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Crimean-Congo hemorrhagic fever (CCHF) and Rift Valley fever (RVF) are among the list of emerging zoonotic diseases that require special attention and priority. RVF is one of the six priority diseases selected by the Senegalese government. Repeated epidemic episodes and sporadic cases of CCHF and RVF in Senegal motivated this study, involving a national cross-sectional serological survey to assess the distribution of the two diseases in this country throughout the small ruminant population. A total of 2127 sera from small ruminants (goat and sheep) were collected in all regions of Senegal. The overall seroprevalence of CCHF and RVF was 14.1% (IC 95%: 12.5–15.5) and 4.4% (95% CI: 3.5–5.3), respectively. The regions of Saint-Louis (38.4%; 95% CI: 30.4–46.2), Kolda (28.3%; 95% CI: 20.9–35.7), Tambacounda (22.2%; 95% CI: 15.8–28.6) and Kédougou (20.9%; 95% CI: 14.4–27.4) were the most affected areas. The risk factors identified during this study show that the age, species and sex of the animals are key factors in determining exposure to these two viruses. This study confirms the active circulation of CCHF in Senegal and provides important and consistent data that can be used to improve the surveillance strategy of a two-in-one health approach to zoonoses. [ABSTRACT FROM AUTHOR]

Little is known about using noninvasive samples for diagnosing Crimean-Congo hemorrhagic fever (CCHF). We investigated detection of CCHF virus in serum, saliva, and urine samples. Our results indicate that serum is the best sample type for CCHF diagnosis; saliva can be used for noninvasive sampling.

Crimean-Congo hemorrhagic fever (CCHF) is a lethal viral disease that has severe public health effects throughout Africa and a case fatality rate of 10%–40%. CCHF virus was first discovered in Crimea in 1944 and has since caused a substantial disease burden in Africa. The shortage of diagnostic tools, ineffective tick control efforts, slow adoption of preventive measures, and cultural hurdles to public education are among the problems associated with continued CCHF virus transmission. Progress in preventing virus spread is also hampered by the dearth of effective serodiagnostic testing for animals and absence of precise surveillance protocols. Intergovernmental coordination, creation of regional reference laboratories, multiinstitutional public education partnerships, investments in healthcare infrastructure, vaccine development, and a One Health approach are strategic methods for solving prevention challenges. Coordinated efforts and financial commitments are needed to combat Crimean-Congo hemorrhagic fever and improve all-around readiness for newly developing infectious illnesses in Africa.

Crimean-Congo hemorrhagic fever (CCHF), caused by CCHF virus, is a tickborne disease that can cause a range of illness outcomes, from asymptomatic infection to fatal viral hemorrhagic fever; the disease has been described in >30 countries. We conducted a literature review to provide an overview of the virology, pathogenesis, and pathology of CCHF for clinicians. The virus life cycle and molecular interactions are complex and not fully described. Although pathogenesis and immunobiology are not yet fully understood, it is clear that multiple processes contribute to viral entry, replication, and pathological damage. Limited autopsy reports describe multiorgan involvement with extravasation and hemorrhages. Advanced understanding of CCHF virus pathogenesis and immunology will improve patient care and accelerate the development of medical countermeasures for CCHF.

Crimean-Congo hemorrhagic fever (CCHF) is a tickborne infection that can range from asymptomatic to fatal and has been described in >30 countries. Early identification and isolation of patients with suspected or confirmed CCHF and the use of appropriate prevention and control measures are essential for preventing human-to-human transmission. Here, we provide an overview of the epidemiology, clinical features, and prevention and control of CCHF. CCHF poses a continued public health threat given its wide geographic distribution, potential to spread to new regions, propensity for genetic variability, and potential for severe and fatal illness, in addition to the limited medical countermeasures for prophylaxis and treatment. A high index of suspicion, comprehensive travel and epidemiologic history, and clinical evaluation are essential for prompt diagnosis. Infection control measures can be effective in reducing the risk for transmission but require correct and consistent application.

Crimean-Congo hemorrhagic fever virus (CCHFV) is the most geographically widespread tickborne viral infection worldwide and has a fatality rate of up to 62%. Despite its widespread range and high fatality rate, no vaccines or treatments are currently approved by regulatory agencies in the United States or Europe. Supportive treatment remains the standard of care, but the use of antiviral medications developed for other viral infections have been considered. We reviewed published literature to summarize the main aspects of CCHFV infection in humans. We provide an overview of diagnostic testing and management and medical countermeasures, including investigational vaccines and limited therapeutics. CCHFV continues to pose a public health threat because of its wide geographic distribution, potential to spread to new regions, propensity for genetic variability, potential for severe and fatal illness, and limited medical countermeasures for prophylaxis and treatment. Clinicians should become familiar with available diagnostic and management tools for CCHFV infections in humans.

We report the detection of Crimean-Congo hemorrhagic fever virus (CCHFV) in Corsica, France. We identified CCHFV African genotype I in ticks collected from cattle at 2 different sites in southeastern and central-western Corsica, indicating an established CCHFV circulation. Healthcare professionals and at-risk groups should be alerted to CCHFV circulation in Corsica.

The review provides the summarized and updated information on the current distribution of the tick Hyalomma marginatum in the natural Crimean hemorrhagic fever (CHF) focus in Russia. The work is based on the analysis of numerous literature sources, as well as the evidence from the personal collecting of ticks during long-term field research. In addition, the collection of ticks of the Stavropol Research Anti-Plague Institute of the Rospotrebnadzor and the database of H. marginatum collections in various regions of southern Russia were used. When delineating the boundaries of the H. marginatum areal and the CHF focus, we also deployed maps of the epidemiological survey of the focus, weekly and annual final reports on the CHF incidence from the Rospotrebnadzor Administrations. H. marginatum inhabits all regions of the Southern Federal District and the North-Caucasian Federal District, as well as the Crimean Peninsula and the south of the Saratov Region. The northern border of the areal reaches the Lugansk People’s Republic, Rostov, Volgograd, and Saratov Regions. H. marginatum is widely disseminated in the territory of Kalmykia and the Astrakhan Region. In the North Caucasus, it inhabits the entire flatland up to the foothills of the Greater Caucasus. The tick is widely distributed in the Stavropol Territory, populating the entire region. In the mountainous part of the Krasnodar Territory, this species is absent, but common in the rest of the areas. Beyond that, it is found on the Black Sea coast. In Karachay-Cherkessia, Kabardino-Balkaria, North Ossetia and Ingushetia, the tick lives in the northern steppe regions of the republics, in some places it invades the foothills. In Chechnya and Dagestan, the species widely inhabits the steppes and semi-deserts of the Terek-Kuma Interfluve. Moreover, in Dagestan, H. marginatum lives across the plain and foothill territory of the republic and even reaches the highlands up to a height of more than 2000 m above sea level. In addition, it is widely disseminated on the Crimean peninsula, both the flatland and the mountainous part.

