Jakimovski Dejan, Banović Pavle, Spasovska Katerina, Rangelov Goran, Cvetanovska Marija, Cana Fadil, Simin Verica, Bogdan Ivana, Mijatović Dragana, Cvetkovikj Aleksandar, Djadjovski Igor, Christova Iva, Meletis Eleftherios, Kostoulas Polychronis, Zana Brigitta, Lanszki Zsófia, Görföl Tamás, Tauber Zsófia, Kemenesi Gabor
Clinical medicine Task Force, Balkan Association for Vector-Borne Diseases, Novi Sad, Serbia.
University Clinic for Infectious Diseases and Febrile Conditions, Skopje, North Macedonia.
Euro Surveill. 2025 Jan;30(4). doi: 10.2807/1560-7917.ES.2025.30.4.2400286.
BackgroundCrimean-Congo haemorrhagic fever (CCHF) is a severe illness characterised by fever, bleeding and high case-fatality rates. The disease is caused by CCHF virus (CCHFV), transmitted by ticks and infectious body fluids and tissues.AimAfter CCHF was diagnosed in three persons in 2023, we aimed to investigate the presence of antibodies against CCHFV in healthcare workers (HCW), sheep and goats, and of CCHFV in ticks, in an area in North Macedonia and characterise virus strains.MethodsIn 2023, we collected blood samples from HCWs involved in treating CCHF patients and sera and ticks from sheep and goats in the village in North Macedonia where the index case resided. The blood samples were analysed by ELISA. Ticks were tested for presence of CCHFV, and the virus from a CCHF case was sequenced.ResultsSamples from four of 52 HCWs and 10 of 17 small ruminants had antibodies against CCHFV. The virus was not detected from any of the 24 ticks. The virus strain from the index case clustered with regional strains within the Europe-1 lineage (genotype V) group and was closest to strains from Kosovo‡.ConclusionThis report shows CCHFV is endemic in North Macedonia. Raising awareness of the risk factors and educating people about the measures they can take to reduce exposure to the virus is important. Healthcare workers need to be aware of the disease. Early detection, robust diagnostic methods, surveillance and collaborative efforts are necessary to prevent and control CCHF in the affected regions.
背景
克里米亚-刚果出血热（CCHF）是一种严重疾病，其特征为发热、出血和高病死率。该疾病由CCHF病毒（CCHFV）引起，通过蜱虫以及感染性体液和组织传播。
目的
2023年有三人被诊断感染CCHF后，我们旨在调查北马其顿某地区医护人员、绵羊和山羊体内抗CCHFV抗体的存在情况以及蜱虫体内CCHFV的存在情况，并对病毒株进行特征分析。
方法
2023年，我们从参与治疗CCHF患者的医护人员中采集血样，并从北马其顿该首例病例所在村庄的绵羊和山羊身上采集血清及蜱虫。血样通过酶联免疫吸附测定（ELISA）进行分析。检测蜱虫是否存在CCHFV，并对一例CCHF病例的病毒进行测序。
结果
52名医护人员中的4人以及17只小反刍动物中的10只的样本含有抗CCHFV抗体。在24只蜱虫中均未检测到该病毒。首例病例的病毒株与欧洲-1谱系（基因型V）组内的区域毒株聚类，且与科索沃的毒株最为接近。
结论
本报告表明CCHFV在北马其顿呈地方流行。提高对危险因素的认识并教育人们采取措施减少接触该病毒非常重要。医护人员需要了解该疾病。早期检测、可靠的诊断方法、监测以及协作努力对于在受影响地区预防和控制CCHF是必要的。
