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Multiple Crimean-Congo hemorrhagic fever virus strains are associated with disease outbreaks in Sudan, 2008-2009.

Aradaib IE, Erickson BR, Karsany MS, Khristova ML, Elageb RM, Mohamed ME, Nichol ST - PLoS Negl Trop Dis (2011)

Bottom Line: Since 2008, several sporadic cases and nosocomial outbreaks associated with high case-fatality have been reported in villages and rural hospitals in the region.In the present study, we describe a cluster of cases occurring in June 2009 in Dunkop village, Abyei District, South Kordufan, Sudan.Seven CCHF cases were involved in the outbreak; however, clinical specimens could be collected from only two patients, both of whom were confirmed as acute CCHF cases using CCHF-specific reverse transcriptase polymerase chain reaction (RT-PCR).

View Article: PubMed Central - PubMed

Affiliation: Molecular Biology Laboratory, Department of Clinical Medicine, Faculty of Veterinary Medicine, University of Khartoum, Khartoum North, Sudan.

ABSTRACT

Background: Crimean-Congo hemorrhagic fever (CCHF) activity has recently been detected in the Kordufan region of Sudan. Since 2008, several sporadic cases and nosocomial outbreaks associated with high case-fatality have been reported in villages and rural hospitals in the region.

Principal findings: In the present study, we describe a cluster of cases occurring in June 2009 in Dunkop village, Abyei District, South Kordufan, Sudan. Seven CCHF cases were involved in the outbreak; however, clinical specimens could be collected from only two patients, both of whom were confirmed as acute CCHF cases using CCHF-specific reverse transcriptase polymerase chain reaction (RT-PCR). Phylogenetic analysis of the complete S, M, and L segment sequences places the Abyei strain of CCHF virus in Group III, a virus group containing strains from various countries across Africa, including Sudan, South Africa, Mauritania, and Nigeria. The Abyei strain detected in 2009 is genetically distinct from the recently described 2008 Sudanese CCHF virus strains (Al-fulah 3 and 4), and the Abyei strain S and L segments closely match those of CCHF virus strain ArD39554 from Mauritania.

Conclusions: The present investigation illustrates that multiple CCHF virus lineages are circulating in the Kordufan region of Sudan and are associated with recent outbreaks of the disease occurring during 2008-2009.

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Related in: MedlinePlus

Map of Sudan showing the location of Abyei and Al-fulah towns in Kordufan region, Sudan.
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pntd-0001159-g001: Map of Sudan showing the location of Abyei and Al-fulah towns in Kordufan region, Sudan.

Mentions: During June 2009, seven patients meeting the hemorrhagic fever (HF) case definition were identified from Dunkop village. Dunkop village is located 15 kilometers to the east of Abyei in the former state of Western Kordufan, Sudan, an area that is shared in part by the government of South Sudan and the government of National Unity, Sudan. The population in Abyei District includes the nomadic Arab tribes of Misariya from the north and the Nilotic tribes of Dinka from the south. Transport from Dunkop village to the hospital in Abyei town is extremely difficult, if not impossible, during the rainy season, which includes the month of June. When passable, the distance between the primary-care centers and the surrounding villages is usually crossed by walking; therefore, evacuation of suspect cases from Dunkop village to Abyei hospital was not possible for all patients due to poor road conditions and prevailing insecurity at the time. Of the five patients able to travel to Abyei hospital, two died and one was discharged before samples could be collected for laboratory testing. Given the proximity of approximately 250 kilometers from Al-fulah (Figure 1), the location of a nosocomial outbreak of CCHF in October 2008, CCHF was considered as a possible cause of the HF illness [14]. Blood samples were available from two patients with signs of acute HF illness. The extracted RNA samples were used in RT-PCR as targets for CCHF definitive diagnosis and subsequent sequencing.


Multiple Crimean-Congo hemorrhagic fever virus strains are associated with disease outbreaks in Sudan, 2008-2009.

Aradaib IE, Erickson BR, Karsany MS, Khristova ML, Elageb RM, Mohamed ME, Nichol ST - PLoS Negl Trop Dis (2011)

Map of Sudan showing the location of Abyei and Al-fulah towns in Kordufan region, Sudan.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3104971&req=5

pntd-0001159-g001: Map of Sudan showing the location of Abyei and Al-fulah towns in Kordufan region, Sudan.
Mentions: During June 2009, seven patients meeting the hemorrhagic fever (HF) case definition were identified from Dunkop village. Dunkop village is located 15 kilometers to the east of Abyei in the former state of Western Kordufan, Sudan, an area that is shared in part by the government of South Sudan and the government of National Unity, Sudan. The population in Abyei District includes the nomadic Arab tribes of Misariya from the north and the Nilotic tribes of Dinka from the south. Transport from Dunkop village to the hospital in Abyei town is extremely difficult, if not impossible, during the rainy season, which includes the month of June. When passable, the distance between the primary-care centers and the surrounding villages is usually crossed by walking; therefore, evacuation of suspect cases from Dunkop village to Abyei hospital was not possible for all patients due to poor road conditions and prevailing insecurity at the time. Of the five patients able to travel to Abyei hospital, two died and one was discharged before samples could be collected for laboratory testing. Given the proximity of approximately 250 kilometers from Al-fulah (Figure 1), the location of a nosocomial outbreak of CCHF in October 2008, CCHF was considered as a possible cause of the HF illness [14]. Blood samples were available from two patients with signs of acute HF illness. The extracted RNA samples were used in RT-PCR as targets for CCHF definitive diagnosis and subsequent sequencing.

Bottom Line: Since 2008, several sporadic cases and nosocomial outbreaks associated with high case-fatality have been reported in villages and rural hospitals in the region.In the present study, we describe a cluster of cases occurring in June 2009 in Dunkop village, Abyei District, South Kordufan, Sudan.Seven CCHF cases were involved in the outbreak; however, clinical specimens could be collected from only two patients, both of whom were confirmed as acute CCHF cases using CCHF-specific reverse transcriptase polymerase chain reaction (RT-PCR).

View Article: PubMed Central - PubMed

Affiliation: Molecular Biology Laboratory, Department of Clinical Medicine, Faculty of Veterinary Medicine, University of Khartoum, Khartoum North, Sudan.

ABSTRACT

Background: Crimean-Congo hemorrhagic fever (CCHF) activity has recently been detected in the Kordufan region of Sudan. Since 2008, several sporadic cases and nosocomial outbreaks associated with high case-fatality have been reported in villages and rural hospitals in the region.

Principal findings: In the present study, we describe a cluster of cases occurring in June 2009 in Dunkop village, Abyei District, South Kordufan, Sudan. Seven CCHF cases were involved in the outbreak; however, clinical specimens could be collected from only two patients, both of whom were confirmed as acute CCHF cases using CCHF-specific reverse transcriptase polymerase chain reaction (RT-PCR). Phylogenetic analysis of the complete S, M, and L segment sequences places the Abyei strain of CCHF virus in Group III, a virus group containing strains from various countries across Africa, including Sudan, South Africa, Mauritania, and Nigeria. The Abyei strain detected in 2009 is genetically distinct from the recently described 2008 Sudanese CCHF virus strains (Al-fulah 3 and 4), and the Abyei strain S and L segments closely match those of CCHF virus strain ArD39554 from Mauritania.

Conclusions: The present investigation illustrates that multiple CCHF virus lineages are circulating in the Kordufan region of Sudan and are associated with recent outbreaks of the disease occurring during 2008-2009.

Show MeSH
Related in: MedlinePlus