Résumé de : SALUZZO (JF), AUBRY (P), Mc CORMICK (JC) & DIGOUTTE (JP) - 1985 - Haemorrhagic fever caused by Crimean Congo Haemorrhagic fever virus in Mauritania. Transactions of the Royal Society of Tropical Medecine & Hygiene, 79 (2): p. 268.


TEXTE COMPLET :

Introduction


The Dakar Pasteur Institute has been engaged since 1983 in a survey of haemorrhagic fevers in Senegal, in collaboration with the Centers for Disease Control in Atlanta, USA. In the present note, we report the first human case of haemorrhagic fever attributed to the Nairovirus Crimean Congo Haemorrhagic Fever (CCHF) virus in West Africa.

Case Report


The patient, a 48-year-old male, lived in Selibaby a (Southern Mauritania). He was admitted to a local hospital on May 26, 1983, with fever, headache and myalgia. On May 29, the patient developed haemorrhage with epistaxis, haematemesis, petechiae, purpura on the legs, large haematomas around venepuncture and injection sites and extravasation of blood in the limbs causing extensive ecchymotic areas. On May 31, he was evacuated to Nouakchott hospital and on June 3, to Dakar hospital. A consultant physician observed a severe haemorrhagic syndrome without jaundice or renal failure. During the haemorrhagic period, the patient had leukopenia (36OO per mm3) of and thrombocytopenia (70,000 per mm3). The patient was discharged from the hospital on June 20. Blood collected on the ninth day after onset was inocu1ate into suckling-mice. No virus was isolated. Four sera collected 9, 27, 66, and 122 days after onset were tested by immunofluorescent antibody (IF A) and complement fixation test (CF) with CCHF antigens. The results are positive. These sera were found negative by CF test against Bandia and Dugbe antigens, two other viruses of the Nairovirus genus (CASALS & TIGNOR, 1980).

Discussion


CHF virus is endemic in a wide area of Africa (HOOOSTRAAL, 1979). The virus has been isolate from ticks collected on cattle and from domestic and wild animals in Senegal, Nigeria, Central African Republic, Uganda, Kenya and the Republic of South Africa. Serological survey results in humans and domestic and wild animals demonstrated antibody to the virus in Tanzania and Ethiopia. 17 human cases have been reported from Africa. In Uganda, 13 strains of CCHF virus were isolated from the blood of febrile persons. In Zaire, two cases were reported. The strain isolated from a 13-year-old African boy in the Kisangani hospital became the prototype of Congo virus. In the Central African Republic, the virus was isolated at the Pasteur Institute from a laboratory worker. Recently, one strain was isolated from the blood of a young child in Johannesburg (South Africa) (GEAR et al., 1982). Only two patients one in Uganda and one in South Africa) developed haemorrhagic syndrome and died.
In West Africa, no human case has been previously reported. From 1969 to 1974, 26 CCHF virus strains were isolated in Senegal from adult ticks collected from cattle at the Dakar abattoirs. Antibodies were detected in sera of cattle collected in different ecological areas in Senegal. In Nigeria, CCHF virus was isolated from ticks and domestic animals.
The present note reports the first case in West Africa of human CCHF virus infection with haemorrhagic syndrome and extends the known distribution of the virus to Mauritania.
The medical importance of the CCHF virus infeclion, the role played by ticks, and potential vertebrate hosts in Southern Mauritania and other areas of West Africa deserve more investigation.