RESUMO
Eastern Mediterranean Health Journal is the official health journal published by the Eastern Mediterranean Regional Office of the World Health Organization. It is a forum for the presentation and promotion of new policies and initiatives in health services; and for the exchange of ideas concepts epidemiological data research findings and other information with special reference to the Eastern Mediterranean Region. It addresses all members of the health profession medical and other health educational institutes interested NGOs WHO Collaborating Centres and individuals within and outside the Region.
المجلة الصحية لشرق المتوسط هى المجلة الرسمية التى تصدرعن المكتب الاقليمى لشرق المتوسط بمنظمة الصحة العالمية. وهى منبر لتقديم السياسات والمبادرات الجديدة فى الصحة العامة والخدمات الصحية والترويج لها، و لتبادل الاراء و المفاهيم والمعطيات الوبائية ونتائج الابحاث وغير ذلك من المعلومات، و خاصة ما يتعلق منها باقليم شرق المتوسط. وهى موجهة الى كل اعضاء المهن الصحية، والكليات الطبية وسائر المعاهد التعليمية، و كذا المنظمات غير الحكومية المعنية، والمراكز المتعاونة مع منظمة الصحة العالمية والافراد المهتمين بالصحة فى الاقليم و خارجه
La Revue de Santé de la Méditerranée Orientale est une revue de santé officielle publiée par le Bureau régional de l’Organisation mondiale de la Santé pour la Méditerranée orientale. Elle offre une tribune pour la présentation et la promotion de nouvelles politiques et initiatives dans le domaine de la santé publique et des services de santé ainsi qu’à l’échange d’idées de concepts de données épidémiologiques de résultats de recherches et d’autres informations se rapportant plus particulièrement à la Région de la Méditerranée orientale. Elle s’adresse à tous les professionnels de la santé aux membres des instituts médicaux et autres instituts de formation médico-sanitaire aux ONG Centres collaborateurs de l’OMS et personnes concernés au sein et hors de la Région.
Assuntos
Vigilância de Evento Sentinela , Transmissão Vertical de Doenças Infecciosas , Vacinas contra COVID-19 , Hepatite C , Tuberculose , Setor Privado , Setor de Assistência à Saúde , Dengue , Febre de Chikungunya , Infecções por HIV , Vírus da Febre Hemorrágica da Crimeia-Congo , Serviços de Laboratório Clínico , Região do MediterrâneoAssuntos
Vírus da Febre Hemorrágica da Crimeia-Congo , Febre Hemorrágica da Crimeia , Surtos de Doenças , Água , Saneamento , Higiene , Controle de Infecções , Gestão de Riscos , Gerenciamento de Resíduos , Equipamento de Proteção Individual , Cuidadores , Salas Cirúrgicas , Aerossóis , Higiene das Mãos , Desinfecção , Doenças Transmissíveis , Guia de Prática ClínicaRESUMO
Transcatheter aortic valve replacement (TAVR) procedures have increased since adoption in 2010. Readmission for TAVR patients with underlying chronic congestive heart failure (cCHF) remains challenging. Therefore, we sought to determine the 30-day readmission rate (30-DRr) of patients who undergo TAVR & co-existing cCHF and its impact on mortality & healthcare utilization in the United States. We performed a retrospective study using the national readmission database year 2017 and 2018. The patients studied were discharged with TAVR as a principal diagnosis and underlying cCHF as a secondary diagnosis according to ICD-10 codes. The primary outcome was a 30-day readmission rate and mortality, while secondary outcomes were the most common diagnoses for readmission, and resource utilization. A total of 76,892 index hospitalization for TAVR with coexisting cCHF: mean age was 79.7 years [SD: ± 2], and 54.5% of patients were males. In-hospital mortality rate for index admission was 1.63%. The 30-DRr was 9.5%. Among the group of readmitted patients, in-hospital mortality rate was 3.13%. Readmission mortality showed a statistically significant increase compared to index mortality (3.13% vs 1.63%, adjusted P ≤ 0.001, aOR: 2.1, 95% CI: 1.6-2.9). The total healthcare in-hospital economic spending was $94.4 million, and total patient charge of $412 million. Approximately 1 in 10 patients who underwent TAVR with underlying cCHF had 30-DRr, with subsequent readmissions associated with increased healthcare spending. Readmission mortality showed a statistically significant increase when compared to index mortality. TAVR patients with cCHF are a vulnerable subset requiring additional outpatient care.
