Seroprevalence of Crimean-Congo hemorrhagic fever in humans in the World Health Organization European region: A systematic review.

• Published in: PLOS Neglected Tropical Diseases
• Main Authors: Lía Monsalve-Arteaga, Montserrat Alonso-Sardón, Juan Luis Muñoz Bellido, María Belén Vicente Santiago, María Carmen Vieira Lista, Julio López Abán, Antonio Muro, Moncef Belhassen-García
• Format: Article in Journal/Newspaper
• Language: English
• Published: Public Library of Science (PLoS) 2020
• Subjects: Arctic medicine. Tropical medicine; RC955-962; Public aspects of medicine; RA1-1270; Arctic; Prisma; Climate change
• Online Access: https://doi.org/10.1371/journal.pntd.0008094; https://doaj.org/article/11aa8f462adf42078f25d3af44b36461

BACKGROUND:Crimean-Congo hemorrhagic fever (CCHF) is an emerging infectious disease caused by a Nairovirus. CCHF is a tick-borne disease that is predominantly associated with Hyalomma ticks and have a widespread distribution in Africa, Asia and Europe. CCHF usually presents as a subclinical disease, but in some cases, it may present as a hemorrhagic fever with a high mortality rate. This systematic review of the literature was performed to identify the available evidence on the prevalence of CCHF in the European Region of the World Health Organization, based on seroprevalence (IgG antibodies). METHODOLOGY:A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement protocol. PubMed, Embase, and the Web of Science were used for the search (up to January 31, 2019), combining the following MeSH terms: ["Crimean-Congo haemorrhagic fever" OR "Crimean-Congo hemorrhagic fever virus" OR "Congo-Crimea" OR "Crimea-Congo"] AND ["Europe"] AND ["epidemiology" OR "seroprevalence"]. The abstracts were screened. Subsequently, full-text articles were selected and reviewed based on the PICOS (Population-Intervention-Comparison-Outcomes-Study type) criteria by two independent reviewers for inclusion in the final analysis. The data were qualitatively synthesized without quantitative pooling due to the heterogeneity in the study populations and methodologies. PRINCIPAL FINDINGS:Thirty articles (9 from western Europe, 18 from central Europe and 3 from eastern Europe) were included in the analysis. All articles were cross-sectional studies (descriptive studies). CONCLUSIONS:The highest seroprevalence of CCHF is found in central and eastern European countries. Southern and western Europe countries, such as Greece and Spain, have low levels of endemicity, but the spread of the infection, which is associated with climate change, is a possibility that we should keep in mind. Further studies, especially larger seroprevalence studies in humans and animals, are needed ...