title: Molecular epidemiology of Crimean-Congo hemorrhagic fever in Bulgaria--An update.
abstract: Crimean-Congo hemorrhagic fever (CCHF) is endemic in Bulgaria. During 2013-2014, 11 confirmed CCHF cases have been reported in the country (seven in 2013 and four in 2014). The present study provides the CCHF molecular epidemiology in Bulgaria based on all currently available S, M, and L RNA segment nucleotide sequences spanning the years 1978-2014. A relatively low genetic difference (0-6%, the maximum seen in the M RNA segment) was seen among the CCHFV sequences suggesting that a slow evolving CCHFV strain belonging to "Europe 1" clade is present in Bulgaria. Although the virus emerged in new foci during the recent years, it is more active in the established endemic foci which seem to offer the most suitable ecosystem and environment. Understanding the CCHF epidemiology and virus evolution is the basis for public health programs and vaccine design.
authors.affiliation: Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Anna
authors.initials: A
authors.lastname: Papa
authors.affiliation: Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Styliani
authors.initials: S
authors.lastname: Pappa
authors.affiliation: National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria.
authors.forename: Elitsa
authors.initials: E
authors.lastname: Panayotova
authors.affiliation: Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Elpida
authors.initials: E
authors.lastname: Papadopoulou
authors.affiliation: National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria.
authors.forename: Iva
authors.initials: I
authors.lastname: Christova
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002031:Bulgaria / Q000453:epidemiology; D002648:Child; D019353:Endemic Diseases; D005260:Female; D014644:Genetic Variation; D016679:Genome, Viral; D003225:Hemorrhagic Fever Virus, Crimean-Congo / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D006479:Hemorrhagic Fever, Crimean / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D016855:Nairovirus; D017422:Sequence Analysis, DNA; D055815:Young Adult
keywords: Bulgaria; Crimean-Congo hemorrhagic fever; molecular epidemiology