The review features the situation on Crimean-Congo hemorrhagic fever (CCHF) in the world and the analysis of the epidemiological and epizootiological situation in the Russian Federation in 2023. The number of CCHF cases (26) in Russia was 2.3 times less than in 2022, and 71.6 % lower than the long-term average (in 2013–2022 – an average of 88.8 cases per year, mortality (8 %) is 2.4 times higher than the long-term average (3.3 %). The epidemically significant indicator of the abundance of the main vector of the CCHF virus, ticks Hyalomma marginatum, was 5 times higher than the threshold value (abundance index for cattle – 15.5) at long-term observation points in April. For the first time, one case of CCHF disease was registered in a new epidemically active territory – in the Botlikh and Novolaksky districts of the Republic of Dagestan. For the first time in the Zaporozhye Region, RNA of the CCHF virus was detected in ticks H. marginatum and Rhipicephalus rossicus. Markers of CCHF virus were found in 0.67–18.27 % of samples, CCHF virus variants of the genetic line Europe 1 were circulating on the territory of Russia in 2023. According to the forecast of the epidemic situation for 2024, CCHF morbidity is likely to increase in the south of the European part of Russia. The recommendations for undertaking preventive measures have been provided.

To estimate the determinants of spatial variation in Crimean-Congo hemorrhagic fever virus (CCHFV) transmission and to create a risk map as a preventive public health tool, we designed a survey of small domestic ruminants in Andalusia, Spain. To assess CCHFV exposure spatial distribution, we analyzed serum from 2,440 sheep and goats by using a double-antigen ELISA and modeled exposure probability with environmental predictors by using generalized linear mixed models. CCHFV antibodies detected in 84 samples confirmed low CCHFV prevalence in small domestic ruminants in the region. The best-fitted statistical model indicated that the most significant predictors of virus exposure risk were cattle/horse density and the normalized difference vegetation index. Model validation showed 99.7% specificity and 10.2% sensitivity for identifying CCHFV circulation areas. To map CCHFV exposure risk, we projected the model at a 1 × 1-km spatial resolution. Our study provides insight into CCHFV ecology that is useful for preventing virus transmission.

(1) Background: Crimean–Congo hemorrhagic fever (CCHF) is an emerging tick-borne disease endemic in Africa, Asia, the Middle East, and the Balkan and Mediterranean regions of Europe. Although no human CCHF cases have been reported, based on vector presence, serological evidence among small vertebrates, and the general human population, Hungary lies within high evidence consensus for potential CCHF introduction and future human infection. Thus, the aim of our pilot serosurvey was to assess CCHF seropositivity among cattle and sheep as indicator animals for virus circulation in the country. (2) Methods: In total, 1905 serum samples taken from free-range cattle and sheep in 2017 were tested for the presence of anti-CCHF virus IgG antibodies using commercial ELISA and commercial and in-house immunofluorescent assays. (3) Results: We found a total of eleven reactive samples (0.58%) from five administrative districts of Hungary comprising 8 cattle and 3 sheep. The most affected regions were the south–central and northwestern parts of the country. (4) Conclusions: Based on these results, more extended surveillance is advised, especially in the affected areas, and there should be greater awareness among clinicians and other high-risk populations of the emerging threat of CCHF in Hungary and Central Europe. [ABSTRACT FROM AUTHOR]

Crimean–Congo hemorrhagic fever (CCHF) is a zoonotic tick-borne disease, caused by an arbovirus of the genus Orthonairovirus and the family Nairoviridae. Crimean–Congo hemorrhagic fever virus (CCHFV) is widespread in several regions of the world. While the virus is not pathogenic to all susceptible livestock and wild mammals, it can lead to severe hemorrhagic fever in humans. In this review, we compiled published data on CCHFV infections in humans, animals, and ticks in Tunisia. Based on that, we discussed the epidemiology and the distribution patterns of CCHFV infections highlighting the risk factors for this virus in the country. CCHF infection prevalence in humans was estimated to 2.76% (5/181) and 5% (2/38) in Tunisian febrile patients and Tunisian slaughterhouse workers, respectively. Concurrently, seroprevalence in domestic ungulates (sheep, goats, cattle, and dromedaries) ranged from zero to 89.7%, and only one Hyalomma impeltatum tick specimen collected from dromedaries in southern Tunisian was positive for CCHFV by reverse transcriptase–polymerase chain reaction (0.6%; 1/165). As Tunisian studies on CCHFV are geographically scattered and limited due to very small sample sizes, further studies are needed to improve the knowledge on the epidemiology of CCHF in Tunisia. [ABSTRACT FROM AUTHOR]

Background and Aims: Crimean‐Congo hemorrhagic fever (CCHF) is a severe and potentially lethal illness. Tick bites of the Hyalomma genus are the primary source of transmission of CCHF to humans. The virus responsible for CCHF is the CCHF virus (CCHFV). It is a single‐stranded negative sensed RNA virus. The virus belongs to the Orthonairoviridae genus within the Nairoviridae family. It occurs in an extensive geographical area spanning the Middle East, western China, southern Asia, southeastern Europe, and much of Africa. The current study aimed to evaluate the pathogenicity and potential risk of CCHFV to cause a public health emergency of international concern. Methods: We searched updated relevant information from PubMed, Google Scholar, and Scopus databases using Crimean‐Congo hemorrhagic fever, tick‐borne virus, and Nairovirus as keywords. Results: The case fatality rate (CFR) varies by region. It can be more than 30% in some cases. Three segments in the genome of CCHFV (L, M, and S) are different in size and function. It is unknown whether the pathogenicity of CCHFV varied based on the genomic diversity. CCHFV can be transmitted through tick bites, handling of infected ticks, contact with infected humans, contaminated body fluids, and so on. A wide range of severity is associated with CCHF, ranging from a moderate fever with no apparent cause to increased vascular permeability, failure of several organs, bleeding, and shock. Hospitals with high‐level isolation units should be the first choice for treating CCHF patients. Individual safety equipment is crucial in healthcare to prevent the spread of the virus. In the farm environment, using integrated pest management techniques, minimizing activity in tick‐infested regions, and dressing appropriately in long sleeves and pants will help to reduce the risk of CCHFV infection via tick bites. Conclusion: There are no approved vaccinations or therapeutics for CCHF except supportive therapeutic approaches. Therefore, scientists recommend early ribavirin therapy for cases of high‐risk exposures. [ABSTRACT FROM AUTHOR]

