@article{fdi:010054174,
  title = {{R}e-emergence of {C}rimean-{C}ongo {H}emorrhagic {F}ever {V}irus in {C}entral {A}frica},
  author = {{G}rard, {G}. and {D}rexler, {J}. {F}. and {F}air, {J}. and {M}uyembe, {J}. {J}. and {W}olfe, {N}. {D}. and {D}rosten, {C}. and {L}eroy, {E}ric},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground: {C}rimean-{C}ongo hemorrhagic fever ({CCHF}) is a severe tick-borne disease well recognized through {E}urope and {A}sia where diagnostic tests and medical surveillance are available. {H}owever, it is largely neglected in {A}frica, especially in the tropical rainforest of {C}entral {A}frica where only sporadic human cases have been reported and date back to more than 30 years. {W}e describe here an isolated human case that occurred in the {D}emocratic {R}epublic of the {C}ongo in 2008 and performed phylogenetic analysis to investigate whether it resulted from a regional re-emergence or from the introduction of a novel virus in the area. {M}ethods and {F}indings: {N}ear complete segment {S} and partial segment {M} sequences were characterized. {B}ayesian phylogenetic analysis and datation were performed to investigate the relationship between this new strain and viral strains from {A}frica, {E}urope and {A}sia. {T}he new strain is phylogenetically close to the previously described regional genotype ({II}) that appears to be specific to {C}entral {A}frica. {P}hylogenetic discrepancy between segment {S} and {M} suggested genetic exchange among local sublineages, which was dated back to 130-590 years before present. {C}onclusions: {T}he phylogenetic analyses presented here suggest ongoing {CCHF} virus circulation in {C}entral {A}frica for a long time despite the absence of reported human cases. {M}any infections have most probably been overlooked, due to the weakness of healthcare structures and the absence of available diagnostic procedure. {H}owever, despite the lack of accurate ecological data, the sporadic reporting of human cases could also be partly associated with a specific sylvatic cycle in {C}entral {A}frica where deforestation may raise the risks of re-emergence. {F}or these reasons, together with the high risk of nosocomial transmission, public health authorities' attention should be drawn to this etiological agent.},
  keywords = {},
  booktitle = {},
  journal = {{P}los {N}eglected {T}ropical {D}iseases},
  volume = {5},
  numero = {10},
  pages = {e1350},
  ISSN = {1935-2727},
  year = {2011},
  DOI = {10.1371/journal.pntd.0001350},
  URL = {https://www.documentation.ird.fr/hor/fdi:010054174},
}