Epidemics of Crimean-Congo Hemorrhagic Fever (CCHF) in Sudan between 2010 and 2020

Ayman Ahmed; Yousif Ali; Bashir Salim; Isabelle Dietrich; Jakob Zinsstag

doi:10.3390/microorganisms10050928

Epidemics of Crimean-Congo Hemorrhagic Fever (CCHF) in Sudan between 2010 and 2020

Microorganisms. 2022 Apr 28;10(5):928. doi: 10.3390/microorganisms10050928.

Authors

Ayman Ahmed^{1

2

3

4}, Yousif Ali⁵, Bashir Salim⁶, Isabelle Dietrich⁷, Jakob Zinsstag^{2

3}

Affiliations

¹ Institute of Endemic Diseases, University of Khartoum, Khartoum 11111, Sudan.
² Swiss Tropical and Public Health Institute (Swiss TPH), CH-4123 Allschwil, Switzerland.
³ Faculty of Science, University of Basel, Petersplatz 1, CH-4001 Basel, Switzerland.
⁴ Sudanese National Academy of Sciences, Khartoum 11111, Sudan.
⁵ Health Emergencies and Epidemics Control General Directorate, Sudan Federal Ministry of Health, Khartoum 11111, Sudan.
⁶ Faculty of Veterinary Medicine, University of Khartoum, Khartoum 11111, Sudan.
⁷ The Pirbright Institute, Pirbright GU24 0NF, UK.

Abstract

Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic arboviral disease that poses a great threat to global health in the Old World, and it is endemic in Europe, Asia, and Africa, including Sudan. In this retrospective study, we reviewed previous epidemiological reports about the major epidemics of CCHF throughout Sudan between 2010 and 2020. During these epidemics, the infection of humans with Crimean-Congo hemorrhagic fever virus (CCHFV), the causative agent of CCHF, was diagnosed using qRT-PCR. We have identified 88 cases of CCHF, including 13 fatalities reported during five epidemics that occurred in 2010, 2011, 2015, 2019, and 2020. The two epidemics in 2010 and 2011 were by far the largest, with 51 and 27 cases reported, respectively. The majority of cases (78%) were reported in the endemic region of Kordofan. Here, we document that the first emergence of CCHFV in the Darfur region, West Sudan, occurred in 2010. We were not able to investigate outbreak dynamics through phylogenetic analysis due to the limited diagnostic capacity and the lack of sequencing services in the country. These findings call for establishing a genomic-based integrated One Health surveillance and response system for the early preparedness, prevention, and control of CCHF in the country.

Keywords: Crimean-Congo hemorrhagic fever (CCHF); Sudan; arboviral diseases; climate change; epidemic; hemorrhagic fever; neurotropic viruses; outbreak; tick-borne diseases; zoonotic diseases.

Grants and funding

A.A. research is supported by R. Geigy-Stiftung and the Swiss Government Excellence Scholarships for Foreign Scholars and Artists that awarded by the Federal Commission for Scholarships for Foreign Students (FCS) (Personal ESKAS-Nr: 2021.0671). ID research is funded by Biotechnology and Biological Sciences Research Council BBS/E/I/00007033, BBS/E/I/00007036, BB/W01100X/1.