This study investigated the intricate interplay between Crimean‐Congo hemorrhagic fever virus (CCHFV) infection and alterations in amino acid metabolism. Our primary aim is to elucidate the impact of Crimean‐Congo hemorrhagic fever (CCHF) on specific amino acid concentrations and identify potential metabolic markers associated with viral infection. One hundred ninety individuals participated in this study, comprising 115 CCHF patients, 30 CCHF negative patients, and 45 healthy controls. Liquid chromatography‐tandem mass spectrometry techniques were employed to quantify amino acid concentrations. The amino acid metabolic profiles in CCHF patients exhibit substantial distinctions from those in the control group. Patients highlight distinct metabolic reprogramming, notably characterized by arginine, histidine, taurine, glutamic acid, and glutamine metabolism shifts. These changes have been associated with the underlying molecular mechanisms of the disease. Exploring novel therapeutic and diagnostic strategies addressing specific amino acids may offer potential means to mitigate the severity of the disease. [ABSTRACT FROM AUTHOR]

This study investigated the intricate interplay between Crimean‐Congo hemorrhagic fever virus infection and alterations in amino acid metabolism. The primary aim is to elucidate the impact of Crimean‐Congo hemorrhagic fever (CCHF) on specific amino acid concentrations and identify potential metabolic markers associated with viral infection. One hundred ninety individuals participated in this study, comprising 115 CCHF patients, 30 CCHF negative patients, and 45 healthy controls. Liquid chromatography‐tandem mass spectrometry techniques were employed to quantify amino acid concentrations. The amino acid metabolic profiles in CCHF patients exhibit substantial distinctions from those in the control group. Patients highlight distinct metabolic reprogramming, notably characterized by arginine, histidine, taurine, glutamic acid, and glutamine metabolism shifts. These changes have been associated with the underlying molecular mechanisms of the disease. Exploring novel therapeutic and diagnostic strategies addressing specific amino acids may offer potential means to mitigate the severity of the disease. [ABSTRACT FROM AUTHOR]

The World Health Organization classified Crimean–Congo hemorrhagic fever (CCHF) as a high‐priority infectious disease and emphasized the performance of research studies and product development against it. Little information is available about the immune response due to natural CCHF virus (CCHFV) infection in humans. Here, we investigated the persistence of IgG and neutralizing antibodies in serum samples collected from 61 Iranian CCHF survivors with various time points after recovery (<12, 12−60, and >60 months after disease). The ELISA results showed IgG seropositivity in all samples while a pseudotyped based neutralization assay findings revealed the presence of neutralizing antibody in 29 samples (46.77%). For both IgG and neutralizing antibodies, a decreasing trend of titer was observed with the increase in the time after recovery. Not only the mean titer of IgG (772.80 U/mL) was higher than mean neutralizing antibody (25.64) but also the IgG persistence was longer. In conclusion, our findings provide valuable information about the long‐term persistence of humoral immune response in CCHF survivors indicating that IgG antibody can be detected at least 8 years after recovery and low titers of neutralizing antibody can be detected in CCHF survivors. [ABSTRACT FROM AUTHOR]

We report an imported Crimean-Congo hemorrhagic fever case in Senegal. The patient received PCR confirmation of virus infection 10 days after symptom onset. We identified 46 patient contacts in Senegal; 87.7% were healthcare professionals. Strengthening border crossing and community surveillance systems can help reduce the risks of infectious disease transmission.

Objective: This review examines the link between the COVID-19 pandemic and the outbreak of Crimean-Congo Hemorrhagic Fever (CCHF) in Iraq. Methods: We reviewed literature and data to explore potential associations between the two diseases. Results: No direct causative link between COVID-19 and increased CCHF cases in Iraq was found. However, changes in healthcare, agriculture, and human-animal interactions during the pandemic may have indirectly affected CCHF transmission. Conclusion: This review highlights the need for further research to confirm any connections between the COVID-19 pandemic and CCHF outbreaks in Iraq. Understanding these links is crucial for effective public health responses to emerging infectious diseases. [ABSTRACT FROM AUTHOR]

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Crimean-Congo hemorrhagic fever (CCHF) is an important zoonotic disease that can cause severe complications in human, especially among residents of rural areas. In this experimental study, 80 rural women were selected in Iran, by multi-stage cluster sampling method and randomly assigned into two intervention (n = 40) and control (n = 40) groups. A CCHF prevention education program was developed and implemented for the intervention group. Data were collected in both pretest and posttest groups (3 months after intervention), using a researcher-made questionnaire to measure knowledge, attitudes and practices effective in the prevention of CCHF. The data were analyzed in SPSS-27 software test at a significance level of 0.05. The mean age of participants was 32.5 ± 7.76 year. Based on the pretest results, the average knowledge (P =.001) and attitude (P =.001) in the control group was significantly higher than those of the intervention group, but the difference was not significant for the practice (P =.210). After 3 months of follow-up, the mean of knowledge, attitude and practice in the intervention group increased significantly, compared to that of the control group (P =.001). Educational interventions can improve the rural women's preventive behaviors toward CCHF. It is suggested to design and implement similar extensive educational interventions to empower rural women's first, and then whole society. [ABSTRACT FROM AUTHOR]

Objective: Crimean-Congo hemorrhagic fever (CCHF) is the most common tick-borne viral hemorrhagic fever in our country and the world. While investigating the etiology of fever, tick contact should be questioned, especially in rural areas, and CCHF should be remembered. This study aimed to review the characteristics of the cases detected in Bayburt, one of the cities where CCHF is endemic. Methods: A total of 100 patients aged 16 years and older who were diagnosed with CCHF in our clinic between April 2020 and October 2022 were included in the study. Demographic, epidemiological, and clinical characteristics, treatments, and prognoses of the patients were reviewed retrospectively through the hospital automation system and CCHF information system of The Ministry of Health. Results: Sixty one (61%) of the patients included in the study were male, and their primary age (± standard deviation) was 50.4±15.7. 77% of the patients engaged in farming and or animal husbandry, and 71% were living in rural areas. The highest number of cases was in June and July. 63% of the patients had a history of a tick bite. At the first presentation, there were complaints of fatigue (95%), generalized body pain (84%), headache (67%), and fever (65%), in order of frequency. Ribavirin was started in 52 (52%) patients. One patient admitted in the late period died, and 99 patients were discharged with good recovery. Conclusion: CCHF is an important public health problem that has been causing seasonal epidemics in our country for nearly two decades. Although sporadic cases have been reported from almost every region, the disease is endemic in some areas. Since signs and symptoms are not specific, the disease can be easily missed when tick contact is not questioned. Therefore CCHF should be considered in patients presenting with fever and thrombocytopenia in rural areas, especially in the spring and summer months.

