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Laboratory management of Crimean-Congo haemorrhagic fever virus infections: perspectives from two European networks
- Barbara Bartolini1 , Cesare EM Gruber1 , Marion Koopmans2 , Tatjana Avšič3 , Sylvia Bino4 , Iva Christova5 , Roland Grunow6 , Roger Hewson7 , Gulay Korukluoglu8 , Cinthia Menel Lemos9 , Ali Mirazimi10,11,12 , Anna Papa13 , Maria Paz Sanchez-Seco14 , Aisha V. Sauer15 , Hervè Zeller16 , Carla Nisii1 , Maria Rosaria Capobianchi1 , Giuseppe Ippolito1 , Chantal B. Reusken2,17,18 , Antonino Di Caro1,18
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View Affiliations Hide AffiliationsAffiliations: 1 ‘L. Spallanzani’ National Institute for Infectious Diseases IRCCS (INMI), WHO Collaborating Center for Clinical Care, Diagnosis, Response and Training on Highly Infectious Diseases, Rome, Italy 2 Erasmus MC, Department of Viroscience, WHO Collaborating Centre for Arbovirus and Viral Hemorrhagic Fever Reference and Research, Rotterdam, The Netherlands 3 Institute of Microbiology and Immunology, Faculty of Medicine, Ljubljana, Slovenia 4 Control of Infectious Diseases Department Institute of Public Health, Tirana, Albania 5 National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria 6 Robert Koch Institute, Berlin, Germany 7 Public Health England, National Infection Service WHO Collaborating Centre for Virus Reference and Research (Special Pathogens), Porton Down, Salisbury, United Kingdom 8 Public Health General Directorate of Turkey, AnkaraCity, Turkey 9 Consumers, Health, Agriculture and Food Executive Agency (CHAFEA), Luxembourg, Luxembourg 10 Public Health agency of Sweden, Solna, Sweden 11 National Veterinary Institute, Uppsala, Sweden 12 Department of Laboratory Medicine, Clinical Microbiology, Karolinska Institute and Karolinska University Hospital, Solna, Sweden 13 Department of Microbiology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece 14 National Centre of Microbiology, Institute of Health Carlos III, Madrid, Spain 15 European Commission, Directorate General for Health and Food Safety, Unit for Crisis Management and Preparedness in Health, Luxembourg, Luxembourg 16 European Center for Disease Prevention and Control, Office of the Chief Scientist, Stockholm, Sweden 17 Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands 18 Authors contributed equally to the work and share last authorshipAntonino Di Caroantonino.dicaro inmi.it
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Citation style for this article: Bartolini Barbara, Gruber Cesare EM, Koopmans Marion, Avšič Tatjana, Bino Sylvia, Christova Iva, Grunow Roland, Hewson Roger, Korukluoglu Gulay, Lemos Cinthia Menel, Mirazimi Ali, Papa Anna, Sanchez-Seco Maria Paz, Sauer Aisha V., Zeller Hervè, Nisii Carla, Capobianchi Maria Rosaria, Ippolito Giuseppe, Reusken Chantal B., Di Caro Antonino. Laboratory management of Crimean-Congo haemorrhagic fever virus infections: perspectives from two European networks. Euro Surveill. 2019;24(5):pii=1800093. https://doi.org/10.2807/1560-7917.ES.2019.24.5.1800093 Received: 02 Jan 2018; Accepted: 18 Jul 2018
Abstract
Crimean-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.
To 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.
We 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).
Consensus 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.
No 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.
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