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Clinical and Molecular Epidemiology of Crimean-Congo Hemorrhagic Fever in Humans in Uganda, 2013-2019

Balinandi, Stephen and Whitmer, Shannon and Mulei, Sophia and Nyakarahuka, Luke and Tumusiime, Alex and Kyondo, Jackson and Baluku, Jimmy and Mutyaba, Joseph and Mugisha, Lawrence and Malmberg, Maja and Lutwama, Julius and Shoemaker, Trevor R. and Klena, John D. (2022). Clinical and Molecular Epidemiology of Crimean-Congo Hemorrhagic Fever in Humans in Uganda, 2013-2019. American Journal of Tropical Medicine and Hygiene. 106 :1 , 88-98
[Research article]

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Abstract

Crimean-Congo Hemorrhagic Fever (CCHF) is endemic in Uganda, yet its epidemiology remains largely uncharacterized. To better understand its occurrence within Uganda, case reports of patients hospitalized with CCHF between 2013 and 2019 were reviewed. Further, genome sequences of CCHF-positive RNA obtained during this period were determined for phylogenetic comparisons. We found that a total of 32 cases (75% males; CFR, 31.2%), aged between 9 to 68 years, were reported during the study period. Most cases were detected during July to December of each outbreak year (81.2%; P < 0.01) and were located along the "cattle corridor" (68.7%, P = 0.03). The most common presenting symptoms were fever (93.8%), hemorrhage (81.3%), headache (78.1 %), fatigue (68.8%), vomiting (68.8%), and myalgia (65.6%). In five patients for whom hematological data were available, varied abnormalities were observed including thrombocytopenia, leukopenia, anemia, lymphopenia, lymphocytosis, polycythemia, and microcytosis. About 56.3% (P = 0.47) of patients reported tick bites or exposure to livestock as their potential source of infection. Person-to-person transmission was suspected for two cases. Using unbiased metagenomics, we found that the viral S- and L- segments have remained conserved in Africa 2 Glade since the 1950s. In contrast, the M segment split into two geographically interspersed Glades; one that belongs to Africa 2 and another that is ancestral to Africa 1 and 2. Overall, this data summarizes information on the history and clinical presentation of human CCHF in Uganda. Importantly, it identifies vulnerable populations as well as temporal and geographic regions in Uganda where surveillance and control interventions could be focused.

Authors/Creators:Balinandi, Stephen and Whitmer, Shannon and Mulei, Sophia and Nyakarahuka, Luke and Tumusiime, Alex and Kyondo, Jackson and Baluku, Jimmy and Mutyaba, Joseph and Mugisha, Lawrence and Malmberg, Maja and Lutwama, Julius and Shoemaker, Trevor R. and Klena, John D.
Title:Clinical and Molecular Epidemiology of Crimean-Congo Hemorrhagic Fever in Humans in Uganda, 2013-2019
Series Name/Journal:American Journal of Tropical Medicine and Hygiene
Year of publishing :2022
Volume:106
Number:1
Page range:88-98
Number of Pages:11
Publisher:AMER SOC TROP MED AND HYGIENE
ISSN:0002-9637
Language:English
Publication Type:Research article
Article category:Scientific peer reviewed
Version:Published version
Copyright:Creative Commons: Attribution 4.0
Full Text Status:Public
Subjects:(A) Swedish standard research categories 2011 > 3 Medical and Health Sciences > 303 Health Sciences > Public Health, Global Health, Social Medicine and Epidemiology
(A) Swedish standard research categories 2011 > 3 Medical and Health Sciences > 302 Clinical Medicine > Infectious Medicine
URN:NBN:urn:nbn:se:slu:epsilon-p-116200
Permanent URL:
http://urn.kb.se/resolve?urn=urn:nbn:se:slu:epsilon-p-116200
Additional ID:
Type of IDID
DOI10.4269/ajtmh.21-0685
Web of Science (WoS)000751855700024
ID Code:27207
Faculty:VH - Faculty of Veterinary Medicine and Animal Science
Department:(VH) > Dept. of Animal Breeding and Genetics
(VH) > Department of Biomedical Science and Veterinary Public Health
Deposited By: SLUpub Connector
Deposited On:25 Feb 2022 10:10
Metadata Last Modified:25 Feb 2022 10:11

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