Abstract Congo virus, or Crimean–Congo hemorrhagic fever (CCHF), is a tick-borne disease caused by a single-stranded RNA virus (genus nairovirus, Bunyaviridae family). It spreads through infected ticks' bites or contact with viremic individuals or livestock. Factors supporting its spread include hot, humid climates, limited pesticide use, poor animal control, inadequate irrigation during monsoons, and vector control deficiencies. Nosocomial transmission in under-resourced hospitals poses a threat to healthcare workers. Decades of CCHF cases persist in Pakistan due to these factors, with six deaths reported by June 2023. To combat the epidemic, Pakistan should raise awareness, improve irrigation, establish surveillance systems, and implement livestock quarantine and vaccination.

Crimean-Congo hemorrhagic fever (CCHF) and Rift Valley fever (RVF) are among the list of emerging zoonotic diseases that require special attention and priority. RVF is one of the six priority diseases selected by the Senegalese government. Repeated epidemic episodes and sporadic cases of CCHF and RVF in Senegal motivated this study, involving a national cross-sectional serological survey to assess the distribution of the two diseases in this country throughout the small ruminant population. A total of 2127 sera from small ruminants (goat and sheep) were collected in all regions of Senegal. The overall seroprevalence of CCHF and RVF was 14.1% (IC 95%: 12.5–15.5) and 4.4% (95% CI: 3.5–5.3), respectively. The regions of Saint-Louis (38.4%; 95% CI: 30.4–46.2), Kolda (28.3%; 95% CI: 20.9–35.7), Tambacounda (22.2%; 95% CI: 15.8–28.6) and Kédougou (20.9%; 95% CI: 14.4–27.4) were the most affected areas. The risk factors identified during this study show that the age, species and sex of the animals are key factors in determining exposure to these two viruses. This study confirms the active circulation of CCHF in Senegal and provides important and consistent data that can be used to improve the surveillance strategy of a two-in-one health approach to zoonoses.

Congo virus, or Crimean–Congo hemorrhagic fever (CCHF), is a tick-borne disease caused by a single-stranded RNA virus (genus nairovirus, Bunyaviridae family). It spreads through infected ticks' bites or contact with viremic individuals or livestock. Factors supporting its spread include hot, humid climates, limited pesticide use, poor animal control, inadequate irrigation during monsoons, and vector control deficiencies. Nosocomial transmission in under-resourced hospitals poses a threat to healthcare workers. Decades of CCHF cases persist in Pakistan due to these factors, with six deaths reported by June 2023. To combat the epidemic, Pakistan should raise awareness, improve irrigation, establish surveillance systems, and implement livestock quarantine and vaccination. [ABSTRACT FROM AUTHOR]

Objective Crimean–Congo hemorrhagic fever (CCHF) is a zoonotic disease that is mainly transmitted by tick bites. During the COVID-19 pandemic, a change of notifications has been reported for most infectious diseases. We aimed to compare CCHF in pediatric patients during the COVID-19 pandemic and before the pandemic period with demographic, clinical, and laboratory features. Methods Overall, 18 CCHF patients were evaluated and divided into two groups: those admitted from May 2014 to February 2020 were placed in the "prepandemic" group and those admitted from March 2020 to August 2021 were placed in the "pandemic" group. Patients were diagnosed as CCHF with polymerase chain reaction (PCR) and immunoglobulin M (IgM) antibody positivity in the blood samples. Results Pediatric CCHF cases were more frequent during the 2 years of the COVID-19 pandemic period compared with the 6 years before the pandemic (10 cases and 8 cases, respectively). There were no demographic and clinically significant differences between the two groups. Prepandemic patients had lower platelet (PLT) levels than pandemic patients (p = 0.021). Two CCHF patients in the pandemic group were hospitalized with a preliminary diagnosis of multisystem inflammatory syndrome in children (MIS-C). Seventeen patients (94.4%) were treated with ribavirin. All the patients recovered. Conclusion The frequency of CCHF appeared to have been increased during the COVID-19 pandemic. But there was no difference between the prepandemic and pandemic groups from a demographic and clinical finding point of view of patients diagnosed with CCHF. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to compare choroidal thickness parameters between patients diagnosed with Crimean–Congo hemorrhagic fever (CCHF) and healthy individuals using spectral domain optical coherence tomography. Methods: The right eyes of 27 individuals diagnosed with CCHF and 27 healthy subjects were included in this study. CCHF cases were assessed based on a history of tick bites and hospitalization. Choroidal thickness was measured using enhanced depth imaging optical coherence tomography. Measurements of choroidal thickness were taken at 5 different points, including the subfoveal quadrant and the fovea up to 2000 μm with 1000 μm intervals in the temporal and nasal quadrants. Choroidal vascular index (CVI) was calculated as the ratio of luminal area (LA) to total choroidal area (TCA) at the macula's total area and at 1500 μm from the center (CVI and CVI1500). Results: Choroidal thickness in the CCHF group was found to be thicker in each quadrant compared to the control group, with the subfoveal and nasal quadrants showing significantly greater thickness. TCA, stromal area, and LA were significantly higher in the CCHF group, while no significant difference was observed in CVI and CVI1500. Conclusion: The findings of this study suggest that CCHF disease may have an impact on the choroidal structure. [ABSTRACT FROM AUTHOR]

During the past four decades, recurrent outbreaks of various arthropod-borne viruses have been reported in Mauritania. This review aims to consolidate the current knowledge on the epidemiology of the major arboviruses circulating in Mauritania. Online databases including PubMed and Web of Science were used to retrieve relevant published studies. The results showed that numerous arboviral outbreaks of variable magnitude occurred in almost all 13 regions of Mauritania, with Rift Valley fever (RVF), Crimean–Congo hemorrhagic fever (CCHF), and dengue (DEN) being the most common infections. Other arboviruses causing yellow fever (YF), chikungunya (CHIK), o'nyong-nyong (ONN), Semliki Forest (SF), West Nile fever (WNF), Bagaza (BAG), Wesselsbron (WSL), and Ngari (NRI) diseases have also been found circulating in humans and/or livestock in Mauritania. The average case fatality rates of CCHF and RVF were 28.7% and 21.1%, respectively. RVF outbreaks have often occurred after unusually heavy rainfalls, while CCHF epidemics have mostly been reported during the dry season. The central and southeastern regions of the country have carried the highest burden of RVF and CCHF. Sheep, cattle, and camels are the main animal reservoirs for the RVF and CCHF viruses. Culex antennatus and Cx. poicilipes mosquitoes and Hyalomma dromedarii, H. rufipes, and Rhipicephalus everesti ticks are the main vectors of these viruses. DEN outbreaks occurred mainly in the urban settings, including in Nouakchott, the capital city, and Aedes aegypti is likely the main mosquito vector. Therefore, there is a need to implement an integrated management strategy for the prevention and control of arboviral diseases based on sensitizing the high-risk occupational groups, such as slaughterhouse workers, shepherds, and butchers for zoonotic diseases, reinforcing vector surveillance and control, introducing rapid point-of-care diagnosis of arboviruses in high-risk areas, and improving the capacities to respond rapidly when the first signs of disease outbreak are identified. [ABSTRACT FROM AUTHOR]

