Large outbreak of Crimean-Congo haemorrhagic fever in Iraq, 2022.

Background: Crimean-Congo haemorrhagic fever (CCHF) is reported sporadically in Iraq. The lack of preventive veterinary activities during 2 years of the coronavirus disease 2019 pandemic (2020 and 2021) led to the largest CCHF outbreak in Iraq since 1979. Objective: To describe the epidemiological characteristics of CCHF cases that occurred during the first half of 2022 in Iraq in terms of age, sex, residence, history of contact with another case, and history of contact with animals. Materials and methods: This descriptive study included laboratory-confirmed cases of CCHF between 1st January 2022 and 26th June 2022. Frequencies and percentages were used to describe the demographic and epidemiologic criteria of the cases. The epidemic curve of the cases was used to describe the timing and duration of the outbreak. Results: In total, there were 219 confirmed cases of CCHF from 1st January 2022 to 26th June 2022. The first confirmed case was reported in March 2022, and cases continued to occur through June 2022. The median age of the cases was 34.5 years. The majority of cases were male (n=130, 59.4%), had an unspecified job (n=126, 57.5%) and lived in southern Iraq (n=142, 64.8%). The first case was reported in week 10 of 2022. Case numbers peaked in week 24 (30 cases were reported), and subsequently declined in week 25 (24 cases were reported). The case fatality rate was 16.4%. Conclusion and recommendations: The CCHF outbreak in 2022 was the largest in Iraq since the disease was first reported four decades ago. Identification of CCHF strains in Iraq is recommended, together with exploration of the knowledge, attitudes and practices of high-risk groups for CCHF, and a national survey of CCHF vectors in Iraq.

Changing Disease Course of Crimean-Congo Hemorrhagic Fever in Children, Turkey.

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.

Crimean-Congo hemorrhagic fever in the COVID-19 pandemic: A case study.

In the COVID-19 pandemic, the overlap of clinical features between other viral infections makes a reliable diagnosis difficult in the initial stage of illness. We describe a confirmed case of CCHF in Tehran Province during this year, who was first misdiagnosed as COVID-19 infection.

Crimean-Congo haemorrhagic fever during the COVID-19 pandemic in Africa: Efforts, recommendations and challenges at hand.

Since the beginning of the COVID-19 pandemic, millions have suffered globally and as a result, attention and resources for other diseases, such as Crimean-Congo Haemorrhagic Fever (CCHF), has declined. Despite a significantly lower incidence rate compared to COVID-19, CCHF has a considerably higher mortality rate at approximately 30%. Both diseases share symptoms such as headache, fever, nausea and vomiting, fatigue, sore throat, however they have different modes of transmission, mortality rates, and incubation periods. Public health professionals have faced several challenges when attempting to prevent and control the spread of both diseases and despite their differences, many of the prevention methods remain the same. These include increasing public awareness regarding avoiding contact with infected individuals and animals, training healthcare professionals in emergency and preparedness for disease outbreaks and increasing the investment in medical supplies and treatment to control the spread of both diseases.

Emerging and re-emerging viral infections in India.

The number of outbreaks have progressively increased since many years in India. In this era of globalization and rapid international travel, any infectious disease in one country can become a potential threat to the entire globe. Outbreaks of Nipah, Zika, Crimean-Congo Haemorrhagic Fever and Kyasanur Forest Disease have been reported since a decade and now we are facing COVID-19 pandemic. One of the challenges in the prevention of these outbreaks is that as the cases decrease, the felt need declines, the public demand decreases and the mitigation responses get overshadowed by the need of emergency responses elsewhere. The One Health approach is a movement to promote alliance between medicine field, veterinary medicine and environmental sciences to upgrade the health of humans, animals, and ecosystem. The data in this article is compiled from different websites and publications of World Health Organization (WHO), Centre for Disease Control and Prevention (CDC), Integrated Disease Surveillance Programme (IDSP), grey literature and media. There is an urgent need for better surveillance and disease burden assessments in the country and to gain detailed insights into vector biology, factors of environment influencing the diseases, mapping of endemic areas, strengthen intersectoral coordination, infection control practices, and ensure use of Personal Protective Equipment's (PPE) and availability of drugs and vaccines to handle the outbreaks in a better way.

The Integration of Human and Veterinary Studies for Better Understanding and Management of Crimean-Congo Haemorrhagic Fever.

Outbreaks that occur as a result of zoonotic spillover from an animal reservoir continue to highlight the importance of studying the disease interface between species. One Health approaches recognise the interdependence of human and animal health and the environmental interplay. Improving the understanding and prevention of zoonotic diseases may be achieved through greater consideration of these relationships, potentially leading to better health outcomes across species. In this review, special emphasis is given on the emerging and outbreak pathogen Crimean-Congo Haemorrhagic Fever virus (CCHFV) that can cause severe disease in humans. We discuss the efforts undertaken to better understand CCHF and the importance of integrating veterinary and human research for this pathogen. Furthermore, we consider the use of closely related nairoviruses to model human disease caused by CCHFV. We discuss intervention approaches with potential application for managing CCHFV spread, and how this concept may benefit both animal and human health.