Assuntos
Estenose da Valva Aórtica , Insuficiência Cardíaca , Vírus da Febre Hemorrágica da Crimeia-Congo , Febre Hemorrágica da Crimeia , Substituição da Valva Aórtica Transcateter , Masculino , Humanos , Estados Unidos/epidemiologia , Idoso , Feminino , Substituição da Valva Aórtica Transcateter/efeitos adversos , Readmissão do Paciente , Estenose da Valva Aórtica/complicações , Estenose da Valva Aórtica/cirurgia , Estenose da Valva Aórtica/diagnóstico , Estudos Retrospectivos , Febre Hemorrágica da Crimeia/complicações , Febre Hemorrágica da Crimeia/cirurgia , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/terapia , Insuficiência Cardíaca/complicações , Resultado do Tratamento , Fatores de Risco , Valva Aórtica/cirurgiaRESUMO
Crimean-Congo hemorrhagic fever virus (CCHFV) is a widespread zoonotic pathogen that can cause mild to severe hemorrhagic disease in humans. CCHFV may be transmitted through direct contact with tissue or blood of viremic animals; however, the primary transmission route is through infected tick bites. CCHFV RNA has been detected in ticks feeding on domestic and wild animals in western Spain, suggesting an established circulation of CCHFV in Western Europe. Ruminants have been recognized as important CCHFV reservoirs and have been linked to human cases in endemic regions. Given the emergence of CCHF in neighboring Spain, and a report of two CCHFV seropositive humans in southern Portugal in 1985, we investigated the potential circulation of this virus in the country by performing a nationwide anti-CCHFV IgG serosurvey in sentinel sheep of Portugal. Sera (n = 459) randomly selected from widely distributed farms (n = 20) of Portugal were tested using a commercial double-antigen enzyme-linked immunosorbent assay, yielding an overall seroprevalence of 0.4% (95% confidence interval [CI] 0.04-1.56%). Positive sheep were from the southern region of Portugal (Alentejo region), which raise the seroprevalence of this region to 0.74% (95% CI 0.09-2.66%). This is the first study reporting the presence of CCHFV antibodies in sheep of Portugal, thus suggesting a geographical expansion of CCHFV to this country. It seems likely that CCHFV may exist focally in southern Portugal.
Assuntos
Vírus da Febre Hemorrágica da Crimeia-Congo , Febre Hemorrágica da Crimeia , Doenças dos Ovinos , Carrapatos , Animais , Anticorpos Antivirais , Vírus da Febre Hemorrágica da Crimeia-Congo/genética , Febre Hemorrágica da Crimeia/epidemiologia , Febre Hemorrágica da Crimeia/veterinária , Humanos , Portugal/epidemiologia , Estudos Soroepidemiológicos , Ovinos , Doenças dos Ovinos/epidemiologiaRESUMO
This study presents the results of laboratory trials of the reagent kit for the rapid detection of RNA of the Crimean-Congo hemorrhagic fever virus (CCHFV) using loop-mediated isothermal amplification with reverse transcription (RT-LAMP). The developed RT-LAMP reagent kit was used to detect the CCHFV and showed a sensitivity of 103 GE/ml of viral RNA, which is sufficient for detection of the CCHFV in the early stage of human infections. The kit showed high specificity and no cross-reactivity with viral panel from the State collection of viruses of the FBRI SRC VB «Vector¼ (arboviruses and hemorrhagic fever viruses). Laboratory trials of the RT-LAMP kit are showed a high analytical and diagnostic sensitivity and specificity for RNA detection of the CCHFV and high speed of the analysis (60-70 min with sample preparation) compared to real-time PCR. Approbation of the kit field version has showed the possibility of setting the RT-LAMP reaction and viral RNA detection without the using of analytical equipments.