Background: There are limited studies on the severity of Crimean-Congo hemorrhagic fever (CCHF) in children. The study aimed to investigate the correlation between the severity scoring index (SSI) score and other laboratory parameters in children. Materials and Methods: Patients younger than 18 years of age who were diagnosed with CCHF in 2011–2022 were included in the study. The SSI score and laboratory parameters at the time of admission were taken into consideration. Results: At 12-year follow-up, 81 pediatric patients were diagnosed with CCHF. According to the SSI calculated at the time of admission, 59 (72.8%) patients were in the mild group and 22 (27.2%) patients were in the moderate group. According to Spearman's correlation analysis results, a positive correlation was found between the SSI score and c-reactive protein (CRP) (r = 0.737, p < 0.001), lactate dehydrogenase (r = 0.312, p = 0.010), alanine transaminase to lymphocyte ratio (r = 0.428, p < 0.001), neutrophil to lymphocyte ratio (r = 0.406, p < 0.001), and derived-neutrophil lymphocyte ratio (r = 0.389, p < 0.001). In addition, lymphocyte to c-reactive protein ratio (LCR) (r = −0.782, p < 0.001), lymphocyte count (r = −0.422, p < 0.001), and white blood cell (r = −0.250, p = 0.026) values were negatively correlated with the SSI. Conclusions: A strong correlation (r > 0.7) was found between LCR (r = −0.782) and CRP (r = 0.737) and the SSI. [ABSTRACT FROM AUTHOR]

Background and Objectives: Crimean-Congo Hemorrhagic Fever (CCHF) is a viral zoonotic infection, which is seen over a wide geographic area. The mortality rate is in inverse proportion to the ability of patients to access healthcare services. Therefore, early identification of patients is extremely important. The aim of this study was to test the sensitivity and specificity of the Hitit Index in the differentiation of CCHF cases at the time of presentation at the Emergency Department and to evaluate the agreement of this index with molecular (CCHFV RNA) and/or serological diagnostic tests (ELISA-CCHF IgM). Materials and Methods: The patients included were those who presented at the Emergency Department (ED) with the complaint of a tick bite or those identified as potential CCHF cases as a result of complaints and/or laboratory findings. For cases that met the study inclusion criteria, the Hitit Index score was calculated automatically from the parameters included in the index formula uploaded to the automation system in the ED at the time of presentation. Through comparisons of the agreement of the Hitit Index with the CCHFV-RNA and/or IgM results the power of the Hitit Index for differentiation of CCHF cases in ED was evaluated. Results: The data of 273 patients were analyzed. There was a history of tick bite in 236 (86%) cases. Of the evaluated cases, 110 (40.2%) were hospitalized; CCHF positivity was determined in 72 (26.4%). The Hitit Index values calculated in ED and at 24 h after hospitalization were determined to be significant in the prediction of the CCHF cases (p < 0.001, AUC = 0.919 (0.887–0.951); p < 0.001, AUC = 0.902 (0.841–0.962). For a cut-off point of 0 of the Hitit Index evaluated in ED, the classification success was found to have a sensitivity of 75% and specificity of 88% (PPV-NPV). For a cut-off point of 0 of the Hitit Index evaluated at 24 h after hospitalization, the classification success was found to have a sensitivity of 79.7% and specificity of 84% (PPV-NPV). Conclusions: The defined form of the Hitit Index can be used in the differentiation of CCHF cases in ED with high sensitivity and specificity levels. Just as evaluation with the Hitit Index prevents unnecessary hospitalization, it can also contribute to reducing mortality rates with the early identification of CCHF cases. [ABSTRACT FROM AUTHOR]

Crimean Congo Hemorrhagic Fever (CCHF) is a zoonotic viral disease with a high mortality rate. The World Health Organization has classified it as a high-priority pathogen due to its severity. To manage this disease, knowledge, attitude, and practices (KAP) of the community play an important role. This study was conducted in a suburban area in southeastern Iran, an endemic region with a high occurrence of CCHF. A cross-sectional study was performed among 176 livestock farmers in Zahedan suburb, and data were collected through an interviewer-administered questionnaire. Single-factor and multi-factor analysis of variance was used to identify factors related to participants’ knowledge, attitude, and risk of CCHF. All statistical analyses were conducted using SPSS 24, and a significance level of p ≤ 0.05 was adopted to determine statistical significance. Overall, the knowledge level about CCHF was moderate. Participants demonstrated a better understanding of high-risk occupations compared to the transmission routes and symptoms of CCHF. Conversely, their knowledge about the prevention and treatment of CCHF was found to be inadequate. The participants exhibited a good attitude towards CCHF prevention; most considered it a dangerous disease, believed in the effectiveness of preventive measures, and demonstrated the ability to address perceived obstacles. High-frequency engagement in high-risk behaviors related to CCHF was observed among the study participants. In the multi-factor model, the most critical factors associated with knowledge were age (p = 0.044), CCHF infection (p = 0.047), and CCHF education (p = 0.004). Income (p = 0.001), keeping livestock at home (p = 0.028), and receiving CCHF education (p = 0.012) were the most critical factors associated with attitude toward the risk of CCHF. The most important factors related to CCHF high-risk behavior were age (p = 0.045), gender (p = 0.028), and handling livestock (p

