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

Abstract

Objectives: In 2021, large outbreak of Crimean-Congo hemorrhagic fever (CCHF) was reported in Iraq and cases have increased without any significant control measures. To raise awareness about the increasing cases in different regions of Iraq, hence remind the necessity to tackle contributing factors and potential outbreak interventions.

Methods: The study included 511 polymerase chain reaction-confirmed CCHF infection cases out of 1827 suspected cases from 18 Provinces from January to August 2023. Approval from the Ministry of Health for data analyzed.

Results: Out of 1827 suspected cases, 511 were confirmed positive by polymerase chain reaction. The total case fatality rate (CFR) was 12.7 with varying severity levels among provinces. Erbil had the highest CFR, 38.5, while Sulaimaniya and Anbar report no deaths. Independent t-test showed a significant difference in CFR between provinces west and south of Baghdad compared to north (P <0.05). Trend showed significant surges after Iftar and Adha holidays.

Conclusion: Differences in CFR among provinces around the religious ceremonies, highlight the need for one public health intervention strategy. Increased temperatures affected vector behavior. Uncontrolled animal movement with neighboring countries is an important factor. Virus or host determinants can shape the clinical case outcomes, which need clinical and extensive laboratory studies to unravel the reasons leading to death.

Keywords: Crimean-Congo hemorrhagic fever (CCHF); Infectious disease; Infectious diseases; Iraq; Ticks; Virus outbreak.

Figure 1

Number of Crimean-Congo hemorrhagic fever confirmed cases in 2023 compared to 2022. Blue arrows refer to Iftar Eid week 17 2022 and week 15 2023. Orange arrows refer to Adha Eid week 26 2022 and week 24 2023.