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Prevalence of Crimean-Congo hemorrhagic fever virus in healthy population, livestock and ticks in Kosovo.

Fajs L, Humolli I, Saksida A, Knap N, Jelovšek M, Korva M, Dedushaj I, Avšič-Županc T - PLoS ONE (2014)

Bottom Line: Kosovo is a highly endemic area for CCHF, with a significant case fatality rate.Our results revealed a seroprevalence of 4.0% (range 0-9.3%) which is comparable to the seroprevalence in other countries.Our study provides key information for CCHF surveillance and raises awareness for possible imported cases in CCHF non-endemic countries.

View Article: PubMed Central - PubMed

Affiliation: Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.

ABSTRACT
Crimean-Congo hemorrhagic fever (CCHF) is an acute, tick borne disease often associated with hemorrhagic presentations and high case fatality rate. Kosovo is a highly endemic area for CCHF, with a significant case fatality rate. The aim of our study was to determine the prevalence of CCHF in Kosovo. We tested 1105 serum samples from healthy population in both endemic and non-endemic areas in the country. Our results revealed a seroprevalence of 4.0% (range 0-9.3%) which is comparable to the seroprevalence in other countries. We show that seroprevalence is correlated to the disease incidence in each studied municipality. We also tested 401 animal sera (353 cow, 30 sheep, 10 goat and 8 chicken) in four endemic municipalities in Kosovo. We detected specific antibodies in all animals except in chicken. Seroprevalence in cows is comparable to other endemic areas and correlates to the seroprevalence in humans. No CCHF RNA could be detected in 105 tick samples obtained in 2012 and 2013. Sequencing of CCHFV positive ticks from 2001 revealed that the virus is most closely related to viral strains that were detected in CCHF patients from Kosovo. Results suggest that mild CCHF cases are most probably underdiagnosed and consequently that the burden of disease is higher than reported. Our study provides key information for CCHF surveillance and raises awareness for possible imported cases in CCHF non-endemic countries.

No MeSH data available.


Related in: MedlinePlus

Prevalence of CCHF in Kosovo A. Cumulative incidence (per 100,000) of CCHF (from 1995 to 2013) in each municipality of Kosovo.Asterisk (*) represents a single reported CCHF case. B. Seroprevalence of CCHF in healthy human population in the studied municipalities of Kosovo and the number of tested sera in each municipality (in brackets), C. CCHF seroprevalence in cows in the studied municipalities of Kosovo, D. maximum likelihood phylogenetic analysis (with 1000 bootstrap) of partial (260 bp) CCHFV S segment nucleotide sequences. The map shows the municipalities where ticks were collected (green and red) and the municipality (red) of the positive ticks that were included in the study for CCHFV sequencing. Designations A1 and A3 represent Kosovo CCHFV sub-lineages described by Fajs et al. [27].
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pone-0110982-g001: Prevalence of CCHF in Kosovo A. Cumulative incidence (per 100,000) of CCHF (from 1995 to 2013) in each municipality of Kosovo.Asterisk (*) represents a single reported CCHF case. B. Seroprevalence of CCHF in healthy human population in the studied municipalities of Kosovo and the number of tested sera in each municipality (in brackets), C. CCHF seroprevalence in cows in the studied municipalities of Kosovo, D. maximum likelihood phylogenetic analysis (with 1000 bootstrap) of partial (260 bp) CCHFV S segment nucleotide sequences. The map shows the municipalities where ticks were collected (green and red) and the municipality (red) of the positive ticks that were included in the study for CCHFV sequencing. Designations A1 and A3 represent Kosovo CCHFV sub-lineages described by Fajs et al. [27].

Mentions: Forty-four participants (4.0%) had detectable IgG antibodies to CCHFV. The highest seroprevalence was observed in the hyper-endemic regions of Klinë (9.3%), Rahovec (9.0%) and Malishevë (7.1%) (Figure 1A). Overall seroprevalence is comparable to other endemic countries in the Balkan region, Bulgaria (2.8%) [16], Greece (4.2%) [18] and Turkey (2.3%) [19] and notably lower than in earlier reports from Turkey (10–19.6%) [20]–[22]. Rather higher seroprevalence in these reports reflects the extreme rise in CCHF incidence in Turkey in the last 10 years [6] and probably also the differences in sampling. Namely, only highly CCHF endemic areas were included in these studies in Turkey. Thereby, seroprevalence in the hyper-endemic areas in Kosovo is comparable to the reports from Turkey. Since the overall seroprevalence rates in both countries are comparable, our results suggest that there is a high rate of unapparent infections in Kosovo. In this view the burden of CCHF is most probably even higher than reported.