Assuntos
Vírus da Febre Hemorrágica da Crimeia-Congo/isolamento & purificação , Febre Hemorrágica da Crimeia/diagnóstico , Técnicas de Amplificação de Ácido Nucleico , Kit de Reagentes para Diagnóstico , Humanos , RNA Viral/análise , Reação em Cadeia da Polimerase em Tempo Real , Transcrição Reversa , Sensibilidade e EspecificidadeRESUMO
BACKGROUND: Crimean-Congo Haemorrhagic fever Virus (CCHFV) is a rapidly emerging vector-borne pathogen and the cause of a virulent haemorrhagic fever affecting large parts of Europe, Africa, the Middle East and Asia. METHODOLOGY/PRINCIPLE FINDINGS: An isothermal recombinase polymerase amplification (RPA) assay was successfully developed for molecular detection of CCHFV. The assay showed rapid (under 10 minutes) detection of viral extracts/synthetic virus RNA of all 7 S-segment clades of CCHFV, with high target specificity. The assay was shown to tolerate the presence of inhibitors in crude preparations of mock field samples, indicating that this assay may be suitable for use in the field with minimal sample preparation. The CCHFV RPA was successfully used to screen and detect CCHFV positives from a panel of clinical samples from Tajikistan. CONCLUSIONS/SIGNIFICANCE: The assay is a rapid, isothermal, simple-to-perform molecular diagnostic, which can be performed on a light, portable real-time detection device. It is ideally placed therefore for use as a field-diagnostic or in-low resource laboratories, for monitoring of CCHF outbreaks at the point-of-need, such as in remote rural regions in affected countries.
Assuntos
Vírus da Febre Hemorrágica da Crimeia-Congo/isolamento & purificação , Febre Hemorrágica da Crimeia/diagnóstico , Técnicas de Diagnóstico Molecular/métodos , Técnicas de Amplificação de Ácido Nucleico/métodos , Sistemas Automatizados de Assistência Junto ao Leito , África/epidemiologia , Ásia/epidemiologia , Europa (Continente)/epidemiologia , Vírus da Febre Hemorrágica da Crimeia-Congo/enzimologia , Vírus da Febre Hemorrágica da Crimeia-Congo/genética , Febre Hemorrágica da Crimeia/epidemiologia , Febre Hemorrágica da Crimeia/virologia , Humanos , Oriente Médio/epidemiologia , Técnicas de Diagnóstico Molecular/economia , Técnicas de Diagnóstico Molecular/instrumentação , Técnicas de Amplificação de Ácido Nucleico/economia , Técnicas de Amplificação de Ácido Nucleico/instrumentação , RNA Viral/análise , RNA Viral/genética , Recombinases/metabolismo , Sensibilidade e Especificidade , Tadjiquistão/epidemiologia , Fatores de TempoRESUMO
Natural focal diseases are caused by biological agents associated with specific landscapes. The natural focus of such diseases is defined as any natural ecosystem containing the pathogen's population as an essential component. In such context, the agent circulates independently on human presence, and humans may become accidentally infected through contact with vectors or reservoirs. Some viruses (i.e., tick-borne encephalitis and Congo-Crimean hemorrhagic fever virus) are paradigmatic examples of natural focal diseases. When environmental changes, increase of reservoir/vector populations, demographic pressure, and/or changes in human behavior occur, increased risk of exposure to the pathogen may lead to clusters of cases or even to larger outbreaks. Intervention is often not highly cost-effective, thus only a few examples of large-scale or even targeted vaccination campaigns are reported in the international literature. To develop intervention models, risk assessment through disease mapping is an essential component of the response against these neglected threats and key to the design of prevention strategies, especially when effective vaccines against the disease are available.
Assuntos
Encefalite Transmitida por Carrapatos/epidemiologia , Encefalite Transmitida por Carrapatos/prevenção & controle , Febre Hemorrágica da Crimeia/epidemiologia , Febre Hemorrágica da Crimeia/prevenção & controle , Vacinação , Vacinas Virais/imunologia , Vírus da Febre Hemorrágica da Crimeia-Congo , Humanos , Programas de Imunização , Medição de Risco , Vacinas Virais/administração & dosagemRESUMO
Crimean-Congo hemorrhagic fever (CCHF) is endemic in Turkey, with peak incidence of hospital admissions in the summer months. The aim of this pilot study was to evaluate the role of the severity grading score (SGS) in predicting length of hospital stay, laboratory usage, need for blood products, and hence total costs of patients. Thirty-five patients admitted to one specialist center in Turkey in 2013 and 2014 with PCR-proven CCHF. The mean (SD) age was 55 (±14) and 63% of the patients were male, with 8 (22.9%) mortality. Patients were classified by SGS into three groups with mortality as follows: low risk (0/19); intermediate (6/14); and high (2/2). The direct hospital cost of these admissions was at least $41 740 with median (range) of $1210 ($97-$13 054) per patient. There was a significant difference between low-risk and combined (intermediate-high) risk groups as 635 (97-1500) and 2264.5 (154-13 054), respectively (p = 0.012). In conclusion, a clinical grading score can be used to predict illness severity and to predict associated health care costs.
