Crimean Congo fever
| Classification according to ICD-10 | |
|---|---|
| A98.0 | Crimean Congo hemorrhagic fever |
| ICD-10 online (WHO version 2019) | |
The Crimean-Congo fever ( Crimean-Congo hemorrhagic fever , English Crimean-Congo hemorrhagic fever , CCHF ) is caused by the Crimean-Congo fever virus (CCHFV). The (-) ssRNA virus belongs to the group of arboviruses due to its transmission route ; taxonomically to the genus Orthonairovirus from the family of the Nairoviridae in the order of the bunyaviruses ( Bunyavirales ).
history
The virus was first isolated from human blood in 1956 in the Belgian Congo (now the Democratic Republic of the Congo ) . The disease "Crimean hemorrhagic fever" had been known for a long time. In the 1940s, cases of disease are on the peninsula Crimea documented, most likely it has in Central Asia , where for centuries sporadic cases of the disease.
The disease became topical in the summer of 2006, when several deaths from Crimean-Congo fever were reported in the Turkish Çorum ( Black Sea region ). A few dozen infected people were treated in April and June 2006. In June, another three people died there within a few days. In June 2008, patients with suspected Crimean-Congo fever were treated for the first time in the area around the holiday town of Antalya on the Mediterranean . According to the Turkish Ministry of Health, 23 people had died of Crimean-Congo fever in 2008.
In 2014, 34 people (17 male, 17 female aged 4 to 77 years) were infected in Georgia, 3 of whom died. Exactly one infected tick was confirmed; all blood samples from animals were negative.
In August 2016, a person who was infected by a tick bite in Europe - in the province of Ávila in Spain - died of Crimean-Congo fever. The index patient also infected a nurse who survived despite severe symptoms.
In the 2010s, the grave goods for a high-ranking personality from around 600 to 450 BC A ceramic vessel with remains of human blood and organs was found at the Heuneburg , in which pathogens of the Crimean-Congo fever were detected, which could indicate an epidemic in the region.
Occurrence
Southern Europe , Asia , the Near and Middle East ; milder forms in Africa
transmission
The virus reservoir is made up of grass-eating domestic and wild animals ( cows , sheep , goats , rabbits , camels ). It is transmitted through the bite of ticks , especially Hyalomma ticks, which are found in warmer regions south of the Balkans . Over 30 species of Hyalomma have been identified as vectors.
First, the ticks ingest the virus with the blood of infected animals, and the virus can then survive for a long time in the tick's digestive tract. If the tick now bites a person or another susceptible mammal, it can be transmitted through the tick's saliva. However, transmission can also occur directly through contact with the blood or meat of sick animals. The virus can be transmitted from person to person through infected urine , feces , saliva, or infected blood . Also droplet infection or aerosols are possible. The more severe the disease, the more viruses are excreted by the patient. Therefore, nosocomial infections also occur to a notable extent.
clinic
The incubation period is usually between one and 13 days. The symptoms set in suddenly: fever (constant for five to twelve days, biphasic course), chills , irritability, headache, muscle and limb pain . Upper abdominal pain, nausea and vomiting . Facial reddening and edema , conjunctiva and throat reddening are typical .
In some of the patients, a hemorrhagic course develops as a complication from the third to fifth day : intestinal bleeding, vomiting of blood ( hematemesis ), skin bleeding (up to ecchymosis , small-scale bleeding), haemorrhagic diathesis .
The lethality (mortality) depends on the virus strain and is between two and 50 percent. It is estimated that about every fifth case in the states of the former USSR is associated with hemorrhagic symptoms. The disease can also be symptom-free ( inapparent ). Death usually occurs in the second week of the disease, the cause of death is multiple organ failure .
therapy
There is no vaccination yet. Antiviral therapy with ribavirin is possible, but its effectiveness cannot yet be conclusively assessed. The pathogen can be detected using virus isolation in cell culture or RT-PCR .
prevention
In endemic areas , tick protection is indicated ( repellants , closed, light-colored clothing, regular self-examination for ticks). Contact with infected people and infected material should be avoided. According to § 6 IfSG, suspected illness, illness and death from virus- related hemorrhagic fever are notifiable.
Reporting requirement
In Switzerland, Crimean-Congo fever must be reported in accordance with the Epidemics Act (EpG) in conjunction with the Epidemics Ordinance and Annex 1 of the EDI Ordinance on the reporting of observations of communicable diseases in humans . Doctors, hospitals, etc. are required to report positive and negative laboratory results on the Crimean-Congo virus. Laboratories must report them in accordance with the standards mentioned and Appendix 3 of the EDI ordinance.
literature
- M. Mardani, M. Keshtkar-Jahromi: Crimean-Congo hemorrhagic fever. In: Arch Iran Med. 2007 Apr; 10 (2), pp. 204-214. Review. PMID 17367225 ( PDF, 205 kB )
- Profiles of rare and imported infectious diseases. Robert Koch Institute, ( PDF )
- H. Liu, X. Gao, G. Liang: Newly recognized mosquito-associated viruses in mainland China, in the last two decades. In: Virology Journal. 2011; 8, p. 68.
Web links
- Crimean-Congo fever - information from the Robert Koch Institute
Individual evidence
- ↑ ICTV : Master Species List 2018a v1 , MSL including all taxa updates since the 2017 release. Fall 2018 (MSL # 33)
- ↑ AFP report from June 20, 2008 Dangerous Crimean-Congo fever reaches Antalya . at n24.de , accessed on August 22, 2014.
- ↑ E. Vashakidze, I. Mikadze: EPIDEMIOLOGY, CLINICAL AND LABORATORY FEATURES OF Crimean-Congo hemorrhagic FEVER IN GEORGIA . In: Georgian Medical News . No. 247 , October 2015, ISSN 1512-0112 , p. 54-58 , PMID 26483375 .
- ↑ Lasha Avaliani: Comprehensiv activities against Crimean-Congo Hemorrhagic Fever (CCHF) in Georgia. (PDF) 2014, accessed on October 14, 2018 (English).
- ^ Crimean – Congo haemorrhagic fever in Spain. ( Memento of the original from October 1, 2016 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. On: ecdc.europa.eu of September 8, 2016
- ^ Tick Virus Warning. In: New Scientist of September 24, 2016, p. 6, full text
-
↑ Garry Shaw: Human blood, organs, and a surprising virus detected in ancient pottery . In: Science . 2016, doi : 10.1126 / science.aal0490 (English, online ). Conner J. Wiktorowicz et al .: Hemorrhagic fever virus, human blood, and tissues in Iron Age mortuary vessels. In: Journal of Archaeological Science. Volume 78, 2017, pp. 29–39, doi: 10.1016 / j.jas.2016.11.009 (online advance publication from December 2016)
