Diagnostic approaches for Crimean-Congo hemorrhagic fever virus

ABSTRACT

Introduction: Crimean-Congo hemorrhagic fever (CCHF) is a potentially severe tick-borne viral disease endemic in several regions of Europe, Africa, and Asia. Rapid and reliable diagnosis is essential for early initiation of patient’s treatment and for prompt implementation of appropriate precaution and infection control measures to prevent further spread of the disease.

Areas covered: A literature search was undertaken on available approaches for laboratory diagnosis of CCHF infections, and the advantages and limitations of the assays are discussed.

Expert opinion: Given that the genetic variability among CCHFV strains is high, attention has to be paid on the molecular protocols to detect all currently known genetic lineages of the virus as the emergence of CCHFV strains belonging to various lineages in new environments is not unexpected. In severe cases, the antibody production may be delayed or absent. It is important that the laboratories involved in CCHFV diagnostics to run quality control assays. Standardized assays and point-of-care tests with high sensitivity and specificity are needed. It is expected that the application of next-generation sequencing will be a powerful tool for CCHF diagnostics. Awareness, preparedness, and surveillance are required for prompt detection of CCHF cases.

KEYWORDS:

• Crimean-Congo hemorrhagic fever
• diagnostics
• molecular methods
• serological methods
• genetic diversity

Article Highlights

• Handling of Crimean-Congo hemorrhagic fever orthonairovirus requires high biocontainment facilities

• It is preferable to apply molecular methods capable to detect all virus lineages

• Increased sensitivity is gained by a combination of molecular and serological methods

• Novel diagnostic tests with increased sensitivity and specificity are needed

• Next-generation sequencing is expected to serve as a powerful tool for CCHF diagnostics

Declaration of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewers Disclosure

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

The study is part of the EU Horizon 2020 research and innovation programme COMPARE (grant agreement No 643476) and EMERGE project Joint Action (CHAFEA n 677 066).