Assuntos
Febre Hemorrágica da Crimeia/economia , Custos Hospitalares , Adulto , Idoso , Feminino , Vírus da Febre Hemorrágica da Crimeia-Congo/fisiologia , Febre Hemorrágica da Crimeia/mortalidade , Febre Hemorrágica da Crimeia/terapia , Febre Hemorrágica da Crimeia/virologia , Hospitalização/economia , Humanos , Incidência , Tempo de Internação/economia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Índice de Gravidade de Doença , Turquia , Adulto JovemRESUMO
A historic review of the discovery of new viruses leads to reminders of traditions that have evolved over 118 years. One such tradition gives credit for the discovery of a virus to the investigator(s) who not only carried out the seminal experiments but also correctly interpreted the findings (within the technological context of the day). Early on, ultrafiltration played a unique role in "proving" that an infectious agent was a virus, as did a failure to find any microscopically visible agent, failure to show replication of the agent in the absence of viable cells, thermolability of the agent, and demonstration of a specific immune response to the agent so as to rule out duplicates and close variants. More difficult was "proving" that the new virus was the etiologic agent of the disease ("proof of causation")-for good reasons this matter has been revisited several times over the years as technologies and perspectives have changed. One tradition is that the discoverers get to name their discovery, their new virus (unless some grievous convention has been broken)-the stability of these virus names has been a way to honor the discoverer(s) over the long term. Several vignettes have been chosen to illustrate several difficulties in holding to the traditions (vignettes chosen include vaccinia and variola viruses, yellow fever virus, and influenza viruses. Crimean-Congo hemorrhagic fever virus, Murray Valley encephalitis virus, human immunodeficiency virus 1, Sin Nombre virus, and Ebola virus). Each suggests lessons for the future. One way to assure that discoveries are forever linked with discoverers would be a permanent archive in one of the universal virus databases that have been constructed for other purposes. However, no current database seems ideal-perhaps members of the global community of virologists will have an ideal solution.
Assuntos
Invenções/história , Ultrafiltração/história , Virologia/história , Animais , Bases de Dados como Assunto , Ebolavirus/isolamento & purificação , Ebolavirus/patogenicidade , Ebolavirus/fisiologia , Vírus da Encefalite do Vale de Murray/isolamento & purificação , Vírus da Encefalite do Vale de Murray/patogenicidade , Vírus da Encefalite do Vale de Murray/fisiologia , HIV-1/isolamento & purificação , HIV-1/patogenicidade , HIV-1/fisiologia , Vírus da Febre Hemorrágica da Crimeia-Congo/isolamento & purificação , Vírus da Febre Hemorrágica da Crimeia-Congo/patogenicidade , Vírus da Febre Hemorrágica da Crimeia-Congo/fisiologia , História do Século XIX , História do Século XX , Humanos , Orthomyxoviridae/isolamento & purificação , Orthomyxoviridae/patogenicidade , Orthomyxoviridae/fisiologia , Vírus Sin Nombre/isolamento & purificação , Vírus Sin Nombre/patogenicidade , Vírus Sin Nombre/fisiologia , Ultrafiltração/estatística & dados numéricos , Vaccinia virus/isolamento & purificação , Vaccinia virus/patogenicidade , Vaccinia virus/fisiologia , Vírus da Varíola/isolamento & purificação , Vírus da Varíola/patogenicidade , Vírus da Varíola/fisiologia , Recursos Humanos , Vírus da Febre Amarela/isolamento & purificação , Vírus da Febre Amarela/patogenicidade , Vírus da Febre Amarela/fisiologiaRESUMO
Crimean-Congo hemorrhagic fever (CCHF) is an often lethal, acute inflammatory illness that affects a large geographic area. The disease is caused by infection with CCHF virus (CCHFV), a nairovirus from the Bunyaviridae family. Basic research on CCHFV has been severely hampered by biosafety requirements and lack of available strains and molecular tools. We report the development of a CCHF transcription- and entry-competent virus-like particle (tecVLP) system that can be used to study cell entry and viral transcription/replication over a broad dynamic range (~4 orders of magnitude). The tecVLPs are morphologically similar to authentic CCHFV. Incubation of immortalized and primary human cells with tecVLPs results in a strong reporter signal that is sensitive to treatment with neutralizing monoclonal antibodies and by small molecule inhibitors of CCHFV. We used glycoproteins and minigenomes from divergent CCHFV strains to generate tecVLPs, and in doing so, we identified a monoclonal antibody that can prevent cell entry of tecVLPs containing glycoproteins from 3 pathogenic CCHFV strains. In addition, our data suggest that different glycoprotein moieties confer different cellular entry efficiencies, and that glycoproteins from the commonly used strain IbAr10200 have up to 100-fold lower ability to enter primary human cells compared to glycoproteins from pathogenic CCHFV strains.
