Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Dec 27:12:1116.
doi: 10.1186/1471-2458-12-1116.

Environmental correlates of Crimean-Congo haemorrhagic fever incidence in Bulgaria

Fenicia M Vescio  1 , Luca Busani, Lapo Mughini-Gras, Cristina Khoury, Luca Avellis, Evgenia Taseva, Giovanni Rezza, Iva Christova
Affiliations

Environmental correlates of Crimean-Congo haemorrhagic fever incidence in Bulgaria

Fenicia M Vescio et al. BMC Public Health. .

Abstract

Background: Crimean-Congo Haemorrhagic Fever (CCHF) is a zoonotic viral disease transmitted by ixodid tick bites, mainly of Hyalomma spp., or through contact with blood/tissues from infected people or animals. CCHF is endemic in the Balkan area, including Bulgaria, where it causes both sporadic cases and community outbreaks.

Methods: We described trends of CCHF in Bulgaria between 1997 and 2009 and investigated the associations between CCHF incidence and a selection of environmental factors using a zero-inflated modelling approach.

Results: A total of 159 CCHF cases (38 women and 121 men) were identified between 1997 and 2009. The incidence was 0.13 cases per 100,000 population/year with a fatality rate of 26%. An epidemic peak was detected close to the Turkish border in the summer of 2002. Most cases were reported between April and September. Increasing mean temperature, Normalized Difference Vegetation Index (NDVI), savannah-type land coverage or habitat fragmentation increased significantly the incidence of CCHF in the CCHF-affected areas. Similar to that observed in Turkey, we found that areas with warmer temperatures in the autumn prior to the case-reporting year had an increased probability of reporting zero CCHF cases.

Conclusions: We identified environmental correlates of CCHF incidence in Bulgaria that may support the prospective implementation of public health interventions.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Distribution of CCHF cases by month and year of occurrence.
See this image and copyright information in PMC

References

    1. Hoogstraal H. The epidemiology of tick-borne Crimean-Congo hemorrhagic fever in Asia, Europe, and Africa. J Med Entomol. 1979;22:307–417. - PubMed
    1. Manilla G. Acari Ixodidae, Fauna d’Italia. Parte speciale: Ixodidae. Acari, Ixodida. 1998. pp. 193–195.
    1. Ergonul O. Crimean-Congo haemorrhagic fever. Lancet Infect Dis. 2006;6:203–214. doi: 10.1016/S1473-3099(06)70435-2. - DOI - PMC - PubMed
    1. Whitehouse CA. Crimean-Congo hemorrhagic fever. Antiviral Res. 2004;64:145–160. - PubMed
    1. Gale P, Estrada-Pena A, Martinez M, Ulrich RG, Wilson A, Capelli G. et al.The feasibility of developing a risk assessment for the impact of climate change on the emergence of Crimean-Congo haemorrhagic fever in livestock in Europe: a Review. J Appl Microbiol. 2010;108:1859–1870. - PubMed

Publication types

LinkOut - more resources