[{"command":"openDialog","selector":"#drupal-modal","settings":null,"data":"\u003Cdiv id=\u0022republish_modal_form\u0022\u003E\u003Cform class=\u0022modal-form-example-modal-form ecl-form\u0022 data-drupal-selector=\u0022modal-form-example-modal-form\u0022 action=\u0022\/en\/article\/modal\/10352\u0022 method=\u0022post\u0022 id=\u0022modal-form-example-modal-form\u0022 accept-charset=\u0022UTF-8\u0022\u003E\u003Cp\u003EHorizon articles can be republished for free under the Creative Commons Attribution 4.0 International (CC BY 4.0) licence.\u003C\/p\u003E\n \u003Cp\u003EYou must give appropriate credit. We ask you to do this by:\u003Cbr \/\u003E\n 1) Using the original journalist\u0027s byline\u003Cbr \/\u003E\n 2) Linking back to our original story\u003Cbr \/\u003E\n 3) Using the following text in the footer: This article was originally published in \u003Ca href=\u0027#\u0027\u003EHorizon, the EU Research and Innovation magazine\u003C\/a\u003E\u003C\/p\u003E\n \u003Cp\u003ESee our full republication guidelines \u003Ca href=\u0027\/horizon-magazine\/republish-our-stories\u0027\u003Ehere\u003C\/a\u003E\u003C\/p\u003E\n \u003Cp\u003EHTML for this article, including the attribution and page view counter, is below:\u003C\/p\u003E\u003Cdiv class=\u0022js-form-item form-item js-form-type-textarea form-item-body-content js-form-item-body-content ecl-form-group ecl-form-group--text-area form-no-label ecl-u-mv-m\u0022\u003E\n \n\u003Cdiv\u003E\n \u003Ctextarea data-drupal-selector=\u0022edit-body-content\u0022 aria-describedby=\u0022edit-body-content--description\u0022 id=\u0022edit-body-content\u0022 name=\u0022body_content\u0022 rows=\u00225\u0022 cols=\u002260\u0022 class=\u0022form-textarea ecl-text-area\u0022\u003E\u003Ch2\u003EA rare and lethal virus is spreading in Europe, prompting hunt for tests and cures\u003C\/h2\u003E\u003Cp\u003EA 62-year-old man was bitten by a tick while hiking through fields in Spain. Two days later he began to feel ill and was taken to a hospital in Madrid, where his condition deteriorated rapidly. He died on the ninth day of his illness.\u003C\/p\u003E\n\n\u003Cp\u003EThis was in 2016 and proved to be the first fatality in Spain caused by Crimean-Congo haemorrhagic fever (CCHF), a disease spread by ticks that starts with flu-like symptoms and often can end in organ failure.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cstrong\u003ENorthward advance\u003C\/strong\u003E\u003C\/p\u003E\n\n\u003Cp\u003E\u2018The ticks are moving up through Europe due to climate change, with longer and drier summers,\u2019 said Professor Ali Mirazimi, a virologist at the Karolinska Institute in Sweden.\u003C\/p\u003E\n\n\u003Cp\u003EThe initial case was challenging to diagnose for Spanish doctors because the haemorrhagic fever had been absent from western Europe. A nurse at the patient\u2019s hospital also contracted the fever from him, but survived after weeks in intensive care.\u003C\/p\u003E\n\n\u003Cp\u003EThen, in\u0026nbsp;\u003Ca href=\u0022https:\/\/www.reuters.com\/world\/europe\/spain-confirms-case-crimean-congo-haemorrhagic-fever-2022-07-21\/\u0022\u003EJuly 2022\u003C\/a\u003E, another man in Spain was hospitalised with the same disease. Scientists are now warning that CCHF, which can kill between 10% and 40% of patients, is spreading northward and westward in Europe.\u003C\/p\u003E\n\n\u003Cp\u003EIt is caused by a virus in a type of tick that feeds on small animals when it\u2019s a juvenile and then moves to larger ones, including livestock, as an adult.\u003C\/p\u003E\n\n\u003Cp\u003ECCHF was first described during an outbreak in 1944 among soldiers in Crimea on the northern coast of the Black Sea and sporadic outbreaks are still recorded today, especially in Africa, eastern Europe, Turkey, central Asia and India. The disease is spreading globally.\u003C\/p\u003E\n\n\u003Cp\u003EOne infected tick can produce thousands of infected eggs. The young ticks feed on small mammals such as rabbits as well as on birds.\u003C\/p\u003E\n\n\u003Cp\u003EThe avian link allows the ticks to\u0026nbsp;hitch a ride and the virus to colonise new areas.