Ngoc Kim, Stoikov Ivan, Trifonova Ivelina, Panayotova Elitsa, Taseva Evgenia, Trifonova Iva, Christova Iva
Department of Microbiology, National Center of Infectious and Parasitic Diseases, 1504 Sofia, Bulgaria.
Department of Virology, National Center of Infectious and Parasitic Diseases, 1233 Sofia, Bulgaria.
Pathogens. 2025 Aug 6;14(8):785. doi: 10.3390/pathogens14080785.
Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic viral disease endemic to parts of Africa, Asia and southeastern Europe. Bulgaria is one of the few European countries with the consistent annual reporting of human CCHF cases. This study provides a descriptive overview of 24 confirmed CCHF cases in Bulgaria between 2015 and 2024. Laboratory confirmation was performed by an enzyme-linked immunosorbent assay (ELISA) and/or real-time reverse transcriptase polymerase chain reaction (RT-qPCR) testing. Common findings included fever, fatigue, gastrointestinal symptoms, thrombocytopenia, leukopenia, liver dysfunction and coagulopathy. Two fatal cases were recorded. Two samples collected in 2016 and 2024 were subjected to whole-genome sequencing. Phylogenetic analysis showed that both strains clustered within the Turkish branch of the Europe 1 genotype and shared high genetic similarity with previous Bulgarian strains, as well as strains from neighboring countries. These findings suggest the long-term persistence of a genetically stable viral lineage in the region. Continuous molecular and clinical surveillance is necessary to monitor the evolution and public health impact of CCHFV in endemic areas.
克里米亚-刚果出血热（CCHF）是一种人畜共患的病毒性疾病，在非洲、亚洲和欧洲东南部的部分地区流行。保加利亚是少数几个每年持续报告人类CCHF病例的欧洲国家之一。本研究对2015年至2024年间保加利亚的24例确诊CCHF病例进行了描述性概述。通过酶联免疫吸附测定（ELISA）和/或实时逆转录聚合酶链反应（RT-qPCR）检测进行实验室确诊。常见症状包括发热、疲劳、胃肠道症状、血小板减少、白细胞减少、肝功能障碍和凝血病。记录了两例死亡病例。对2016年和2024年采集的两个样本进行了全基因组测序。系统发育分析表明，这两个毒株都聚集在欧洲1基因型的土耳其分支内，与保加利亚先前的毒株以及邻国的毒株具有高度的遗传相似性。这些发现表明该地区存在一种基因稳定的病毒谱系的长期持续存在。有必要进行持续的分子和临床监测，以监测CCHFV在流行地区的演变及其对公共卫生的影响。
