Crimean-Congo hemorrhagic fever (CCHF) is a potentially fatal disease caused by a tick-borne virus in the family Bunyavridae. The disease occurs in parts of Africa, Asia, Middle East, and Eastern Europe. During recent years, an increasing number of human CCHF cases have been diagnosed in Iran, but very little information is available on the prevalence and genetic diversity of CCHFV in Iran. In the present study, CCHF virus (CCHFV) isolates from nine Iranian patients infected during 2002 were examined genetically. Nucleotide sequencing of the S- and M-segments, encoding the nucleocapsid protein (NP) and the glycoproteins, respectively, revealed that the different isolates were related closely to each other with nucleotide sequence identities exceeding 98% for both S- and M-segments. Phylogenetic analysis of partial S-segment nucleotide sequences showed that the viruses clustered along with strains from Pakistan and Madagascar in one distinct lineage. Phylogenetic analysis also demonstrated that the Iranian isolates examined in this study and the previously published CCHFV strain ArTeh193-3 clustered into different genetic groups, indicating that at least two genetic lineages of CCHFV could be co-circulating in Iran.

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Crimean-Congo haemorrhagic fever (CCHF) is a viral zoonotic disease with a high mortality rate in humans. The CCHF virus is transmitted to humans through the bite of Ixodid ticks or contact with blood or tissues of CCHF patients or infected livestock. In December 2008, a re-emerging outbreak of CCHF occurred in the southern part of Iran. Five people were hospitalised with sudden fever and haemorrhaging, and CCHF was confirmed by RT-PCR and serological assays. One of the cases had a fulminant course and died. Livestock was identified as the source of infection; all animals in the incriminated herd were serologically analysed and more than half of them were positive for CCHFV. We demonstrated that two routes of transmission played a role in this outbreak: contact with tissue and blood of infected livestock, and nosocomial transmission. Phylogenetic analyses helped to identify the origin of this transmission. This outbreak should be considered as a warning for the national CCHF surveillance system to avoid further outbreaks through robust prevention and control programmes.

e32413th International Congress on Infectious Diseases Abstracts, Poster Presentations Australia) detect interferon-gamma (IFN-␥) production in whole blood samples in response to stimulation with TB antigens. The role of QFT and Tuberculin skin test (TST) in the diagnosis of active TB among adults in high burden countries is not clear.Methods: We prospectively evaluated pulmonary and extrapulmonary TB suspects from a tertiary center in India, in a blinded comparison of new diagnostic tests. We aim to recruit 200 patients for the study. The blood samples collected from the patients were processed as per manufacturers instructions. The cut off for positivity used was 0.35 IU/ml. TST was performed using 2TU dose and 10 mm or greater was considered positive. Both were evaluated against a combined gold standard of solid (Lowenstein Jensen) and liquid (BACTEC 460 TB) culture.Results: To date the results of QFT and culture for 51 patients are available. Four indeterminate results were not included. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of QFT for culture positive TB were 81% (54-95), 67% (47-82), 57% (35-76) and 87% (65-96) respectively. 52 patients had TST and culture results available. The sensitivity, specificity, PPV and NPV of TST for culture positive TB were 68% (45-85), 50% (32-68), 50% (32-68) and 68% (45-85) respectively.Conclusion: QFT has adequate sensitivity but poor specificity to detect active TB in India. QFT shows a trend to better sensitivity than TST. As expected, latent TB infection causes false positives. QFT is a single visit test with good negative predictive value but should not be used alone to rule out active TB.Background: Conventional cultures for TB have limitations. Solid media cultures are time consuming and liquid cultures are too expensive for developing countries. MODS is thought to be more sensitive, more rapid and less expensive than conventional culture because it detects early growth at a microscopic level.Methods: We prospectively evaluated pulmonary and extrapulmonary TB suspects who met inclusion criteria, from a tertiary center in India, in a blinded comparison of new diagnostics. We aim to recruit 200 patients for the study. Specimens were pretreated with NALC/NaOH and inoculated into 7H9 middlebrook liquid media with OADC and PANTA in a 24 well tissue culture plate and incubated at 37 • C incubator. The liquid media was observed daily using an inverted microscope for 'cording' growth typical of M. tuberculosis complex. MODS was evaluated against combined gold standard of solid and liquid (BACTEC 460 TB) culture.Results: The results of 67 patients are available to date and were included in this analysis. The sensitivity, speci-ficity, PPV, NPV of MODS for detection were 65% (41-84), 73% (54-87), 62% (39-81) and 76% (56-89) respectively. The mean time to detection was 12.8 (±1.0) days for MODS, and 11 (±1.0), 28 days for BACTEC and culture on Lowenstein Jensen media respectively. The basic cost of MODS which is Rs.250 INR i...

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Through 3 different phases, PA indicators for 4 phases of a chain of results were developed. The authors believe that these PA indicators can assess the system's performance and its achievements in response to disasters. (Disaster Med Public Health Preparedness. 2018;page 1 of 7).

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