Background and purpose: Crimean-Congo hemorrhagic fever (CCHF) is one of the viral hemorrhagic fevers caused by Nairovirus group. Epidemiological investigation and clinical symptoms of the disease in each region can help to identify disease-prone foci and early diagnosis of the disease in epidemic cases. Therefore, the purpose of this study was to investigate the clinical, epidemiological, and laboratory symptoms of patients with CCHF in Mazandaran province in 2014-2018. Materials and methods: In this cross-sectional epidemiological survey, 135 patients with proven CCHF in Mazandaran province were enrolled in a census manner. The clinical, epidemiological, and laboratory findings in these patients were determined. Results: In this study, 23% were younger than 30 years of age and 80.7% were men. In hospitalized patients, 33.3% had high risk jobs linked to the disease and 39.3% had livestock exposure. The patients were most affected in spring (45.9%) and summer (42.2%) and less during fall (5.9%), and winter (5.9%). Clinical manifestations, including fever, rash, abdominal pain, bleeding, epistaxis, headache, musculoskeletal pain, cough, and menorrhagia were observed in 88.1%, 11.1%, 23%, 28.9%, 7.4%, 52.6%, 69.7%, 0%, and 0% of the infected subjects, respectively. Thrombocytopenia were seen in 51.9% of the patients and about other laboratory results there were no any specific findings in 29.6%. According to laboratory findings, LFT raise, anemia, leukopenia, leukocytosis, LTF raise plus anemia, and LFT raise plus leukopenia were seen in 13.3%, 5.2%, 27.4%, 9.6%, 3.7%, and 11.1%, respectively. Conclusion: According to the present study, although the clinical, epidemiological, and laboratory findings in CCHF cases in Mazandaran province are similar to other studies worldwide, so, the regular analysis of CCHF patients is highly recommended.

Crimean-Congo hemorrhagic fever (CCHF) is a viral hemorrhagic fever syndrome that can cause multi-organ failure with hyperactivation of the immune system. There is no proven treatment for CCHF, supportive care is essential for management. Extracorporeal depurative techniques have been used to remove inflammatory mediators from the bloodstream. This report aims to present the use of coupled plasma filtration and adsorption (CPFA) in CCHF patients. We performed CPFA on three patients with CCHF, all of which were confirmed with polymerase chain reaction. A 35-year-old female was admitted one week after tick-exposure. Despite supportive treatment, patient developed mucosal and gastrointestinal bleeding due to disseminated intravascular coagulation (DIC). After CFPA, her clinic situation and laboratory results improved. A 54-year-old female was admitted to the intensive care unit due to severe bleeding and had a history of tick bite nine-days-ago. She had multiple organ failure with DIC, we started CPFA. Patient didn’t respond to the treatment and died. A 69-year-old male was admitted to the hospital on the seventh-day of exposure to tick. He had diabetes, hypertension and coronary artery disease. Next day, patient developed alveolar hemorrhage and his liver enzymes, coagulation parameters deteriorated. We performed CFPA, however, the patient didn’t respond to treatment and died. We suggested that CPFA may have positive effects on the outcome and prognosis of critically ill CCHF patients. Only one patient responded well which can be a result of being young, early admission to the hospital and lack of comorbidity. CPFA may be an option to treat severe CCHF infection with cytokine storm. However,there is a need for further studies on when we should apply this treatment and whether early application prevents mortality.

Aim:To evaluate the power of the systemic immune-inflammation index (SII) in the prediction of mortality in patients with Crimean-Congo hemorrhagic fever (CCHF) presenting at the emergency department (ED).Materials and Methods:The study included patients who presented at the ED between April 2020 and November 2022 and were hospitalized for treatment in the Infectious Diseases Department. The demographic data, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and SII were recorded. Categorical data were analyzed with the chi-square test and continuous data with the Mann-Whitney U test. Receiver operating characteristic (ROC) curve analysis was performed to determine the factors predicting the risk of mortality.Results:The SII value (p=0.010) and NLR (p

The review presents an analysis of the epidemiological and epizootiological situation on Crimean-Congo hemorrhagic fever (CCHF) in the Russian Federation in 2022. The incidence rate of CCHF registered in 2022 (59 cases) was 1.2 times higher as compared to 2021, however, below the long-term average annual values. The mortality rate was 10.2 %, which exceeds the indicators of long-term observations (in 2012–2021 – 3.2 %). Following epizootiological survey of stationary observation points, it was found that the number of Hyalomma marginatum imago in 2022, in general, corresponded to the average long-term indicators. CCHF virus isolates circulating in Russia in 2017–2022 belonged to the genetic lines “Europe-1” (V), “Europe-2” (VI), and “Europe-3” (VII). The ratio of CCHF virus genovariants in the population on the territory of the Russian Federation in 2017–2022 didn’t change. Based on the analysis of naturalclimatic factors, the forecast for the incidence of CCHF in the Russian Federation for 2023 has been made.

(1) Background: Crimean–Congo hemorrhagic fever (CCHF) is an emerging tick-borne disease endemic in Africa, Asia, the Middle East, and the Balkan and Mediterranean regions of Europe. Although no human CCHF cases have been reported, based on vector presence, serological evidence among small vertebrates, and the general human population, Hungary lies within high evidence consensus for potential CCHF introduction and future human infection. Thus, the aim of our pilot serosurvey was to assess CCHF seropositivity among cattle and sheep as indicator animals for virus circulation in the country. (2) Methods: In total, 1905 serum samples taken from free-range cattle and sheep in 2017 were tested for the presence of anti-CCHF virus IgG antibodies using commercial ELISA and commercial and in-house immunofluorescent assays. (3) Results: We found a total of eleven reactive samples (0.58%) from five administrative districts of Hungary comprising 8 cattle and 3 sheep. The most affected regions were the south–central and northwestern parts of the country. (4) Conclusions: Based on these results, more extended surveillance is advised, especially in the affected areas, and there should be greater awareness among clinicians and other high-risk populations of the emerging threat of CCHF in Hungary and Central Europe.

