title: Molecular epidemiology of Crimean-Congo hemorrhagic fever virus in Kosovo.
abstract: Crimean-Congo hemorrhagic fever virus (CCHFV) is a zoonotic agent that causes severe, life-threatening disease, with a case fatality rate of 10-50%. It is the most widespread tick-borne virus in the world, with cases reported in Africa, Asia and Eastern Europe. CCHFV is a genetically diverse virus. Its genetic diversity is often correlated to its geographical origin. Genetic variability of CCHFV was determined within few endemic areas, however limited data is available for Kosovo. Furthermore, there is little information about the spatiotemporal genetic changes of CCHFV in endemic areas. Kosovo is an important endemic area for CCHFV. Cases were reported each year and the case-fatality rate is significantly higher compared to nearby regions. In this study, we wanted to examine the genetic variability of CCHFV obtained directly from CCHF-confirmed patients, hospitalized in Kosovo from 1991 to 2013. We sequenced partial S segment CCHFV nucleotide sequences from 89 patients. Our results show that several viral variants are present in Kosovo and that the genetic diversity is high in relation to the studied area. We also show that variants are mostly uniformly distributed throughout Kosovo and that limited evolutionary changes have occurred in 22 years. Our results also suggest the presence of a new distinct lineage within the European CCHF phylogenetic clade. Our study provide the largest number of CCHFV nucleotide sequences from patients in 22 year span in one endemic area.
authors.affiliation: Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
authors.forename: Luka
authors.initials: L
authors.lastname: Fajs
authors.affiliation: National Institute of Public Health of Kosovo, Pristina, Republic of Kosovo.
authors.forename: Xhevat
authors.initials: X
authors.lastname: Jakupi
authors.affiliation: Clinic of Infectious Diseases, Pristina, Republic of Kosovo.
authors.forename: Salih
authors.initials: S
authors.lastname: Ahmeti
authors.affiliation: National Institute of Public Health of Kosovo, Pristina, Republic of Kosovo.
authors.forename: Isme
authors.initials: I
authors.lastname: Humolli
authors.affiliation: National Institute of Public Health of Kosovo, Pristina, Republic of Kosovo.
authors.forename: Isuf
authors.initials: I
authors.lastname: Dedushaj
authors.affiliation: Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Avšič-Županc
mesh_terms: D016000:Cluster Analysis; D014644:Genetic Variation; D005838:Genotype; D003225:Hemorrhagic Fever Virus, Crimean-Congo / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D006479:Hemorrhagic Fever, Crimean / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D063826:Kosovo / Q000453:epidemiology; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D010802:Phylogeny; D012367:RNA, Viral / Q000235:genetics*; D017422:Sequence Analysis, DNA
chemical_list: D012367:RNA, Viral