Distribution pattern of Crimean–Congo Hemorrhagic Fever in Asia and the Middle East

Abstract

Crimean–Congo Hemorrhagic Fever (CCHF) is one of the most important vector-borne diseases of zoonotic potential that can be acquired following the bite of the Hyalomma species of ticks. It is a highly prevalent disease in Asia and the Middle East. The risk factors of this disease are contact with infected tissue, blood, patient, or livestock in the acute viremic phase, infected tick bites, or the manual removal of ticks. The disease is clinically described as progressive hemorrhages, fever, and pain in musculature. Biochemical tests reveal elevated levels of creatinine phosphokinase, alanine transaminase, aspartate aminotransferase, and lactate dehydrogenase. Clotting time is prolonged in pro-thrombin tests, and pathogenesis is mostly related to the disruption of the epithelium during viral replication and indirectly by secreting cytotoxic molecules. These molecules cause endothelial activation and result in the loss of function. Supportive therapy is given through blood or plasma infusions to treat or manage the patients. According to the most advanced studies, CCHF can be treated by Ribavirin, which is an antiviral drug that shows excellent results in preventing the disease. Health-care staff are more prone to infection. The hemorrhagic phase represents a high risk for accidental exposures. This literature review presents a comprehensive overview of the viral epidemiology, zoonotic perspectives, and significant risk factors of CCHF in various Middle East and Asian countries. Furthermore, the pathophysiology and preventive strategies of CCHF have also been discussed as well as legislation and policies regarding public outreach programs, research, and development aimed at infection prevention and control that are required at a global level.

Temporal tendency, seasonality and relationship with climatic factors of Crimean-Congo Hemorrhagic Fever cases (East of Turkey: 2012–2021)

“…However, it should be noted that CF does not directly affect the incidence of CCHF in humans. Case numbers are probably affected by the changes in the living conditions of ticks because of CF, as well as by the factors listed earlier and their combinations [ 3 , 9 , 28 , 29 ]. In addition, some studies indicate that geographical location, small settlements that can be defined as rural, and altitude may be important variables in estimating the dynamics of CCHF occurrence [ 6 , 9 , 17 , 19 , 30 ].…”

Tick-borne viruses and their risk to public health in the Caribbean: Spotlight on bats as reservoirs in Cuba

“…Multiple tick species can serve as carriers for CCHF, with the Ixodes genus being the most efficient, and within it, Hyalomma marginatum acting as the primary vector. Other tick species, including Hyalomma aegyptium , Hyalomma schulzei , Hyalomma onatoli , Hyalomma dromedarii , Hyalomma rufipes , Hyalomma excavatum , Hyalomma anatolicum , R. sanguineus , Rhipicephalus turanicus , Rhipicephalus annulatus , Haemaphysalis punctata , A. variegatum , and Hyalomma truncatum , among others, also have the potential to transmit the virus [ 23 ].…”

Distinguishing host responses, extensive viral dissemination and long-term viral RNA persistence in domestic sheep experimentally infected with Crimean-Congo hemorrhagic fever virus Kosovo Hoti

“…There have been emerging signs that CCHFV is expanding into new territories such as Western Europe, which may be facilitated by emergence of favorable ecological environment driven by climate change and introduction of infected ticks by migratory birds or livestock trade [1,4,[8][9][10][11][12][13]. In recent years there has been a trend of rising global incidence of CCHFV infections, with greatly increasing case numbers reported from several major endemic countries, demonstrating an imminent public health impact of this re-emerging virus [14][15][16][17][18][19][20][21][22].…”