Laboratory management of Crimean-Congo haemorrhagic fever virus infections: Perspectives from two European networks

Barbara Bartolini, Cesare E.M. Gruber, Marion Koopmans, Tatjana Avšič, Sylvia Bino, Iva Christova, Roland Grunow, Roger Hewson, Gulay Korukluoglu, Cinthia Menel Lemos, Ali Mirazimi, Anna Papa, Maria Paz Sanchez-Seco, Aisha V. Sauer, Hervè Zeller, Carla Nisii, Maria Rosaria Capobianchi, Giuseppe Ippolito, Chantal B. Reusken, Antonino Di Caro*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)


Background: Crimean-Congo haemorrhagic fever virus (CCHFV) is considered an emerging infectious disease threat in the European Union. Since 2000, the incidence and geographic range of confirmed CCHF cases have markedly increased, following changes in the distribution of its main vector, Hyalomma ticks. Aims: To review scientific literature and collect experts’ opinion to analyse relevant aspects of the laboratory management of human CCHF cases and any exposed contacts, as well as identify areas for advancement of international collaborative preparedness and laboratory response plans. Methods: We conducted a literature review on CCHF molecular diagnostics through an online search. Further, we obtained expert opinions on the key laboratory aspects of CCHF diagnosis. Consulted experts were members of two European projects, EMERGE (Efficient response to highly dangerous and emerging pathogens at EU level) and EVDLabNet (Emerging Viral Diseases-Expert Laboratory Network).Results: Consensus was reached on relevant and controversial aspects of CCHF disease with implications for laboratory management of human CCHF cases, including biosafety, diagnostic algorithm and advice to improve lab capabilities. Knowledge on the diffusion of CCHF can be obtained by promoting syndromic approach to infectious diseases diagnosis and by including CCHFV infection in the diagnostic algorithm of severe fevers of unknown origin. Conclusion: No effective vaccine and/or therapeutics are available at present so outbreak response relies on rapid identification and appropriate infection control measures. Frontline hospitals and reference laboratories have a crucial role in the response to a CCHF outbreak, which should integrate laboratory, clinical and public health responses.

Original languageEnglish
Article number1800093
Issue number5
Publication statusPublished - 31 Jan 2019

Bibliographical note

Funding Information:
This work was supported by the Health programme 2014– 2020, from the European Commission; EMERGE Joint Action grant number: 677066. INMI received ‘Ricerca Corrente, Linea 1, Patogeni ad alto impatto sociale, emergenti, tropi-cali, MDR, negletti’ grants from the Italian Ministry of Health. This work was supported by the European Centre for Disease Prevention and Control (ECDC) under the EVD-LabNet Framework contract ECDC/2016/002. This work was supported by the CCHVaccine project 2 ‘the European Union’s Horizon 2020 research and innovation program’, grant agreement no. 732732.

Publisher Copyright:
© 2019, European Centre for Disease Prevention and Control (ECDC). All rights reserved.


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