MOLECULAR INVESTIGATION OF A MULTISOURCE OUTBREAK OF CRIMEAN-CONGO HEMORRHAGIC-FEVER IN THE UNITED-ARAB-EMIRATES

During the investigation of an outbreak of Crimean-Congo hemorrhagic f ever (CCHF) in the United Arab Emirates (UAE) between 1994 and 1995, b lood samples from suspected CCHF cases and ticks collected from livest ock were tested for CCHF virus by antigen-capture ELISA and by a rever se transcription-polymerase chain reaction. Phylogenetic analysis of p artial small (S) segment nucleotide sequences from four ticks and five human samples showed that with one exception, all the human and tick viruses clustered along with samples from Pakistan and Madagascar in o ne distinct lineage. Within this lineage, sequences from the UAE patie nts were identical or closely related to those from three Hyalomma spp . ticks obtained from livestock recently imported from Somalia. Anothe r sequence from a UAE patient was more closely related to a CCHF virus from Nigeria. These data indicate that the 1994-1995 CCHF epidemic in the UAE was a multisource outbreak possibly associated with importati on of CCHF virus-infected livestock and ticks.