Genetic analysis and epidemiology of Crimean Congo hemorrhagic fever viruses in Baluchistan province of Pakistan

Abstract

BackgroundPakistan is considered as an endemic country for Crimean-Congo Hemorrhagic fever with numerous outbreaks and sporadic cases reported during the past two decades. Majority of cases are reported from Baluchistan province with subsequent transmissions to non-endemic regions mainly through infected animals directly or via infested ticks. We hereby describe the molecular investigations of CCHF cases reported during 2008 in Quetta city of Baluchistan province.MethodsSerum Samples from 44 patients, with clinical signs of hemorrhagic fever attending a tertiary care hospital in Quetta city, were collected and tested for CCHF virus antigen and genomic RNA, using capture IgM EIA kit and standard RT-PCR assay, respectively. The partial S-gene fragments were directly sequenced to get information related to the prevailing CCHFV genotypes and their molecular epidemiology in Pakistan.ResultsOut of the total forty four, sixteen (36%) samples were found positive for CCHF IgM. Similarly, viral RNA was detected in six (16%) samples. Phylogenetic analysis revealed that all study viruses belong to genotype Asia-1 with closest similarity (99-100%) to the previously reported strains from Pakistan, Afghanistan and Iran.ConclusionWe conclude that CCHF virus remains endemic within Baluchistan and its neighboring regions of Afghanistan warranting a need of incessant surveillance activities.

Crimean-Congo hemorrhagic fever and its relationship with climate factors in southeast Iran: a 13-year experience

“…It is worth mentioning that CCHF is also endemic in both Afghanistan and Pakistan; without a doubt, livestock trading, traveling, and the movement of nomadic populations between the two sides of the border influences the epidemiology of the disease in both the animal and human sectors [7,14,19,20].…”

“…Several studies have discussed the relationship between the climatic factors and the vector's lifecycle, ecological conditions, and, consequently, the occurrence of CCHF in human populations [1,[4][5][6]. In addition to climate variables, there are some other epidemiologic factors that influence the occurrence of CCHF that should be considered in controlling the disease [7][8][9].…”

Crimean-Congo hemorrhagic fever: Risk factors and control measures for the infection abatement

“…There are certain other Hyalomma species, which are three-host ticks as they drop off their host following each molt (3). Another factor responsible for the transmission of CCHF is the migration of infected livestock populations from infected areas to new areas (23).…”

Crimean-Congo Hemorrhagic Fever: What Do We Know about Pulmonary Injury? A Compilation of Evidence

“…They realized that dyspnoea and cough were common symptoms, but haemoptysis was only present in Discussion CCHF incidence and prevalence have increased recently with more than 1000 cases reported from southeastern Europe and western Asia each year [9]. This is important because fatality rates in hospitalized patients have reached approximately 50% and death occurs mainly due to disseminated intravascular coagulation and multi organ failure [11][12][13][14][15][16][17][18][19][20][21]. There are no specific treatment or vaccine prophylaxes at this moment.…”

“…Therefore, people who work with these animals (eg: butchers) are considered to be at risk. Livestock and bird migratory patterns can also affect spread of infection [1,2,5,[10][11][12][13][14][15]. Person to person transmission can occur through contact with six cases.…”