Haemorrhagic fever confirmed in Sudan

[Shiloh]

Source: http://www.eht-forum.org/news.html?fileId=news100429061451&from=home&id=0

Thursday 29 April 2010
Haemorrhagic fever confirmed in Sudan
Genetic analysis identifies human infections with haemorrhagic fever virus for the first time

Source: Flickr/Rita Willaert

Outbreaks of suspected Crimean-Congo haemorrhagic fever (CCHF) have been occurring in the Kordufan region of Sudan over the past two years, but scientists could not say for sure whether the CCHF virus circulates in the country.

Molecular tests on blood samples taken from patients during an outbreak affecting 12 people in 2008 have identified the virus for the first time in the country. The results of the analysis are published in the May edition of Emerging Infectious Diseases.

?Laboratory confirmation of 8 cases of CCHF demonstrates the presence of this disease in Sudan,? write Imadeldin Aradaib, from the National Ribat University in Khartoum, and colleagues...

...Reference and link

1.
Aradaib IE, Erickson BR, Mustafa ME, Khristiva ML, Saeed NS, Elageb RM, et al. Nosocomial outbreak of Crimean-Congo haemorrhagic fever, Sudan. Emerg Infect Dis2010, 16:837?9. doi: 10.3201/eid1605.091815
World Health Organization information about Crimean-Congo haemorrhagic fever

 

[Anne]

Re: Haemorrhagic fever confirmed in Sudan

http://www.cdc.gov/eid/content/16/5/837.htm

Detailed analysis of virus outbreaks is often limited by the lack of appropriate high-containment facilities required for virus isolation. However, appropriately sampled and stored acute-phase serum samples can have high titers of the virus, which enable extraction of virus RNA and genome sequencing studies without prior amplification of the virus in cell culture. In this study, serum specimens from 8 patients who died were positive for CCHFV by RT-PCR. Lack of virus-specific antibodies 1?3 days after onset of illness can be explained by the severity and rapid course of the disease, which does not allow sufficient time for antibody production. Virus-specific antibodies are, however, generally seen later in the course of illness and in persons who survive the infection.
Antibody studies have suggested the presence of various arboviruses in Sudan (10,11). Indirect evidence for CCHFV in animals in Sudan came from finding CCHFV-specific antibodies in animals imported from Sudan: camels in Egypt (12) and sheep and goats in Saudi Arabia (13). The finding that the Al-fulah outbreak was caused by a CCHFV strain from genetic group III illustrates how different virus strains and lineages can move with livestock transport or possibly bird migrations. The genome plasticity of the virus is surprisingly high for an arthropod-borne virus. This genetic diversity appears to be the result of not only accumulation of mutations but also of frequent RNA segment reassortment and even RNA recombination (8,14,15).
Clearly, this CCHFV is present in Sudan, and physicians should consider CCHF as a diagnosis for hemorrhagic fever cases in the region. In addition, efforts to provide appropriate personal protective supplies and training to medical staff in rural areas should be increased to help minimize risk for caregivers.