Clinical and Epidemiological Characteristics of Crimean-Congo Hemorrhagic Fever in Iraq in 2023
Eman Fawzi Turki, Hasan Alwan Baiee, Ghazwan Abdulsalam IbraheemAbstract
Background:
Crimean-Congo 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 consequences captured the interest of conducting this study.
Objectives:
To identify the epidemiological characteristics of CCHF in Iraq and its correlation for the year 2023.
Materials and Methods:
This case-series study was conducted at the Center of Communicable Diseases, Iraqi Ministry of Health, Baghdad, by reviewing the records of all patients with CCHF, both confirmed (polymerase chain reaction [PCR] positive) and suspected patients, according to World Health Organization criteria. Person, place, and time epidemiological models were used to describe the distribution of cases from the first of January through the end of December 2023.
Results:
A total of 2773 CCHF suspected cases were reported to the Iraqi Center for Disease Control and Prevention surveillance system from January 1, 2023, to December 31, 2023. The confirmatory reverse transcription-PCR test revealed that 587 (21%) patients were positive (confirmed patients), and 2186 (79%) were negative (patients with suspected CCHF). Males were predominant. The overall median age of the patients was 33 years, and 83.8% of them were aged 10–59 years. The incidence rates (IRs) for both suspected (negative) and confirmed (positive) cases were 5.05 and 1.35 per 100,000 populations, respectively. The geographical distribution of confirmed cases showed that the highest IR was reported in Dhi-Qar governorate, with 5.96 per 100,000 population, followed by Al-Muthanna and Maysan governorates, with IRs of 3.78 and 3.08 per 100,000 population, respectively. People at high risk were housewives, animal breeders, and butchers. Most of the cases occurred in the summer season; they increased in April, continued to peak in June and July, and then declined in autumn and winter.
Conclusion:
The significant number of CCHF cases indicates a clear and serious epidemic of this viral zoonotic disease. In most cases, males were in their productive age. People at high risk include animal breeders and butchers.