Assuntos
Avaliação Pré-Clínica de Medicamentos/métodos , Genes Reporter , Vírus da Febre Hemorrágica da Crimeia-Congo/fisiologia , Transcrição Gênica/efeitos dos fármacos , Internalização do Vírus/efeitos dos fármacos , Replicação Viral/efeitos dos fármacos , Anticorpos Monoclonais/metabolismo , Anticorpos Neutralizantes/metabolismo , Anticorpos Antivirais/metabolismo , Vírus da Febre Hemorrágica da Crimeia-Congo/genética , Vírus da Febre Hemorrágica da Crimeia-Congo/isolamento & purificação , Dados de Sequência Molecular , Análise de Sequência de DNA , Vírion/genética , Vírion/fisiologia , Vírion/ultraestruturaRESUMO
Crimean-Congo haemorrhagic fever (CCHF) is endemic in the southeast of Iran. This study aimed to predict the incidence of CCHF and its related factors and explore the possibility of developing an empirical forecast system using time-series analysis of 13 years' data. Data from 2000 to 2012 were obtained from the Health Centre of Zahedan University of Medical Sciences, Climate Organization and the Veterinary Organization in the southeast of Iran. Seasonal autoregressive integrated moving average (SARIMA) and Markov switching models (MSM) were performed to examine the potential related factors of CCHF outbreaks. These models showed that the mean temperature (°C), accumulated rainfall (mm), maximum relative humidity (%) and legal livestock importation from Pakistan (LIP) were significantly correlated with monthly incidence of CCHF in different lags (P < 0·05). The modelling fitness was checked with data from 2013. Model assessments indicated that the MSM had better predictive ability than the SARIMA model [MSM: root mean square error (RMSE) 0·625, Akaike's Information Criterion (AIC) 266·33; SARIMA: RMSE 0·725, AIC 278·8]. This study shows the potential of climate indicators and LIP as predictive factors in modelling the occurrence of CCHF. Our results suggest that MSM provides more information on outbreak detection and can be a better predictive model compared to a SARIMA model for evaluation of the relationship between explanatory variables and the incidence of CCHF.
Assuntos
Febre Hemorrágica da Crimeia/epidemiologia , Animais , Surtos de Doenças/estatística & dados numéricos , Previsões/métodos , Vírus da Febre Hemorrágica da Crimeia-Congo , Febre Hemorrágica da Crimeia/etiologia , Febre Hemorrágica da Crimeia/transmissão , Humanos , Incidência , Irã (Geográfico)/epidemiologia , Gado/virologia , Cadeias de Markov , Vigilância da População , Estações do Ano , Tempo (Meteorologia)RESUMO
Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne zoonosis which is common in Africa, Asia, Eastern Europe, and the Balkan Peninsula. CCHF has been reported in Turkey with high frequency since 2002. The aim of the present study was to investigate the genetic diversity and genetic relationship between CCHF virus (CCHFV) isolates derived from infected patients over a 2-year period (2009 and 2010) in several provinces of Turkey. Serum samples (n = 48) were selected from CCHFV RNA positive patients and subjected to sequence analysis of the gene regions encoding the S (48 samples) and M (14 samples) segments. The nucleotide sequence alignments showed that the nucleic acid relatedness of CCHFV isolates ranged from 95.7% to 100% and from 93.7% to 100% for S and M segments, respectively. Phylogenetic analysis of both segment sequences revealed that CCHFV isolates circulating in Turkey belonged to the European lineage I and were closely related to the viruses found in the Eastern European-Russian and Balkan Peninsula. The M gene segment-based phylogenetic analysis suggested that 2/14 CCHFV isolates (KYSR3159/09 and YZGT714/10) had additional genetic variations. The results of the present study confirmed that the CCHFV isolates present in Turkey associated with human disease had high genetic homology in S segment, but some variability in the M segment of the RNA.
