CRIMEAN-CONGO HEMORRHAGIC FEVER – GREECE (NORTHEAST)

****************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Thu 3 Jul 2008
Source: PR-Inside.com, Associated Press report [edited]
<http://www.pr-inside.com/hospitals-in-northeastern-greece-on-r683082.htm>

Health authorities say hospitals in northeastern Greece have been put
on alert after a woman died of a form of insect-carried fever. [The
vectors of CCHF are ticks not insects. Ticks are ectoparasites
classified in the superfamily _Ixodoidea_, which, along with mites,
constitute the_Acarina_. – Mod.CP]. A Health Ministry statement says
tests showed the Greek woman was infected with Crimean-Congo
hemorrhagic fever (CCHF) after being bitten by a tick when working in
the fields. She died on 25 Jun 2008 in a hospital in the city of
Alexandroupoli, hospital officials say.

The fever is more common among livestock. Health officials said on
Thursday [3 Jul 2008] the disease can only be transmitted among
humans through contact with blood or other infected tissues. It is
endemic in many countries in Africa, Europe and Asia; Turkey has a
current outbreak [see ProMED-mail references below]. The World Health
Organisation (WHO) says the mortality rate from the disease is
approximately 30 percent.


Communicated by:
Claudio Po <ClPo@regione.emilia-romagna.it>
& Dimitrios Zonios <dzonios@yahoo.com>

[The Greek city of Alexandroupoli(s) is located several hundred km due
east of Thessaloniki, not far from the border with Turkey, in the
province of Macedonia & Thrace. It can be located on the
HealthMap/ProMED-mail interactive map of Greece at:
<http://healthmap.org/promed?v=39.1,23,6>.
This case of CCHF in Greece is within the normal range of the disease
and probably not linked epidemiologically to the current outbreak in
central Turkey (see ProMED-mail references below).

FJ Burt and R Swanepoel (Epidemiol Infect. 2005 Aug;133(4):659-66)
have examined the phylogenetic relationships of 70 Crimean-Congo
haemorrhagic fever (CCHF) isolates from southern, central and West
Africa, the Middle East and Greece using sequence data determined for
a region of the S segment of the genome. Analysis revealed up to 18
percent genetic differences, and the tree topology supported previous
evidence for the existence of 3 groups of genetically related
isolates, A, B and C. Within group A, there are 2 clades: an African
clade and a predominantly Asian clade comprising isolates from
Pakistan, China, Iran, Russia and Madagascar. Group B includes
isolates from southern and West Africa and Iran, and group C includes
a single isolate from Greece.

They concluded that despite the potential which exists for dispersal
of the virus between Africa and Eurasia, it appears that circulation
of the virus is largely compartmentalized within the 2 land masses,
and the inference is that the geographic distribution of phylogenetic
groups is related to the distribution and dispersal of tick vectors
of the virus. It will be of interest to compare the current Greek and
Turkish isolates in this respect.

A WHO Factfile on Crimean-Congo hemorrhagic fever can be accessed at
<http://www.who.int/mediacentre/factsheets/fs208/en/>.
– Mod.CP]

[see also:
Crimean-Congo hem. fever – Turkey (09) 20080622.1935
Crimean-Congo hem. fever – Turkey (08) 20080620.1917
Crimean-Congo hem. fever – Turkey (07) 20080616.1892
Crimean-Congo hem. fever – Turkey (06) 20080615.1888
Crimean-Congo hem. fever – Turkey (05) 20080612.1866
Crimean-Congo hem. fever – Turkey (04) 20080611.1838
Crimean-Congo hem. fever – Turkey (03) 20080522.1686
Crimean-Congo hem. fever – Turkey (02) 20080511.1610
Crimean-Congo hem. fever – Turkey 20080508.1567]

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