranging from 20% for the viral S segment to 31% for the M segment. Viruses with diverse sequences can be found within the same geographic area, while closely related viruses have been isolated in far distant regions, suggesting that widespread dispersion of CCHFV has occurred at times in the past, possibly by ticks carried on migratory birds or through the international livestock trade. Reassortment among genome segments during co-infection of ticks or vertebrates appears to have played an important role in generating diversity, and represents a potential future source of novel viruses. In this article, we first review current knowledge of CCHFV, summarizing its molecular biology, maintenance and transmission, epidemiology and geographic range. We also include an extensive discussion of CCHFV genetic diversity, including maps of the range of the virus with superimposed phylogenetic trees. We then review the features of CCHF, including the clinical syndrome, diagnosis, treatment, pathogenesis, vaccine development and laboratory animal models of CCHF. The paper ends with a discussion of the possible future geographic range of the virus. For the benefit of researchers, we include a Supplementary Table listing all published reports of CCHF cases and outbreaks in the English-language literature, plus some principal articles in other languages, with total case numbers, case fatality rates and all CCHFV strains on GenBank.

AB - Crimean-Congo hemorrhagic fever (CCHF) is the most important tick-borne viral disease of humans, causing sporadic cases or outbreaks of severe illness across a huge geographic area, from western China to the Middle East and southeastern Europe and throughout most of Africa. CCHFV is maintained in vertical and horizontal transmission cycles involving ixodid ticks and a variety of wild and domestic vertebrates, which do not show signs of illness. The virus circulates in a number of tick genera, but Hyalomma ticks are the principal source of human infection, probably because both immature and adult forms actively seek hosts for the blood meals required at each stage of maturation. CCHF occurs most frequently among agricultural workers following the bite of an infected tick, and to a lesser extent among slaughterhouse workers exposed to the blood and tissues of infected livestock and medical personnel through contact with the body fluids of infected patients. CCHFV is the most genetically diverse of the arboviruses, with nucleotide sequence differences among isolates ranging from 20% for the viral S segment to 31% for the M segment. Viruses with diverse sequences can be found within the same geographic area, while closely related viruses have been isolated in far distant regions, suggesting that widespread dispersion of CCHFV has occurred at times in the past, possibly by ticks carried on migratory birds or through the international livestock trade. Reassortment among genome segments during co-infection of ticks or vertebrates appears to have played an important role in generating diversity, and represents a potential future source of novel viruses. In this article, we first review current knowledge of CCHFV, summarizing its molecular biology, maintenance and transmission, epidemiology and geographic range. We also include an extensive discussion of CCHFV genetic diversity, including maps of the range of the virus with superimposed phylogenetic trees. We then review the features of CCHF, including the clinical syndrome, diagnosis, treatment, pathogenesis, vaccine development and laboratory animal models of CCHF. The paper ends with a discussion of the possible future geographic range of the virus. For the benefit of researchers, we include a Supplementary Table listing all published reports of CCHF cases and outbreaks in the English-language literature, plus some principal articles in other languages, with total case numbers, case fatality rates and all CCHFV strains on GenBank.

KW - Arbovirus

KW - Bunyavirus

KW - Crimean-Congo hemorrhagic fever virus

KW - Nairovirus

KW - Tick-borne virus

KW - Viral hemorrhagic fever

UR - http://www.scopus.com/inward/record.url?scp=84883067286&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84883067286&partnerID=8YFLogxK

U2 - 10.1016/j.antiviral.2013.07.006

DO - 10.1016/j.antiviral.2013.07.006

M3 - Article

VL - 100

SP - 159

EP - 189

JO - Antiviral Research

JF - Antiviral Research

SN - 0166-3542

IS - 1

ER -