Flusin O, Iseni F, Rodrigues R, Paranhos-Baccalà G, Crance J M, Marianneau P, Bouloy M, Peyrefitte C N
Unité de virologie, Institut de Recherche Biomédicale des Armées-CRSSA antenne de Grenoble, La Tronche.
Med Trop (Mars). 2010 Dec;70(5-6):429-38.
Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease described in more than 30 countries in Europe, Asia and Africa. The causative agent is the Crimean-Congo hemorrhagic fever virus (CCHFV) that is a member of the genus Nairovirus of the family Bunyaviridae. CCHFV that is characterized by a high genetic variability is transmitted to humans by tick bites or contact with fluids from an infected individual or animal. The initial symptoms of CCHF are nonspecific and gradually progress to a hemorrhagic phase that can be lethal (case-fatality rate: 10 to 50%). Characteristic laboratory findings of CCHF are thrombocytopenia, elevated liver and muscle enzymes, and coagulation defects. The pathogenesis of CCHF remains unclear but might involve excessive pro-inflammatory cytokine production and dysfunction of the innate immune response. Diagnosis of CCHF is based mainly on isolation of the virus, identification of the viral genome by molecular techniques (RT-PCR), and serological detection of anti-CCHFV antibodies. There is currently no specific treatment for CCHFV infection and the efficacy of ribavirin is controversial. In absence of an effective vaccine, prevention is based mainly on vector control, protection measures, and information to increase the awareness of the population and of healthcare workers.
克里米亚-刚果出血热（CCHF）是一种蜱传疾病，在欧洲、亚洲和非洲的30多个国家均有记载。病原体是克里米亚-刚果出血热病毒（CCHFV），它属于布尼亚病毒科内罗病毒属。CCHFV具有高度的基因变异性，可通过蜱叮咬或接触受感染个体或动物的体液传播给人类。CCHF的初始症状不具特异性，随后会逐渐发展至出血期，这可能会致命（病死率：10%至50%）。CCHF的典型实验室检查结果为血小板减少、肝酶和肌酶升高以及凝血功能缺陷。CCHF的发病机制尚不清楚，但可能涉及促炎细胞因子过度产生和固有免疫反应功能障碍。CCHF的诊断主要基于病毒分离、通过分子技术（RT-PCR）鉴定病毒基因组以及血清学检测抗CCHFV抗体。目前尚无针对CCHFV感染的特效治疗方法，利巴韦林的疗效存在争议。在缺乏有效疫苗的情况下，预防主要基于病媒控制、防护措施以及开展宣传教育以提高公众和医护人员的意识。
