Detection of an Imported Case of Severe Crimean-Congo Hemorrhagic Feverbres2058

1. BIBLIOgRAPhIC INFORMATION SySTEM Journal Full Title:Journal of Biomedical Research & Environmental Sciences Journal NLM Abbreviation: J Biomed Res Environ Sci Journal Website Link: https://www.jelsciences.com Journal ISSN: 2766-2276 Category: Multidisciplinary Subject Areas: Medicine Group, Biology Group, General, Environmental Sciences Topics Summation: 133 Issue Regularity: Monthly Review Process: Double Blind Time to Publication: 21 Days Indexing catalog: IndexCopernicus ICV 2022: 88.03 | GoogleScholar | View more Publication fee catalog: Visit here DOI: 10.37871 (CrossRef) Plagiarism detection software: iThenticate Managing entity: USA Language: English Research work collecting capability: Worldwide Organized by: SciRes Literature LLC License: Open Access by Journal of Biomedical Research & Environmental Sciences is licensed under a Creative Commons Attribution 4.0 International License. Based on a work at SciRes Literature LLC. Manuscript should be submitted in Word Document (.doc or .docx) through Online Submission form or can be mailed to support@jelsciences.com IndexCopernicus ICV 2022: 83.03 Vision: Journal of Biomedical Research & Environmental Sciences main aim is to enhance the importance of science and technology to the scientific community and also to provide an equal opportunity to seek and share ideas to all our researchers and scientists without any barriers to develop their career and helping in their development of discovering the world.

2. CASE STUDY Detection of an Imported Case of Severe Crimean-Congo Hemorrhagic Fever in a Patient with Comorbidities, Dakar, Senegal 2023 Samba Niang Sagne1*, Ousseynou Sene2, Idrissa Dieng2, Mamadou Korka Diallo1, Amadou Moustapha Ndoye1, Moufi d Mhamadi2, Safi etou Sankhe2, Yoro Sall3, Boly Diop3, Oumar Faye2, Abdourahmane Sow4, Boubacar Diallo4, Moussa Moise Diagne2, Cheikh Loucoubar1, Gamou Fall2 and Mamadou Aliou Barry1 1Pole of Epidemiology, Clinical Research & Data Science, Institut Pasteur de Dakar, Dakar, Senegal 2Pole of Virology, Institut Pasteur de Dakar, Dakar, Senegal 3Prevention Department Ministry of Health, Dakar, Senegal 4Public Health Department, Institut Pasteur de Dakar, Dakar, Senegal *Corresponding author(s) Abstract Samba Niang Sagne, Pole of Epidemiology, Clinical Research & Data Science, Institut Pasteur de Dakar, Dakar, Senegal In July 2023, a diabetic from Mauritania was diagnosed as a severe case of Crimean- Congo hemorrhagic fever (CCHF) at Dakar hospital, Senegal. The phylogenetic analysis revealed the new strain as a CCHF virus reassortant between Genotype Ⅰ and Ⅲ, closely linked to strains from Spain, Mauritania, Senegal and South Africa. Genetic variability of the virus in West Africa underscores the urgent need for enhanced surveillance in West Africa. Email: sambaniang.sagne@pasteur.sn DOI: 10.37871/jbres2058 Submitted: 20 January 2025 Accepted: 31 January 2025 Published: 31 January 2025 Introduction Copyright: © 2025 Sagne SN, et al. Distributed under Creative Commons CC-BY 4.0 Crimean-Congo Hemorrhagic Fever (CCHF) have been reported across Africa, Asia and Europe regions where the primary vectors Hyalomma ticks are prevalent. CCHF infection is correlated with several risk factors, including the bites of ticks, the contact with a patient with CCHF during the acute phase of the infection as well as with blood or tissues from viremic livestock [1]. The initial symptoms of CCHF are nonspecifi c and can advance to a hemorrhagic phase, with fatality rate ranging from 20 to 30% [2]. OPEN ACCESS Keywords Imported  Severe  Crimean-Congo hemorrhagic fever  Comorbidities  Senegal 2023  The virus CCHFV belongs to the Orthonairovirus genus of the Nairoviridae family characterized by a negative tripartite RNA genome with three segments namely S (Small), M (Medium), and L (Large) [3]. The current CCHFV classifi cation includes fi ve genotypes: Ⅰ-Ⅲ in Africa, Ⅳ in Asia and Ⅴ in Europe [4]. In West Africa, the fi rst human CCHF cases were reported in Mauritania in 1983 [5]. Since them numerous outbreaks were described in Mauritania while sporadic cases were identifi ed in Senegal BIOLOGY GROUP INFECTIOUS DISEASES VIROLOGY VOLUME: 6 ISSUE: 1 - JANUARY, 2025 How to cite this article: Sagne SN, Sene O, Dieng I, Diallo MK, Ndoye AM, Mhamadi M, Sankhe S, Sall Y, Diop B, Faye O, Sow A, Diallo B, Diagne MM, Loucoubar C, Fall G, Barry MA. Detection of an Imported Case of Severe Crimean-Congo Hemorrhagic Fever in a Patient with Comorbidities, Dakar, Senegal 2023. J Biomed Res Environ Sci. 2025 Jan 31; 6(1): 082-085. doi: 10.37871/jbres2058, Article ID: JBRES2058, Available at: https://www.jelsciences.com/articles/ jbres2058.pdf

