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Review
. 2019 Jan;24(5):1800093.
doi: 10.2807/1560-7917.ES.2019.24.5.1800093.

Laboratory management of Crimean-Congo haemorrhagic fever virus infections: perspectives from two European networks

Barbara Bartolini  1 , Cesare Em Gruber  1 , Marion Koopmans  2 , Tatjana Avšič  3 , Sylvia Bino  4 , Iva Christova  5 , Roland Grunow  6 , Roger Hewson  7 , Gulay Korukluoglu  8 , Cinthia Menel Lemos  9 , Ali Mirazimi  10   11   12 , Anna Papa  13 , Maria Paz Sanchez-Seco  14 , Aisha V Sauer  15 , Hervè Zeller  16 , Carla Nisii  1 , Maria Rosaria Capobianchi  1 , Giuseppe Ippolito  1 , Chantal B Reusken  17   18   2 , Antonino Di Caro  1   18
Affiliations
Review

Laboratory management of Crimean-Congo haemorrhagic fever virus infections: perspectives from two European networks

Barbara Bartolini et al. Euro Surveill. 2019 Jan.

Abstract

BackgroundCrimean-Congo haemorrhagic fever virus (CCHFV) is considered an emerging infectious disease threat in the European Union. Since 2000, the incidence and geographic range of confirmed CCHF cases have markedly increased, following changes in the distribution of its main vector, Hyalomma ticks.AimsTo review scientific literature and collect experts' opinion to analyse relevant aspects of the laboratory management of human CCHF cases and any exposed contacts, as well as identify areas for advancement of international collaborative preparedness and laboratory response plans.MethodsWe conducted a literature review on CCHF molecular diagnostics through an online search. Further, we obtained expert opinions on the key laboratory aspects of CCHF diagnosis. Consulted experts were members of two European projects, EMERGE (Efficient response to highly dangerous and emerging pathogens at EU level) and EVD-LabNet (Emerging Viral Diseases-Expert Laboratory Network).ResultsConsensus was reached on relevant and controversial aspects of CCHF disease with implications for laboratory management of human CCHF cases, including biosafety, diagnostic algorithm and advice to improve lab capabilities. Knowledge on the diffusion of CCHF can be obtained by promoting syndromic approach to infectious diseases diagnosis and by including CCHFV infection in the diagnostic algorithm of severe fevers of unknown origin.ConclusionNo effective vaccine and/or therapeutics are available at present so outbreak response relies on rapid identification and appropriate infection control measures. Frontline hospitals and reference laboratories have a crucial role in the response to a CCHF outbreak, which should integrate laboratory, clinical and public health responses.

Keywords: CCHF; CCHFV; Crimean-Congo haemorrhagic fever virus; European network; emerging diseases; laboratory preparedness; laboratory response.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Maximum likelihood phylogenetic analysis for complete S segment of Crimean-Congo haemorrhagic fever virus (n = 65)
Figure 2
Figure 2
World map of Crimean-Congo haemorrhagic fever virus distribution (n = 163)
Figure 3
Figure 3
Algorithm for molecular diagnosis of Crimean-Congo haemorrhagic fever acute infection based on expert opinion
See this image and copyright information in PMC

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