Ahmad Shekaib Rasikh,1 Mohammad Maroof Aram,2 Abdul Tawab Noory1 1Department of Infectious Diseases, Ali Abad Teaching Hospital, Kabul University of Medical Sciences, Kabul, Afghanistan; 2Department of Internal Medicine, Ali Abad Teaching Hospital, Kabul University of Medical Sciences, Kabul, AfghanistanCorrespondence: Ahmad Shekaib Rasikh, Tel +93 791906514, Email shekaib.rasikh@gmail.comObjective: Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic disease associated with a high fatality rate. CCHF is endemic in Afghanistan, and its morbidity and mortality have increased recently but there is limited data about the characteristics of fatal cases. We aimed to report the clinical and epidemiological features of fatal CCHF cases who were admitted to Kabul Referral Infectious Diseases (Antani) Hospital.Methods: This is a retrospective cross-sectional study. The demographic and presenting clinical and laboratory features of 30 fatal CCHF cases diagnosed by reverse transcription polymerase chain reaction (RT-PCR) or enzyme-linked immunosorbent assay (ELISA) tests were collected from the patients’ records between March 2021 and March 2023.Results: During the study period, a total of 118 laboratory-confirmed CCHF patients were admitted to Kabul Antani Hospital of whom 30 patients (25 males, 5 females) consequently died, indicating a 25.4% case fatality rate (CFR). The age of the fatal cases ranged from 15 to 62 years and their mean age was 36.6 ± 11.7 years. Concerning occupation, the patients were butchers (23.3%), animal dealers (20%), shepherds (16.6%), housewives (16.6%), farmers (10%), student (3.3%), and others (10%). The clinical symptoms of the patients on admission were fever (100%), generalized body pain (100%), fatigue (90%), bleeding (any type) (86.6%), headache (80%), nausea/vomiting (73.3%), and diarrhea (70%). The initial abnormal laboratory findings were leukopenia (80%), leukocytosis (6.6%), anemia (73.3%), and thrombocytopenia (100%), raised hepatic enzymes (ALT & AST) (96.6%) and prolonged prothrombin time/international normalized ratio (PT/INR) (100%).Conclusion: The hemorrhagic manifestations associated with low platelet and raised PT/INR levels are linked with fatal outcomes. A high index of clinical suspicion is required to recognize the disease at an early stage and to begin the treatment promptly for reducing mortality.Keywords: Afghanistan, Crimean-Congo hemorrhagic fever, fatal, thrombocytopenia

Introduction. The study focuses on methods providing mathematical substantiation of discrepancies between actual incidence rates of Astrakhan rickettsial fever (ARF) and Crimean-Congo hemorrhagic fever (CCHF) and predicted rates due to the indirect impact of weather conditions during the current epidemic season. The purpose of the study was to develop explanatory models for ARF and CCHF incidence using satellite monitoring (remote sensing) data and to present the results of their practical evaluation in the Stavropol Territory and Astrakhan Region. Materials and methods. The materials included climate data provided by the Space Research Institute of the Russian Academy of Sciences as well as epidemiological data on CCHF and ARF incidence from 2005 to 2021. The explanatory models incorporated the Bayes theorem and Wald sequential analysis. All the calculations were completed using the Microsoft Excel 2010-based program developed by the authors. Results. It has been found that the greatest indirect effect on development of the CCHF epidemiological situation is produced by the normalized difference vegetation index and relative air humidity in June-July in the Stavropol Territory and by the maximum, minimum and average air temperature in October as well as the minimum air temperature in July in the Astrakhan Region. ARF incidence rates depend on the indirect effect of the annual average and average annual maximum temperature, maximum temperature and the normalized difference vegetation index in April-July. The match between explanatory model-based results and prediction model-based results ranged within 46.2-100%. Discussion. In addition to projecting incidence rates, which could be reached with the observed values of climatic factors in the current year, the explanatory models can be used for indirect verification of prediction models and for identification of factors causing differences in results. Conclusion. The practical evaluation of explanatory models confirms the prospects and benefits of the study that should be continued, involving other regions highly endemic for tick-borne infections.

Crimean-Congo Hemorrhagic Fever (CCHF) is a viral disease that can infect humans via contact with tick vectors or livestock reservoirs and can cause moderate to severe disease. The first human case of CCHF in Uganda was identified in 2013. To determine the geographic distribution of the CCHF virus (CCHFV), serosampling among herds of livestock was conducted in 28 Uganda districts in 2017. A geostatistical model of CCHF seroprevalence among livestock was developed to incorporate environmental and anthropogenic variables associated with elevated CCHF seroprevalence to predict CCHF seroprevalence on a map of Uganda and estimate the probability that CCHF seroprevalence exceeded 30% at each prediction location. Environmental and anthropogenic variables were also analyzed in separate models to determine the spatially varying drivers of prediction and determine which covariate class resulted in best prediction certainty. Covariates used in the full model included distance to the nearest croplands, average annual change in night-time light index, percent sand soil content, land surface temperature, and enhanced vegetation index. Elevated CCHF seroprevalence occurred in patches throughout the country, being highest in northern Uganda. Environmental covariates drove predicted seroprevalence in the full model more than anthropogenic covariates. Combination of environmental and anthropogenic variables resulted in the best prediction certainty. An understanding of the spatial distribution of CCHF across Uganda and the variables that drove predictions can be used to prioritize specific locations and activities to reduce the risk of future CCHF transmission.

Crimean-Congo hemorrhagic fever (CCHF) is a viral hemorrhagic fever syndrome that can cause multi-organ failure with hyperactivation of the immune system. There is no proven treatment for CCHF, supportive care is essential for management. Extracorporeal depurative techniques have been used to remove inflammatory mediators from the bloodstream. This report aims to present the use of coupled plasma filtration and adsorption (CPFA) in CCHF patients. We performed CPFA on three patients with CCHF, all of which were confirmed with polymerase chain reaction. A 35-year-old female was admitted one week after tick-exposure. Despite supportive treatment, patient developed mucosal and gastrointestinal bleeding due to disseminated intravascular coagulation (DIC). After CFPA, her clinic situation and laboratory results improved. A 54-year-old female was admitted to the intensive care unit due to severe bleeding and had a history of tick bite nine-days-ago. She had multiple organ failure with DIC, we started CPFA. Patient didn’t respond to the treatment and died. A 69-year-old male was admitted to the hospital on the seventh-day of exposure to tick. He had diabetes, hypertension and coronary artery disease. Next day, patient developed alveolar hemorrhage and his liver enzymes, coagulation parameters deteriorated. We performed CFPA, however, the patient didn’t respond to treatment and died. We suggested that CPFA may have positive effects on the outcome and prognosis of critically ill CCHF patients. Only one patient responded well which can be a result of being young, early admission to the hospital and lack of comorbidity. CPFA may be an option to treat severe CCHF infection with cytokine storm. However,there is a need for further studies on when we should apply this treatment and whether early application prevents mortality. [ABSTRACT FROM AUTHOR]

