title: Towards an understanding of the migration of Crimean-Congo hemorrhagic fever virus.
abstract: Crimean-Congo haemorrhagic fever (CCHF) is a lethal disease caused by Crimean-Congo hemorrhagic fever virus (CCHFV). It is one of the most widespread medically significant tick-borne pathogens, with a distribution that coincides well with the geographical occurrence of its tick vector, Hyalomma marginatum marginatum. Sporadic outbreaks of CCHF have previously been recognized in Asia, Africa, the Middle East and Europe but, in the 21st century, outbreaks have become more frequent in former Yugoslavia, Turkey and Iran. It has been suggested that CCHFV is a migrating pathogen, but it is not clear to what extent. We have, for the first time, analysed the worldwide migration pattern of CCHFV. Our results showed that Turkey may be a donor in Europe, towards both the east and the west, while the United Arab Emirates acted as a donor in the Middle East, and China was found to be the origin for genotype 2. Finally, we showed that migration of CCHFV was unrestricted between Iran and Pakistan. Considering the distribution and coincidence of the tick vector with CCHFV and CCHF, and the fact that the tick vector is present in western Europe, future outbreaks may extend to include hitherto-naïve areas, suggesting that increased surveillance and geographical mapping of this lethal pathogen are needed.
authors.affiliation: Department of Microbiology, Tumor and Cell Biology, Karolinska Institute, Nobels vag 16, 17182 Stockholm, Sweden. mattias.mild@smi.se
authors.forename: Mattias
authors.initials: M
authors.lastname: Mild
authors.forename: Melinda
authors.initials: M
authors.lastname: Simon
authors.forename: Jan
authors.initials: J
authors.lastname: Albert
authors.forename: Ali
authors.initials: A
authors.lastname: Mirazimi
mesh_terms: D000349:Africa / Q000453:epidemiology; D000818:Animals; D001208:Asia / Q000453:epidemiology; D016000:Cluster Analysis; D004196:Disease Outbreaks; D005060:Europe / Q000453:epidemiology; D005843:Geography; D003225:Hemorrhagic Fever Virus, Crimean-Congo / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification*; D006479:Hemorrhagic Fever, Crimean / Q000453:epidemiology* / Q000635:transmission / Q000821:virology*; D006801:Humans; D026863:Ixodidae; D008877:Middle East / Q000453:epidemiology; D017720:Molecular Epidemiology; D010802:Phylogeny; D012367:RNA, Viral / Q000235:genetics; D017422:Sequence Analysis, DNA; D017385:Sequence Homology
chemical_list: D012367:RNA, Viral