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cstrong\u003EDangerous arrivals\u003C\/strong\u003E\u003C\/p\u003E\n\n\u003Cp\u003E\u2018Once we find the infected ticks, we know that sooner or later there will be an outbreak,\u2019 said Mirazimi\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cblockquote class=\u0022tw-text-center tw-text-blue tw-font-bold tw-text-2xl lg:tw-w-1\/2 tw-border-2 tw-border-blue tw-p-12 tw-my-8 lg:tw-m-12 lg:tw--ml-16 tw-float-left\u0022\u003E\n \u003Cspan class=\u0022tw-text-5xl tw-rotate-180\u0022\u003E\u201c\u003C\/span\u003E\n \u003Cp class=\u0022tw-font-serif tw-italic\u0022\u003EThe ticks are moving up through Europe due to climate change, with longer and drier summers\r\n\u003C\/p\u003E\n \u003Cfooter\u003E\n \u003Ccite class=\u0022tw-not-italic tw-font-normal tw-text-sm tw-text-black\u0022\u003EAli Mirazimi, VHFMoDRAD\u003C\/cite\u003E\n \u003C\/footer\u003E\n\u003C\/blockquote\u003E\n\u003C\/p\u003E\n\n\u003Cp\u003EThe virus is currently in ticks in, for example, Italy, but there have been no outbreaks. Its arrival in new countries is dangerous because it can be difficult for doctors to identify the new disease in patients.\u003C\/p\u003E\n\n\u003Cp\u003E\u2018We don\u2019t have good medical cures,\u2019 said Mirazimi. \u2018There is no good antiviral, no approved vaccine and knowledge of the disease is not complete.\u2019\u003C\/p\u003E\n\n\u003Cp\u003EThis means that doctors have no choice but to rely on general medical treatment, which consists of fluids, medication and intensive care if needed.\u003C\/p\u003E\n\n\u003Cp\u003EAnother challenge is that a person infected with the haemorrhagic fever can spread it to close contacts through saliva and sweat. That poses a risk to family members as well as to the doctors and nurses treating the person.\u003C\/p\u003E\n\n\u003Cp\u003ESo the sooner a patient is diagnosed, the better it is for everyone, because rapid diagnosis allows patients to be properly isolated.\u003Cbr \/\u003E\n\u003Cbr \/\u003E\n\u003Cstrong\u003ETesting 1, 2, 3\u003C\/strong\u003E\u003C\/p\u003E\n\n\u003Cp\u003EAll of which highlights the importance of a project that Mirazimi led called \u003Ca href=\u0022https:\/\/cordis.europa.eu\/project\/id\/823666\u0022\u003EVHFMoDRAD\u003C\/a\u003E\u0026nbsp;to develop tests for the disease. The initiative, funded by the EU and industry, ran from 2019 through 2022.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003EOne resulting approach uses polymerase chain reaction \u2013 or PCR \u2013 tests, which usually require sophisticated laboratory equipment and trained personnel. But here it taps into a special machine that\u2019s easier and faster.\u003C\/p\u003E\n\n\u003Cp\u003EIn another approach, the project developed easy-to-use tests like those that became readily available for Covid-19 rapid checks.\u003C\/p\u003E\n\n\u003Cp\u003EAn added benefit of these tests is that they aim to detect not just CCHF but also other viral haemorrhagic fevers\u0026nbsp;\u2013 a group that includes Ebola, Marburg and Lassa viruses. As recently as February and March this year, two distinct outbreaks of \u003Ca href=\u0022https:\/\/emergency.cdc.gov\/han\/2023\/han00489.asp#:~:text=Marburg%20virus%20disease%20is%20a,in%20Equatorial%20Guinea%20and%20Tanzania.\u0022\u003EMarburg virus\u003C\/a\u003E were reported in Equatorial Guinea and Tanzania.\u003C\/p\u003E\n\n\u003Cp\u003EBut the most notorious is Ebola. This virus infected more than 28\u0026nbsp;000 people in \u003Ca href=\u0022https:\/\/www.who.int\/emergencies\/situations\/ebola-outbreak-2014-2016-West-Africa\u0022\u003Ean outbreak\u003C\/a\u003E that began in Guinea in 2014. It spread to seven other countries and killed more than 11\u0026nbsp;000 people by the time the outbreak ended in 2016.\u003C\/p\u003E\n\n\u003Cp\u003EOutbreaks of haemorrhagic fevers in general need to be identified urgently, according to Professor Roger Hewson, an expert on CCHF and other haemorrhagic viruses at the Liverpool School of Tropical Medicine in the UK.