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Open Access Highly Accessed Research article

Genetic analysis and epidemiology of Crimean Congo hemorrhagic fever viruses in Baluchistan province of Pakistan

Muhammad Masroor Alam, Adnan Khurshid, Salmaan Sharif, Shahzad Shaukat, Muhammad Suleman Rana, Mehar Angez and Syed Sohail Zahoor Zaidi*

Author Affiliations

Department of Virology, National Institute of Health, Chak Shahzad, Park Road, Islamabad, 44000, Pakistan

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BMC Infectious Diseases 2013, 13:201  doi:10.1186/1471-2334-13-201

Published: 4 May 2013

Abstract

Background

Pakistan is considered as an endemic country for Crimean-Congo Hemorrhagic fever with numerous outbreaks and sporadic cases reported during the past two decades. Majority of cases are reported from Baluchistan province with subsequent transmissions to non-endemic regions mainly through infected animals directly or via infested ticks. We hereby describe the molecular investigations of CCHF cases reported during 2008 in Quetta city of Baluchistan province.

Methods

Serum Samples from 44 patients, with clinical signs of hemorrhagic fever attending a tertiary care hospital in Quetta city, were collected and tested for CCHF virus antigen and genomic RNA, using capture IgM EIA kit and standard RT-PCR assay, respectively. The partial S-gene fragments were directly sequenced to get information related to the prevailing CCHFV genotypes and their molecular epidemiology in Pakistan.

Results

Out of the total forty four, sixteen (36%) samples were found positive for CCHF IgM. Similarly, viral RNA was detected in six (16%) samples. Phylogenetic analysis revealed that all study viruses belong to genotype Asia-1 with closest similarity (99-100%) to the previously reported strains from Pakistan, Afghanistan and Iran.

Conclusion

We conclude that CCHF virus remains endemic within Baluchistan and its neighboring regions of Afghanistan warranting a need of incessant surveillance activities.

Keywords:
Crimean Congo hemorrhagic fever; Pakistan; CCHFV Asia type-1 genotype; Baluchistan; Molecular epidemiology