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

Alhilfi, Riyadh Abdulameer; Khaleel, Hanan Abdulghafoor; Raheem, Baghdad Muayad; Mahdi, Sinan Ghazi; Tabche, Celine

doi:10.1016/j.ijregi.2023.01.007

Cited by 19 publications

(17 citation statements)

References 18 publications

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“…Most small outbreaks were limited to the same province [15] . CCHFV infections have recently increased from 33 cases in 2021 to a 6-fold increase in the first half of 2022 [16 , 17] , underscoring the urgent need for actions to control the disease. This study aims to highlight the increased occurrence, fatality rates, and probable reasons with careful follow-up on the current genotype circulating in Iraq.…”

Section: Introductionmentioning

confidence: 99%

Alarming update on incidence of Crimean-Congo hemorrhagic fever in Iraq in 2023

Atwan,

Alhilfi,

Mousa

et al. 2024

IJID Regions

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Section: Introductionmentioning

confidence: 99%

Alarming update on incidence of Crimean-Congo hemorrhagic fever in Iraq in 2023

Atwan,

Alhilfi,

Mousa

et al. 2024

IJID Regions

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“…Crimean-Congo hemorrhagic fever (CCHF) is an endemic disease in Iraq, with intermittent documented instances tracing back to its initial appearance in the 1970s [1]. CCHF is a viral disease transmitted by ticks, posing significant challenges to public health as well as the social and economic sectors.…”

Section: Introductionmentioning

confidence: 99%

“…In Iraq, studies on CCHF disease are limited to case reports, transmission, and control measures [3,17]; epidemiological characteristics of CCHF cases [1]; trend analysis of CCHF cases between 1990 and 2010 [18]; isolation and identification [19]; and seroepidemiological surveys [20]. Recent outbreaks in 2021, 2022, and 2013 captured the interest of the current investigation into distribution of the disease.…”

Section: Introductionmentioning

confidence: 99%

“…For example, the Ministry of Health in Iraq has reported a significant increase in cases during the past two years. In 2021, there were 19 confirmed cases based on laboratory data, and the number rose to 108 laboratoryconfirmed cases in the first half of 2022 [1]. In 2023, according to local media news (as of 13 July 2023) from the Minister of Health, since January, 375 confirmed cases have been recorded across the country.…”

Section: Introductionmentioning

confidence: 99%

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Predicting the Spatial Distribution of Hyalomma ssp., Vector Ticks of Crimean–Congo Haemorrhagic Fever in Iraq

Khwarahm

2023

Sustainability

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Crimean–Congo hemorrhagic fever (CCHF) typically spreads through ticks and is categorized as a viral hemorrhagic fever. CCHF is a fatal endemic disease in Iraq, and it has been reported sporadically since its first report in 1979. Recent outbreaks during 2021–2023 and their fatal consequences captured the interest of this study. CCHF is a tick-borne disease that represents a major challenge to the public health, social, and economic sectors. The geographical distribution of CCHF is closely linked with Hyalomma vector tick distribution. Therefore, predicting and mapping the spatial distribution of the disease vector in relation to relevant environmental factors provides invaluable information for establishing an early warning system based on which preventive measures can be taken to minimize the spread and, hence, the fatal consequences of CCHF. To achieve this, this study incorporates geospatial techniques and maximum entropy modeling (Maxent) to assess the habitat suitability of the Hyalomma vector and to identify the key environmental drivers contributing to its spatial distribution in Iraq. Utilizing the area under the ROC curve (AUC) as the performance metric, the model evaluation yielded successful results in predicting habitat suitability for Hyalomma vector ticks in Iraq. The AUC attained an average score of 0.885 with a regularization multiplier (β) set at 1. The Hyalomma ticks’ suitable habitat distribution within the study area covers a fraction of the total land, at approximately 51% (225,665 km2) of the entire 441,724 km2 region. Among these suitable areas, 41.57% (183,631 km2) were classified as lowly suitable, 8.61% (38,039 km2) as moderately suitable, and 0.9% (3994 km2) as highly suitable. Several factors have significantly influenced Hyalomma vector tick distribution in Iraq. These include land cover (accounting for 50.8%), elevation (contributing 30.4%), NDVI (5.7%), temperature seasonality (4.7%), precipitation seasonality (3.3%), sheep density (2.3%), goat density (2.2%), and the mean diurnal range (0.5%). The findings of this study could have significant implications for establishing a strategic early warning system and taking preventive measures beforehand to minimize and control Crimean–Congo haemorrhagic fever in Iraq and similar ecoregions in the Middle East. As a primary precaution, this study recommends focusing on highly suitable areas (3994 km2) in the southern part of Iraq for management and preventive actions.