3. the patient succumbed to the complication. This case demonstrates clinical and biological similarities with the initial documented CCHF cases in West Africa including the fi rst instance in Mauritania and the 2004 case involving two tourist in Dakar in 2004 [6,7]. [5-7]. Here, we report the longitudinal clinical and biological observations of a CCHF case imported from Mauritania to Senegal in 2023 as well as the genomic characterization of the detected virus. The Study BLASTn analyses revealed that the newly identifi ed strain shares over 98% nucleotide sequence similarity with strains isolated from Spain in 2014 and 2016 (ASV45882, ATG31912), Senegal in 1975 (WAD86875), Mauritania in 1984 (ABB30041) and Sudan in 2009 (AEI70581). Phylogenetic analysis revealed that the new CCHF strain is a probable reassortant between Genotype I (L and M segment) and Ⅲ (S segment) and clustered with the recent known reassortant strain from Koumpentoum, Eastern Senegal in 2022 (Koum_SEN_2022) along the three segment [12]. Furthermore, these strains appear to have multiples origins as they form clusters with strain from Spain in 2014 and 2016, Mauritania in 1984, Senegal in 2019 and 2022 (ArD374334, Boki_CCHF_2019) and South-Africa in 1985 (AAZ38665, ABB30048) across the L, M and S segments (Figure 1). Reassortment in bunyaviruses can alter their pathogenicity, exemplifi ed by Ngari virus, a reassortant orthobunyavirus with L and S segment from Bunyamwera virus and the M segment from Batai virus. Although Bunyamwera and Batai viruses typically cause mild disease, Ngari has been associated with hemorrhagic fever cases in East Africa [13,14] . Therefore, it is crucial to investigate the potential impact of this reassortment on the biological properties of the new strains and ascertain its potential involvement in the observed severe clinical manifestations. The patient travelled from Mauritania, an epidemic country for CCHFV, supporting the idea of transboundary transmission and strain exchange between Senegal and Mauritania. In July 2023, a 59-year-old man with type 2 diabetes was admitted to emergency in Dakar hospital for febrile syndrome with negative rapid malaria test, an algic syndrome, an anemic syndrome, diff use petechiae and purpura, vomiting and asthenia. The illness had begun 02 weeks prior to admission. Biological results revealed severe hyperglycemia at 4.86 g/dl with glycosuria and absence of ketonuria, negative thickened gout, C-reactive protein at 28 mg/l, hemoglobin at 9.7 g/dl, thrombocytopenia at 2000/mm3, impaired renal function creatinemia at 46 mg/l, hyponatremia at 131 mEq/l, hypochloremia at 91 mEq/l, hepatic cytolysis with SGOT transaminase at 2020 IU/l, SGPT transaminase at 762 IU/l, biological cholestasis, direct bilirubin increased to 9.7 mg/l. He was treated with antipyretics, insulinotherapy and platelet concentrate transfusions. The evolution marked by the occurrence of gingivorrhagia and epitaxis. A Viral Hemorrhagic Fever (VHF) suspected, blood sample taken and sent to Institut Pasteur Dakar (IPD) laboratory. He succumbed two days after his admission from hemorrhagic shock. At IPD, viral RNA was extracted from the clinical sample using the QIAamp viral RNA mini kit according to the manufacturer's instructions (Qiagen, Hilden, Germany) and screened for several arboviruses and VHFs including CCHFV by real time RT-PCR [8]. The results confi rmed the presence of CCHFV in the sample. Whole genome sequencing was performed following an hybrid capture approach with the Twist Biosciences Comprehensive Viral Research Panel (CVRP) as previously described on an Illumina iSeq100 instrument [9]. The sequencing reads were analyzed using the open-source metagenomics CZ- ID platform (http://czid.org), employing default threshold fi lters for quality checking reads, base- calling and generating consensus sequences. Nearly complete genomes obtained during this work were submitted to a public nucleotide BLAST database to identify their homologous sequences. Sequences were aligned using the MAFFT program and Maximum Likelihood phylogenetic tree build with IQ-TREE with 1000 bootstrap replicates for robustness [10,11]. Our study reports a CCHF case imported from Mauritania in a patient with comorbidities (diabetic). Regrettably, Our study highlights Mauritania’s high-risk status for CCHF and confi rm the hypothesis of strains exchange between diff erent countries including Senegal and Mauritania. Additionally, it sheds light on the genetic diversity among West African CCHF strains and raises question about the potential introduction of CCHF strains from other countries including Spain and South Africa and underscoring the need for enhanced surveillance to prevent future outbreaks. It also emphasizes the importance of considering comorbidity factors, such as diabetes, in the management of CCHF cases. Lack of early detection of CCHF in Mauritania might be due to the unspecifi c symptoms during the acute stage of the disease or to ineffi cient surveillance system. Sagne SN, et al. (2025) J Biomed Res Environ Sci, DOI: https://dx.doi.org/10.37871/jbres2058 083

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