Clinical Research:

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.
       (UI:  97424499)

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.

Simbu Serogroup

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.
       (UI:  97364120)

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
    serogroup viruses.

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