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“…There have been emerging signs that CCHFV is expanding into new territories such as Western Europe, which may be facilitated by emergence of favorable ecological environment driven by climate change and introduction of infected ticks by migratory birds or livestock trade [1,4,[8][9][10][11][12][13]. In recent years there has been a trend of rising global incidence of CCHFV infections, with greatly increasing case numbers reported from several major endemic countries, demonstrating an imminent public health impact of this re-emerging virus [14][15][16][17][18][19][20][21][22].…”

Section: Introductionmentioning

confidence: 99%

Distinguishing host responses, extensive viral dissemination and long-term viral RNA persistence in domestic sheep experimentally infected with Crimean-Congo hemorrhagic fever virus Kosovo Hoti

Li,

Pinette,

Smith

et al. 2023

Preprint

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Crimean-Congo hemorrhagic fever orthonairovirus (CCHFV) is a tick-borne, biosafety level 4 pathogen often causing a fatal hemorrhagic disease in humans (CCHF). Although the virus is believed to be maintained in a tick-vertebrate-tick ecological cycle involving numerous wild and domestic animal species, the biology of CCHFV infection in these animals is far from clearly understood. Old experimental infection studies, remaining to be validated with modern laboratory methods, were largely based on CCHFV strains of unknown pathogenicity and limited to the observation of viremia. Here, domestic sheep are challenged with CCHFV Kosovo Hoti, a highly pathogenic clinical isolate increasingly utilized in current research. Despite a lack of prominent signs of disease, the infection demonstrates an acute viremia with coinciding viral shedding, high fever and makers for potential impairment in liver and kidney functions. The immune response is characterized by an early reduction of neutrophil recruitment and its chemoattractant, IL-8, in the blood stream, while neutrophil infiltration and elevated IL-8 are features of fatal CCHFV infections reported in immunodeficient mice and humans. Several inflammatory cytokines, which are predictive indicators of mortality in humans and have potential to cause vascular dysfunction, a primary hallmark of severe CCHF, are down-regulated or restricted from increase. Of particular interest, the detection of CCHFV RNA in a variety of organ tissues long after the acute phase of infection, while indicating a widespread viral dissemination in the host, suggests a potentially long-term persisting impact of CCHFV infection. Consistent with this, antibody responses exhibit features reminiscent of recurring antigenic boost, and a prolonged fever or late fever spike correlates with high levels of viral RNA persistence. These findings reveal previously unrecognized aspects of CCHFV biology in animals and highlight the need for extended experimental infection studies.

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

Cited by 19 publications

References 18 publications

Alarming update on incidence of Crimean-Congo hemorrhagic fever in Iraq in 2023

Alarming update on incidence of Crimean-Congo hemorrhagic fever in Iraq in 2023

Predicting the Spatial Distribution of Hyalomma ssp., Vector Ticks of Crimean–Congo Haemorrhagic Fever in Iraq

Distinguishing host responses, extensive viral dissemination and long-term viral RNA persistence in domestic sheep experimentally infected with Crimean-Congo hemorrhagic fever virus Kosovo Hoti

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