Germany and Kosovo Collaborate to Combat Hyalomma Ticks and Crimean-Congo Hemorrhagic Fever

Germany has high-security laboratories while Kosovo has Hyalomma ticks and experience with the deadly Crimean-Congo hemorrhagic fever. Working together, German and Kosovar scientists are addressing the disease and its vectors. The Hyalomma tick, known as "the great hunting tick," can detect its prey from up to 200 meters (about 650 feet) away and actively pursues animals and humans. Previously found mainly in Africa, Asia, and southern Europe, climate change has allowed it to survive further north, with sightings reported in Germany and various Eastern European countries. Kosovo has been a hotspot for the tick for some time. The Hyalomma tick is a vector for the Crimean-Congo hemorrhagic fever virus, which has a high fatality rate and presents symptoms similar to Ebola fever or the Marburg virus, potentially leading to internal bleeding and death. Kurtesh Sherifi, a veterinarian from Kosovo, became interested in the disease after reading about it in 2005 when 11 people in Kosovo contracted the disease, resulting in five fatalities. He later began working with the faculty of agriculture and veterinary medicine at the University of Pristina, but faced challenges due to limited research funding and lack of high-security laboratory facilities. Sherifi reached out to Germany's Bernhard Nocht Institute for Tropical Medicine in Hamburg, where he connected with virologist Petra Emmerich, an expert on Risk Group 4 viruses, including the Crimean-Congo virus. Emmerich, who also serves as a reservist in the German military, visited Kosovo in 2009, initiating a collaborative effort. This partnership has led to the establishment of a monitoring structure for the Hyalomma tick and the virus, receiving funding through the German Biosecurity Program. Emmerich noted the mutual benefits of the collaboration, stating, "It's give and take. We have the diagnostic expertise and the necessary resources but we don't have the patients." Public awareness is also a focus of the cooperation, particularly among farmers in Kosovo who are at risk of infection. Sherifi explained that many infections likely occur when farmers use their bare hands to remove ticks from animals, risking exposure to infected blood. The researchers have engaged in educational outreach in schools to inform students about the virus and prevention methods, such as using tick repellents and wearing protective clothing. While not all Hyalomma ticks carry the virus, there is currently no vaccine or specific treatment for those who do contract Crimean-Congo fever. Emmerich highlighted the severity of the disease, which can begin with flu-like symptoms and progress to severe bleeding and organ failure. Treatment primarily focuses on maintaining vital functions, with the antiviral drug ribavirin being administered, although its effectiveness in acute cases is limited. Prevention is emphasized, with ongoing monitoring of tick populations and recommendations to avoid areas where ticks are prevalent. The researchers have conducted seroprevalence studies using blood tests to identify antibodies from past infections, particularly in farm animals, which do not suffer from the virus but can indicate its presence in an area. In Kosovo, serious infections have decreased significantly over the past decade, with only five cases reported compared to approximately 100 in the previous decade, suggesting the success of their efforts. However, the potential for the ticks and virus to spread further in Europe remains a concern, as Hyalomma ticks with the Crimean-Congo virus have recently been detected in France, although no human infections have been reported there. Emmerich stated, "Over the past 13 years, Hyalomma ticks have spread geographically," underscoring the need for continued monitoring. The collaboration aims to share knowledge with neighboring countries like Macedonia and Albania that have less experience in monitoring these ticks.