Emerging Infectious Disease ISSN: 1080-6059

Virus Detection and Monitoring of Viral Load in Crimean-Congo Hemorrhagic Fever Virus Patients

Roman Wölfel*†, Janusz T. Paweska‡, Nadine Petersen†, Antoinette A. Grobbelaar‡, Patricia A. Leman‡, Roger Hewson§, Marie-Claude Georges-Courbot¶, Anna Papa#, Stephan Günther†, and Christian Drosten†

Author affiliations: *Bundeswehr Institute of Microbiology, Munich, Germany; †Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany; ‡National Institute for Communicable Diseases, Sandringham, South Africa; §Health Protection Agency, Porton Down, Salisbury, United Kingdom; ¶Institute Pasteur, Lyon, France; #Aristotle University of Thessaloniki, Thessaloniki, Greece;

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Figure 1

Global distribution and phylogenetic relationships of Crimean-Congo hemorrhagic fever virus (CCHFV) strains selected for design and validation of the assay. All strains except those marked with asterisks were tested. Phylogenetic analysis was based on available 450-bp sequences (from the National Center for Biotechnology Information) of CCHFV small (S-) segment and generated by the neighbor-joining method with TreeCon for Windows (version 1.3b; Yves van de Peer, University Konstanz, Germany). Nomenclature of CCHFV clades is based on (7). Note that group VII can be resolved only when analyzing the M-segment, not the s-segment as shown here. *These CCHFV strains are shown for reference, but they were not available for testing. **This strain was not available; however, strain Kosovo, which is almost identical, was tested instead. ***Strain AP92 has also not been available for testing. It was isolated from a Rhipicephalus bursa tick and has never been associated with human disease.

Figure 1. Global distribution and phylogenetic relationships of Crimean-Congo hemorrhagic fever virus (CCHFV) strains selected for design and validation of the assay. All strains except those marked with asterisks were tested. Phylogenetic analysis was based on available 450-bp sequences (from the National Center for Biotechnology Information) of CCHFV small (S-) segment and generated by the neighbor-joining method with TreeCon for Windows (version 1.3b; Yves van de Peer, University Konstanz, Germany). Nomenclature of CCHFV clades is based on (7). Note that group VII can be resolved only when analyzing the M-segment, not the s-segment as shown here. *These CCHFV strains are shown for reference, but they were not available for testing. **This strain was not available; however, strain Kosovo, which is almost identical, was tested instead. ***Strain AP92 has also not been available for testing. It was isolated from a Rhipicephalus bursa tick and has never been associated with human disease.

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