Objective: Crimean-Congo Hemorrhagic Fever (CCHF) is a zoonotic viral disease mainly transmitted by tick contact and progresses with fever and bleeding. This study aimed to examine the epidemiological, clinical, and laboratory characteristics of the patients who were followed up with the diagnosis of Crimean-Congo Hemorrhagic Fever in the last 11 years in our hospital's Infectious Diseases and Clinical Microbiology clinic. Methods: Patients older than 18 years of age who were followed up with the diagnosis of Crimean-Congo Hemorrhagic Fever between January 2011 and December 2022 were included in the study. Patients' age, gender, occupation, etc. sociodemographic characteristics, complaints on admission, tick contact histories, laboratory parameters, length of hospital stay, and 3-month survival were retrospectively analyzed from the data in the patient files. The diagnosis of the disease was based on the detection of virus-specific IgM by ELISA (enzyme-linked immunosorbent assay) or detection of viral RNA by RT-PCR (Reverse Transcriptase-Polymerase Chain Reaction). Results: Of the 106 patients, 73 (68.9%) were male, and 33 (33.1%) were female. The mean age was 49.43±14.16 years. 105 (99.1%) of the patients lived in rural areas. There were 76 (71.7%) patients with a history of tick contact, and 58 (76.3%) of them stated that they removed the tick by their means. The month with the highest number of applications was June (n=55, 51.8%). The year 2022 (n=38, 35.9%) had the highest number of patients detected. The time between the onset of symptoms and admission to the hospital was 3.14±7.66 (min 1-max 13) days. While the most common complaints of body pain (n=101, 95.3%), fatigue (n=101, 95.3%), and fever (n=81, 76.4%) were described at the first admission, the most common findings in physical examination were high fever (n= 79, 74.5%), hematuria (n=9, 8.5%), hypotension, and tachycardia (n=8, 7.5%). While 42 (39.6) patients were referred to a 3rd level center, 64 (60.4%) were discharged with good recovery. One patient died in the 3rd level center to which he was referred. Conclusion: In this study, it was determined that livestock workers/farmers and men were more likely to get the disease, the history of tick contact was significantly described in disease transmission, and the cases occurred more frequently, especially in June. Especially in the spring and summer when the incidence increases, tick contact history should be questioned in patients presenting with suspicious clinical findings, and the preliminary diagnosis of CCHF should not be ignored. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to determine whether frontal QRS-T (fQRS-T) angle measurements assist in predicting prognosis in severe CCHF (Crimean-Congo Hemorrhagic Fever) patients. Material and Methods: The study was conducted with 140 intensive care patients diagnosed with CCHF between 01.01.2012 and 2022. Demographic data and length of stay were recorded. In addition, laboratory data were recorded, including hemoglobin, troponin T, C-reactive protein, lymphocyte numbers, neutrophil, and platelet. fQRS-T angles were measured on electrocardiographic (ECG) data of the patients. Results: The mean fQRS-T angle was 53.9°±29.3° in non-survivors and 34.2°±17.3° in the survivors (p<0.001). Regarding non-survivors, they were older, and their hemoglobin, platelet and lymphocyte levels were lower (p<0.001), and their QRS durations were broader (p=0.021) than survivors. The fQRS-T angle cutoff value in predicting mortality was determined as 41.5°. For fQRS-T ≥41.5°, specificity was 61.1%, and sensitivity was 80.9% (area under the curve: 0.711, 95% CI: 0.624-0.798, p<0.001). Conclusion: Current study's results showed the usability of the fQRS-T angle as an inexpensive, convenient, strong, and repeatable predictor to determine the prognosis of CCHF patients. A detailed electrocardiographic evaluation in the routine follow-up of high-risk CCHF patients may indicate the prognosis of the disease. [ABSTRACT FROM AUTHOR]

Brucella is one of the most common bacterial zoonosis. Crimean-Congo Hemorrhagic Fever (CCHF) is a potentially life-threatening infection. They have similar epidemiologic and clinical presentations. A 40-year-old male patient, engaged in animal husbandry, presented to the emergency unit with complaints of weakness, headache, and fever. Because of his low platelet count, he was referred to the internal medicine clinic. The patient did not have a history of contact with a tick or a CCHF patient. The Brucella Rose Bengal Test (RBT) was performed and the result was positive. After he was referred to the infectious diseases clinic, the CCHF RT-PCR test was found to be positive and the Brucella Wright agglutination test was negative. The patient, who was diagnosed with CCHF, was discharged in good condition. A positive RBT result does not always make a definitive diagnosis of Brucella infection. In areas where CCHF and Brucella are endemic, CCHF should be considered even if there is no history of ticks.

Background: Crimean-Congo hemorrhagic fever (CCHF) is a contagious viral disease that can be transmitted through various means, including tick bites, contact with infected blood and animal tissues in slaughterhouses, and healthcare-related infections. Methods: In this study, we examined the incidence of CCHF and analyzed the demographic and clinical data of 130 patients diagnosed with CCHF in Kermanshah, a city located in western Iran, over a period of 15 years (2006 - 2020). Results: During the study, 19 cases tested positive, 66 were verisimilar, and the remaining cases (31.54%) were considered suspected. Among the positive cases, 15 patients recovered, and four died. Of those infected, 63.16% were males residing in rural areas. Additionally, 78.95% of the infected individuals had contact with domestic livestock, 26.31% had a history of contact with ticks, and 10.53% had contact with raw meat or raw liver. Furthermore, 5.26% had a history of contact with a CCHF patient. Conclusions: The highest prevalence of CCHF was observed among men aged 15 to 30 who lived in rural areas. According to the annual reports of people suffering from CCHF, health authorities should prioritize this disease in their public health programs. Since individuals who come into direct contact with livestock and livestock products are at a high risk of contracting diseases, it is important to educate them. [ABSTRACT FROM AUTHOR]

Crimean-Congo hemorrhagic fever virus (CCHFV) is endemic in Asia, infecting many animal hosts, but CCHFV has not been reported in Myanmar. We conducted a seroepidemiologic survey of logging communities in Myanmar and found CCHFV exposure was common (9.8%) and exposure to wild animal blood and body fluids was associated with seropositivity.

Crimean-Congo hemorrhagic fever (CCHF), endemic in certain regions of the world, is listed as a priority disease with pandemic potential. Since CCHF was first identified in Turkey, children have been known to experience milder disease than adults. However, during the COVID-19 pandemic, we observed an unusually severe disease course, including hemophagocytic lymphohistiocytosis (HLH). We examined cytokine/chemokine profiles of 9/12 case-patients compared with healthy controls at 3 time intervals. Interferon pathway–related cytokines/chemokines, including interleukin (IL) 18, macrophage inflammatory protein 3α, and IL-33, were elevated, but tumor necrosis factor-α, IL-6, CXCL8 (formerly IL-8), and cytokines acting through C-C chemokine receptor 2 and CCR5 were lower among case-patients than controls. Interferon pathway activation and cytokines/chemokines acting through CCR2 and CCR5 improved health results among children with severe CCHF. Children can experience severe CCHF, including HLH, and HLH secondary to CCHF can be successfully treated with intravenous immunoglobulin and steroid therapy.