Scoping Review of Crimean-Congo Hemorrhagic Fever (CCHF) Literature and Implications of Future Research

Wahid, Braira; Altaf, Saba; Naeem, Nabiha; Ilyas, Nimra; Idrees, Muhammad

doi:10.29271/jcpsp.2019.06.563

Cited by 22 publications

(18 citation statements)

References 90 publications

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“…Another study carried out in the same region during 1997-2002 involving 83 laboratory confirmed CCHF patients revealed a mortality of 9.6% [15]. During 2003-2006, 42 deaths (12.8%) were reported due to CCHF across Pakistan [9]. Similarly, a study involving the investigation of CCHF in patients belonging to 5 districts of Balochistan during 2011 showed a mortality rate of 20.4% [14].…”

Section: Discussionmentioning

confidence: 95%

“…The outcome of the treatment was a nosocomial outbreak in the hospital staff resulting in three fatalities including a surgeon [8]. Since 1976, several sporadic outbreaks of CCHF have been described in Pakistani population and during 2010-2014 a total of 286 cases with a case fatality rate (CFR) of 20-29% was reported [9]. An alarming rise in CCHF cases was observed in 2016 with 86 positive cases and 41% CFR [10].…”

Section: Introductionmentioning

confidence: 99%

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Genetic diversity and phylogenetic analysis of Crimean-Congo Hemorrhagic Fever viruses circulating in Pakistan during 2019

et al. 2020

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Being an endemic country for Crimean Congo hemorrhagic fever (CCHF), this study aimed to explore the genetic diversity of CCHF virus (CCHFV) detected in Pakistan during 2019. Serum samples from patients with clinical signs of hemorrhagic fever attending tertiary care hospitals in Pakistan were tested for CCHFV RNA using real-time PCR at Department of Virology, National Institute of Health. The partial S-gene fragments were directly sequenced to determine the prevailing CCHFV genotypes and their molecular epidemiology in Pakistan. During January-December 2019, 280 samples from suspected CCHF patients were tested and 28 (10%) were found positive on real-time PCR. Positive cases were detected from 14 districts and across all four provinces of Pakistan with majority reported during August-September. The mean age of CCHFV positive patients was 37.25 years (range 5-65 years) with a high frequency in males (92.8%; n = 26) and a case fatality rate of 40.7% was observed. Phylogenetic analysis showed that S-segment of 2019 PAK CCHFV strains (n = 13) belonged to Asia-1 genotype and clustered with regional strains from Iran, Oman, and Afghanistan. We conclude that Asia-1 genotype of CCHF virus remains endemic in Pakistan. Our findings emphasize to establish a laboratory based surveillance program to monitor the disease burden and identify outbreak hotspots for effective control.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

Genetic diversity and phylogenetic analysis of Crimean-Congo Hemorrhagic Fever viruses circulating in Pakistan during 2019

et al. 2020

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“…Its spatial distribution drivers include long-distance live animal trade, habitat fragmentation, expansion of agricultural/cultivation lands, and increase in environmental mean temperatures [17,25]. Migratory birds are also implicated in the spread of CCHFV by carrying infected ticks over long distances [26,27].…”

Section: Introductionmentioning

confidence: 99%

Seroprevalence and Risk Factors of Crimean-Congo Hemorrhagic Fever in Cattle of Smallholder Farmers in Central Malawi

et al. 2021

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Crimean-Congo hemorrhagic fever virus (CCHFV) is endemic in Africa, Asia, and Eastern Europe where it circulates among animals and ticks causing sporadic outbreaks in humans. Although CCHF is endemic in sub-Saharan Africa, epidemiological information is lacking in many countries, including Malawi. To assess the risk of CCHF in Malawi, we conducted an epidemiological study in cattle reared by smallholder livestock farmers in central Malawi. A cross-sectional study was conducted in April 2020 involving seven districts, four from Kasungu and three from Lilongwe Agriculture Development Divisions. A structured questionnaire was administered to farmers to obtain demographic, animal management, and ecological risk factors data. Sera were collected from randomly selected cattle and screened for CCHF virus (CCHFV) specific antibodies using a commercial ELISA kit. Ticks were collected from cattle and classified morphologically to species level. An overall CCHFV seropositivity rate of 46.9% (n = 416; 95% CI: 42.0–51.8%) was observed. The seropositivity was significantly associated with the age of cattle (p < 0.001), sex (p < 0.001), presence of ticks in herds (p = 0.01), district (p = 0.025), and type of grazing lands (p = 0.013). Five species of ticks were identified, including Hyalomma truncatum, a known vector of CCHFV. Ticks of the species Hyalomma truncatum were not detected in two districts with the highest seroprevalence for CCHF and vector competency must be further explored in the study area. To our knowledge, this is the first report of serologic evidence of the presence of CCHV among smallholder cattle in central Malawi. This study emphasizes the need for continued monitoring of CCHFV infection among livestock, ticks, and humans for the development of data-based risk mitigation strategies.

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“…They discussed that despite the evidence suggesting that oral ribavirin therapy is effective against CCHF, a recent study did not show its efficacy in reducing mortality rate, so its role in the treatment of CCHF patients is controversial. Specific immunoglobulin against CCHF may be used as a novel therapy for CCHF, but the data about its efficacy is not sufficient (12).…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review of Treatment Strategies Including Future Novel Therapies in Crimean-Congo Hemorrhagic Fever

Kouhpayeh

2021

Int J Infect

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Introduction: Crimean-Congo hemorrhagic fever (CCHF) is an acute fetal illness the case fatality rate (CFR), which without treatment is between 26% to more than 80%. Despite the administration of ribavirin as a specific antiviral drug for the treatment of CCHF from many years ago, its clinical efficacy is still controversial. Objectives: This systematic review aimed to evaluate the clinical efficacy of ribavirin, favipiravir, and other treatment options for CCHF, including steroids, immunoglobulin, etc. Method: This systematic review included 31 articles, three factsheet from WHO, CDC, and ECDC, two editorial letters, and two textbooks from 2002 to 2020. The following databases were searched: Google Scholar, PubMed, Medscape, Cochrane, WHO, CDC, and ECDC. Results: The selected results of the above articles were concentrated on the different options of supportive treatment, including steroids, immunoglobulin, etc., as well as the efficacy of antiviral drugs, especially ribavirin and favipiravir. While some studies confirmed the clinical efficacy of ribavirin in the treatment of CCHF, some other studies did not confirm its efficacy. All studies justified that supportive therapies are the mainstay of treatment. Conclusions: The cornerstone of therapy of CCHF is supportive treatment. The clinical efficacy of ribavirin for CCHF treatment is questionable, and further randomized case-control clinical trials are required to confirm and recommend it for CCHF treatment. Also, other treatment strategies, including administration of steroids, immunoglobulin, and monoclonal antibodies (mAbs) require more conclusive data. The promising antiviral drug for CCHF treatment is favipiravir.

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Scoping Review of Crimean-Congo Hemorrhagic Fever (CCHF) Literature and Implications of Future Research

Cited by 22 publications

References 90 publications

Genetic diversity and phylogenetic analysis of Crimean-Congo Hemorrhagic Fever viruses circulating in Pakistan during 2019

Genetic diversity and phylogenetic analysis of Crimean-Congo Hemorrhagic Fever viruses circulating in Pakistan during 2019

Seroprevalence and Risk Factors of Crimean-Congo Hemorrhagic Fever in Cattle of Smallholder Farmers in Central Malawi

A Systematic Review of Treatment Strategies Including Future Novel Therapies in Crimean-Congo Hemorrhagic Fever

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