Assuntos
Variação Genética , Vírus da Febre Hemorrágica da Crimeia-Congo/genética , Febre Hemorrágica da Crimeia/epidemiologia , Sequência de Aminoácidos , Genes Virais/genética , Vírus da Febre Hemorrágica da Crimeia-Congo/classificação , Vírus da Febre Hemorrágica da Crimeia-Congo/isolamento & purificação , Humanos , Dados de Sequência Molecular , Filogenia , RNA Viral/análise , Alinhamento de Sequência , Turquia/epidemiologiaRESUMO
Crimean-Congo haemorrhagic fever virus (CCHFV) is one of the most widespread of all medically important arboviruses with ticks of the Hyalomma spp. serving as the main vectors. Infection of livestock by CCHFV serves as a route of exposure to humans, as a reservoir of disease and as a route of importation. This study discusses the pathways and data requirements for a qualitative risk assessment for the emergence of CCHFV in livestock in Europe. A risk map approach is proposed based on layers that include the potential routes of release (e.g. by migrating birds carrying infected ticks) together with the main components for exposure, namely the distributions of the tick vectors, the small vertebrate host reservoirs and the livestock. A layer on landscape fragmentation serves as a surrogate for proximity of livestock to the tick cycle. Although the impact of climate change on the emergence of CCHF is not clear, comparing the distribution of risk factors in each layer currently with those predicted in the 2080s with climate change can be used to speculate how potential high-risk areas may shift. According to the risk pathway, transstadial and/or transovarial transmission in the tick vector are crucial for CCHFV spread. Vector competence and tick vector switching, however, remain critical factors for CCHFV colonization of new regions in Europe. The species of migratory bird is also an important consideration in the release assessment with greater abundance and biodiversity of ground-dwelling birds in southern Europe than in northern Europe.
Assuntos
Mudança Climática , Febre Hemorrágica da Crimeia/transmissão , Febre Hemorrágica da Crimeia/veterinária , Medição de Risco , Animais , Reservatórios de Doenças/virologia , Europa (Continente)/epidemiologia , Sistemas de Informação Geográfica , Vírus da Febre Hemorrágica da Crimeia-Congo , Febre Hemorrágica da Crimeia/epidemiologia , Febre Hemorrágica da Crimeia/virologia , Humanos , Gado/virologia , Carrapatos/virologiaRESUMO
At the end of the 20th--the beginning of the 21st century activation of a natural focus of Crimean-Congo haemorrhagic fever (CCHF) in southern Russia was noted. As a consequence, in 2002 outbreaks and sporadic cases of this disease were registered on the territory of 6 out of 13 administrative units of the Southern Federal District. To minimize the epidemiological consequences of the aggravating epidemiological situation considerable efforts and means were required from health care organs and institutions of the state sanitary and epidemiological service, including essential financial expenditures. The results of natural foci of CCHF survey, obtained by 2002, as well as main trends of prophylactic and antiepidemic interventions are presented. Scientific research and practical observations made it possible to work out a number of methodological regulations concerning the diagnostics, treatment and prophylaxis of CCHF.
Assuntos
Surtos de Doenças , Febre Hemorrágica da Crimeia/epidemiologia , Animais , Mordeduras e Picadas , Competência Clínica , Programas Governamentais/economia , Programas Governamentais/tendências , Conhecimentos, Atitudes e Prática em Saúde , Vírus da Febre Hemorrágica da Crimeia-Congo , Febre Hemorrágica da Crimeia/prevenção & controle , Humanos , Federação Russa/epidemiologia , Estações do Ano , CarrapatosRESUMO
The parasitological data and the results of the virological and serological investigations of materials, collected in nature and in the course of study of the immune structure of the population, are indicative of the circulation of CHF virus in the Crimea and the possibility of human infection. Data on spontaneous infection of four species of Ixodes ticks with CHF virus have been confirmed, including the data, obtained for the first time for this region, on the participation of Dermacentor marginatus in this process. The study has revealed, also for the first time, that, together with European brown hares, the natural foci of this infection may be maintained by scilly shrews, common voles and European wood mice. Low activity of the Crimean focus may be the result of active land reclamation, keeping the cattle stalled in most of the stock-breeding farms of the region, as well as a sharp decline in the number of hares at the territories of hunting preserves.