title: Sero-epidemiological survey of Crimean-Congo hemorrhagic fever virus in Tunisia.
abstract: Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease associated with a high case fatality rate and transmitted mainly by Hyalomma marginatum. The geographical distribution of H. marginatum covers most of the Western Mediterranean basin. We aimed to investigate whether CCHF virus (CCHFv) is circulating in Tunisia. Samples from unexplained acute febrile patients (n = 181) and a high risk group of humans, mainly slaughter workers (n = 38), were collected in the summer of 2014 and analyzed for exposure to CCHFv using serological tests and real-time RT-PCR. Ticks were collected from Northern and Southern Tunisia during May-June 2014 and examined for the presence of CCHFv by real-time RT-PCR. Of the 181 febrile patients, 5 showed only high titers of IgM suggesting a recent exposure to CCHFv. Among 38 slaughter workers, 2 had IgG anti-CCHFv responses yielding a seroprevalence of 5.2%. No CCHFv was detected in ticks and sera. Our results provide evidence of human exposure to CCHFv in Tunisia.
authors.affiliation: Institut Pasteur de Tunis, Laboratory of Vector Ecology, 13 Place Pasteur, 1002 Tunis, Tunisia.
authors.forename: Fares
authors.initials: F
authors.lastname: Wasfi
authors.affiliation: Public Health England, Porton Down, Salisbury, Wiltshire SP4 0JG, UK.
authors.forename: Stuart
authors.initials: S
authors.lastname: Dowall
authors.affiliation: Infectious Diseases Department, Farhat Hached University Hospital, 4004 Sousse, Tunisia.
authors.forename: Tayssir
authors.initials: T
authors.lastname: Ghabbari
authors.affiliation: Public Health England, Porton Down, Salisbury, Wiltshire SP4 0JG, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Bosworth
authors.affiliation: Infectious Diseases Department, Fatouma Bourguiba University Hospital, 5000 Monastir, Tunisia.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Chakroun
authors.affiliation: Public Health England, Porton Down, Salisbury, Wiltshire SP4 0JG, UK.
authors.forename: Anitha
authors.initials: A
authors.lastname: Varghese
authors.affiliation: Infectious Diseases Department, 3000 Sfax, Tunisia.
authors.forename: Hanene
authors.initials: H
authors.lastname: Tiouiri
authors.affiliation: Laboratory of Microbiology, 3000 Sfax, Tunisia.
authors.forename: Mounir
authors.initials: M
authors.lastname: Ben Jemaa
authors.affiliation: Laboratory of Microbiology, 3000 Sfax, Tunisia.
authors.forename: Abir
authors.initials: A
authors.lastname: Znazen
authors.affiliation: Public Health England, Porton Down, Salisbury, Wiltshire SP4 0JG, UK - National Institute of Health Research, Health Protection Research Unit in Emerging and Zoonotic Infections, L3 5RF Liverpool, UK.
authors.forename: Roger
authors.initials: R
authors.lastname: Hewson
authors.affiliation: Institut Pasteur de Tunis, Laboratory of Vector Ecology, 13 Place Pasteur, 1002 Tunis, Tunisia.
authors.forename: Elyes
authors.initials: E
authors.lastname: Zhioua
authors.affiliation: Infectious Diseases Department, Farhat Hached University Hospital, 4004 Sousse, Tunisia.
authors.forename: Amel
authors.initials: A
authors.lastname: Letaief
mesh_terms: D000003:Abattoirs; D000328:Adult; D000818:Animals; D000829:Animals, Domestic / Q000469:parasitology; D000914:Antibodies, Viral / Q000097:blood*; D001096:Arachnid Vectors / Q000821:virology; D005260:Female; D005334:Fever / Q000209:etiology; D003225:Hemorrhagic Fever Virus, Crimean-Congo / Q000276:immunology*; D006479:Hemorrhagic Fever, Crimean / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood / Q000276:immunology; D026863:Ixodidae / Q000821:virology; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology / Q000821:virology; D016036:Seroepidemiologic Studies; D064927:Tick Bites / Q000821:virology; D017282:Tick-Borne Diseases / Q000453:epidemiology / Q000821:virology; D014416:Tunisia / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000914:Antibodies, Viral; D007075:Immunoglobulin M