Crimean-Congo Hemorrhagic Fever
Burt FJ; Swanepoel R; Shieh WJ; Smith
JF; Leman PA; Greer PW; Coffield LM;
Rollin PE; Ksiazek TG; Peters CJ; et al.
Immunohistochemical and in situ localization of Crimean-Congo hemorrhagic
fever (CCHF) virus in human tissues and implications for CCHF
Archives of Pathology and Laboratory Medicine, 1997 Aug, 121(8):839-46.
Abstract: BACKGROUND: Crimean-Congo
hemorrhagic fever (CCHF) is a potentially
fatal disease that occurs in parts of Africa, Asia, and eastern Europe, and
that is caused by a recently emerged bunyavirus. Rapid laboratory diagnosis
of CCHF infection is essential and is currently performed by virus
isolation and serology. Histopathologic studies have been limited to a
small number of cases, and little is known about the cellular tropism of
CCHF virus and the pathogenesis of this disease. DESIGN: We conducted a
retrospective case analysis of 12 patients with a diagnosis of CCHF
infection, confirmed by virus isolation, who were evaluated at the Special
Pathogens Unit, National Institute for Virology, South Africa. The
clinicopathologic features of CCHF and the diagnostic role of virus
isolation as compared with serology, immunohistochemistry, and in situ
hybridization were evaluated. Additionally, the distribution of CCHF virus
in human tissues was examined. RESULTS: The clinical and histopathologic
features of CCHF resemble those of other viral hemorrhagic fevers. Of the
12 patients with virus isolation-confirmed CCHF infection, 5 were positive
by serology, 10 by immunohistochemistry, and 5 by in situ hybridization.
Immunohistochemistry and in situ hybridization analyses showed that the
mononuclear phagocytes, endothelial cells, and hepatocytes are main targets
of infection. Association of parenchymal necrosis in liver with viral
infection suggests that cell damage may be mediated by a direct viral
cytopathic effect. CONCLUSIONS: The diagnosis of CCHF, suspected by history
and clinical features, can be supported histopathologically. However, since
the pathologic features resemble those of other viral hemorrhagic fevers,
an unequivocal diagnosis can be made only by laboratory tests. The utility
of immunohistochemistry as a sensitive and rapid diagnostic modality was
established by the high degree of concordance with virus isolation.
Infection of mononuclear phagocytes, endothelial cells, and hepatocytes may
play a critical role in the pathogenesis of CCHF.
Blacksell SD; Lunt RA; White JR.
Rapid identification of Australian bunyavirus isolates belonging to the
Simbu serogroup using indirect ELISA formats.
Journal of Virological Methods, 1997 Jun, 66(1):123-33.
Abstract: The Bunyavirus genus, belonging
to the Bunyaviridae family, is
comprised of a large group of antigenically and geographically disparate
arthropod-borne viruses of medical and veterinary significance. In
Australia, viruses belonging to the Simbu serogroup of the Bunyavirus
genus, Akabane, Tinaroo, Peaton, Aino, Douglas, Thimiri and Facey's Paddock
have been isolated. In this communication we describe two indirect ELISAs,
referred to as the Simbu serogroup ELISA (SG-ELISA), and the Simbu typing
ELISA (ST-ELISA), for the identification of these Simbu serogroup viruses.
Infected cell lysate antigens prepared from Simbu serogroup virus isolates
were assessed in the SG-ELISA for reactivity with a mouse monoclonal
antibody (4H9/B11/F1). The monoclonal antibody reacted strongly with all
Australian members of Simbu serogroup reference viruses and is proposed for
use as a serogrouping reagent for Simbu viruses. Furthermore, the ST-ELISA
enabled specific identification of viruses from within this group by
recognition of characteristic reaction patterns between infected cell
lysate antigens and a panel of polyclonal antisera raised to Simbu