Molecular Investigation of a Multisource Outbreak of Crimeancongo Hemorrhagic Fever in the United Arab Emirates

Luis L. RodriguezDivision of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Virology Division, U.S. Army Medical Research Institute of Infectious Diseases, Ministry of Health, Atlanta, Georgia

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Gary O. MaupinDivision of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Virology Division, U.S. Army Medical Research Institute of Infectious Diseases, Ministry of Health, Atlanta, Georgia

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Thomas G. KsiazekDivision of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Virology Division, U.S. Army Medical Research Institute of Infectious Diseases, Ministry of Health, Atlanta, Georgia

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Pierre E. RollinDivision of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Virology Division, U.S. Army Medical Research Institute of Infectious Diseases, Ministry of Health, Atlanta, Georgia

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Ali S. KhanDivision of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Virology Division, U.S. Army Medical Research Institute of Infectious Diseases, Ministry of Health, Atlanta, Georgia

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Tino F. SchwarzDivision of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Virology Division, U.S. Army Medical Research Institute of Infectious Diseases, Ministry of Health, Atlanta, Georgia

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Richard S. LoftsDivision of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Virology Division, U.S. Army Medical Research Institute of Infectious Diseases, Ministry of Health, Atlanta, Georgia

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Jonathan F. SmithDivision of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Virology Division, U.S. Army Medical Research Institute of Infectious Diseases, Ministry of Health, Atlanta, Georgia

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Abdul M. NoorDivision of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Virology Division, U.S. Army Medical Research Institute of Infectious Diseases, Ministry of Health, Atlanta, Georgia

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Clarence J. PetersDivision of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Virology Division, U.S. Army Medical Research Institute of Infectious Diseases, Ministry of Health, Atlanta, Georgia

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Stuart T. NicholDivision of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Virology Division, U.S. Army Medical Research Institute of Infectious Diseases, Ministry of Health, Atlanta, Georgia

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During the investigation of an outbreak of Crimean-Congo hemorrhagic fever (CCHF) in the United Arab Emirates (UAE) between 1994 and 1995, blood samples from suspected CCHF cases and ticks collected from livestock were tested for CCHF virus by antigen-capture ELISA and by a reverse transcription-polymerase chain reaction. Phylogenetic analysis of partial 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 one distinct lineage. Within this lineage, sequences from the UAE patients were identical or closely related to those from three Hyalomma spp. ticks obtained from livestock recently imported from Somalia. Another 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 importation of CCHF virus-infected livestock and ticks.

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