Prevalence of Crimean-Congo hemorrhagic fever virus in healthy population, livestock and ticks in Kosovo.

Fajs L, Humolli I, Saksida A, Knap N, Jelovšek M, Korva M, Dedushaj I, Avšič-Županc T - PLoS ONE (2014)

Prevalence of CCHF in Kosovo A. Cumulative incidence (per 100,000) of CCHF (from 1995 to 2013) in each municipality of Kosovo.Asterisk (*) represents a single reported CCHF case. B. Seroprevalence of CCHF in healthy human population in the studied municipalities of Kosovo and the number of tested sera in each municipality (in brackets), C. CCHF seroprevalence in cows in the studied municipalities of Kosovo, D. maximum likelihood phylogenetic analysis (with 1000 bootstrap) of partial (260 bp) CCHFV S segment nucleotide sequences. The map shows the municipalities where ticks were collected (green and red) and the municipality (red) of the positive ticks that were included in the study for CCHFV sequencing. Designations A1 and A3 represent Kosovo CCHFV sub-lineages described by Fajs et al. [27].
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4230912&req=5

pone-0110982-g001: Prevalence of CCHF in Kosovo A. Cumulative incidence (per 100,000) of CCHF (from 1995 to 2013) in each municipality of Kosovo.Asterisk (*) represents a single reported CCHF case. B. Seroprevalence of CCHF in healthy human population in the studied municipalities of Kosovo and the number of tested sera in each municipality (in brackets), C. CCHF seroprevalence in cows in the studied municipalities of Kosovo, D. maximum likelihood phylogenetic analysis (with 1000 bootstrap) of partial (260 bp) CCHFV S segment nucleotide sequences. The map shows the municipalities where ticks were collected (green and red) and the municipality (red) of the positive ticks that were included in the study for CCHFV sequencing. Designations A1 and A3 represent Kosovo CCHFV sub-lineages described by Fajs et al. [27].
Mentions: Forty-four participants (4.0%) had detectable IgG antibodies to CCHFV. The highest seroprevalence was observed in the hyper-endemic regions of Klinë (9.3%), Rahovec (9.0%) and Malishevë (7.1%) (Figure 1A). Overall seroprevalence is comparable to other endemic countries in the Balkan region, Bulgaria (2.8%) [16], Greece (4.2%) [18] and Turkey (2.3%) [19] and notably lower than in earlier reports from Turkey (10–19.6%) [20]–[22]. Rather higher seroprevalence in these reports reflects the extreme rise in CCHF incidence in Turkey in the last 10 years [6] and probably also the differences in sampling. Namely, only highly CCHF endemic areas were included in these studies in Turkey. Thereby, seroprevalence in the hyper-endemic areas in Kosovo is comparable to the reports from Turkey. Since the overall seroprevalence rates in both countries are comparable, our results suggest that there is a high rate of unapparent infections in Kosovo. In this view the burden of CCHF is most probably even higher than reported.

Bottom Line: Kosovo is a highly endemic area for CCHF, with a significant case fatality rate.Our results revealed a seroprevalence of 4.0% (range 0-9.3%) which is comparable to the seroprevalence in other countries.Our study provides key information for CCHF surveillance and raises awareness for possible imported cases in CCHF non-endemic countries.

View Article: PubMed Central - PubMed

Affiliation: Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.

ABSTRACT
Crimean-Congo hemorrhagic fever (CCHF) is an acute, tick borne disease often associated with hemorrhagic presentations and high case fatality rate. Kosovo is a highly endemic area for CCHF, with a significant case fatality rate. The aim of our study was to determine the prevalence of CCHF in Kosovo. We tested 1105 serum samples from healthy population in both endemic and non-endemic areas in the country. Our results revealed a seroprevalence of 4.0% (range 0-9.3%) which is comparable to the seroprevalence in other countries. We show that seroprevalence is correlated to the disease incidence in each studied municipality. We also tested 401 animal sera (353 cow, 30 sheep, 10 goat and 8 chicken) in four endemic municipalities in Kosovo. We detected specific antibodies in all animals except in chicken. Seroprevalence in cows is comparable to other endemic areas and correlates to the seroprevalence in humans. No CCHF RNA could be detected in 105 tick samples obtained in 2012 and 2013. Sequencing of CCHFV positive ticks from 2001 revealed that the virus is most closely related to viral strains that were detected in CCHF patients from Kosovo. Results suggest that mild CCHF cases are most probably underdiagnosed and consequently that the burden of disease is higher than reported. Our study provides key information for CCHF surveillance and raises awareness for possible imported cases in CCHF non-endemic countries.

No MeSH data available.


Related in: MedlinePlus