\u0026nbsp;\u003C\/p\u003E\n\n\u003Cp\u003E\u2018They cause very profound and devastating mortality rates,\u2019 said Hewson, who collaborated with Mirazimi in the VHFMoDRAD project. \u2018If you have rapid diagnosis, patients can be rapidly isolated and lives saved.\u2019\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cblockquote class=\u0022tw-text-center tw-text-blue tw-font-bold tw-text-2xl lg:tw-w-1\/2 tw-border-2 tw-border-blue tw-p-12 tw-my-8 lg:tw-m-12 lg:tw--ml-16 tw-float-left\u0022\u003E\n \u003Cspan class=\u0022tw-text-5xl tw-rotate-180\u0022\u003E\u201c\u003C\/span\u003E\n \u003Cp class=\u0022tw-font-serif tw-italic\u0022\u003EThe viruses are often removed from the body after a few weeks, but the immune response then causes haemorrhaging\r\n\u003C\/p\u003E\n \u003Cfooter\u003E\n \u003Ccite class=\u0022tw-not-italic tw-font-normal tw-text-sm tw-text-black\u0022\u003ERoger Hewson, VHFMoDRAD\u003C\/cite\u003E\n \u003C\/footer\u003E\n\u003C\/blockquote\u003E\n\u003C\/p\u003E\n\n\u003Cp\u003ECCHF isn\u2019t the only\u0026nbsp;haemorrhagic fever that can be spread as a result of close contact via, for example, saliva or sweat, making other forms easy to pass on during, say, medical care or funerals.\u003C\/p\u003E\n\n\u003Cp\u003EThis happened in West Africa during the Ebola outbreak. Crucially, VHFMoDRAD found a way to deactivate any virus present as the blood sample is drawn, making it safer to test for these diseases.\u003C\/p\u003E\n\n\u003Cp\u003EIn the past, deadly outbreaks of Ebola in isolated communities in Africa likely occurred without getting reported. Today, better transport links enable such viruses to spread rapidly to large urban areas.\u003C\/p\u003E\n\n\u003Cp\u003EOnce identified, patients can often be saved with appropriate treatment.\u003C\/p\u003E\n\n\u003Cp\u003EIn Turkey, CCHF is so common that doctors readily identify the illness and administer appropriate life-saving care to patients. As a result, according to scientists, the mortality rate from CCHF in Turkey is a relatively low 7%.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cstrong\u003EFierce fight\u003C\/strong\u003E\u003C\/p\u003E\n\n\u003Cp\u003EViruses that cause haemorrhagic fevers usually live in animals such as bats \u2013 which is true for Ebola and Marburg \u2013 and rarely jump to people. Once such infections occur, many people\u2019s immune systems fight the invader so fiercely that fatal organ damage occurs.\u003C\/p\u003E\n\n\u003Cp\u003E\u2018The viruses are often removed from the body after a few weeks, but the immune response then causes haemorrhaging,\u2019 said Hewson.\u003C\/p\u003E\n\n\u003Cp\u003EHis lab is studying CCHF to understand immune responses to the virus. This research is feeding into another EU-funded project, \u003Ca href=\u0022https:\/\/cordis.europa.eu\/project\/id\/732732\u0022\u003ECCHFVaccine\u003C\/a\u003E, to develop a vaccine.\u003C\/p\u003E\n\n\u003Cp\u003EThis initiative, also run from Sweden, began in 2017 and is due to wrap up in June this year. So far, two types of vaccines have been pursued.\u003C\/p\u003E\n\n\u003Cp\u003EIn planned follow-up work, vaccine safety trials will be carried out in Sweden towards the end of this year or in early 2024. Phase III trials to prove a vaccine is effective could then move to Turkey.\u003C\/p\u003E\n\n\u003Cp\u003EThe vaccine would be aimed at people on the frontlines most at risk. These include doctors, nurses, veterinarians, workers in livestock slaughter facilities and perhaps even tourists in endemic areas.\u003C\/p\u003E\n\n\u003Cp\u003EWhile still rare in Europe, CCHF is posing serious challenges.\u003C\/p\u003E\n\n\u003Cp\u003E\u2018The consequences are really huge for anyone who gets infected,\u2019\u0026nbsp;said Mirazimi.\u003C\/p\u003E\n\n\u003Cp\u003E\u003Cem\u003EThe VHFMoDRAD project was funded\u0026nbsp;\u003C\/em\u003E\u003Cem\u003Eby the \u003C\/em\u003E\u003Ca href=\u0022https:\/\/www.imi.europa.eu\/\u0022\u003E\u003Cem\u003EInnovative Medicines Initiative\u003C\/em\u003E\u003C\/a\u003E\u003Cem\u003E, a partnership between the EU and the European pharmaceutical industry. 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