Epidemiological Profile of Crimean-Congo Hemorrhagic Fever, Iraq, 2018 (Preprint)

BACKGROUND Crimean-Congo hemorrhagic fever (CCHF) is a potentially fatal tick-borne disease that is widely distributed in Africa and Eurasia countries. It is caused by the CCHF virus of the Nairovirus genus of the Bunyaviridae family. OBJECTIVE This study aims to describe the 2018 CCHF epidemic wave in Iraq and epidemiological patterns to assist the implementation of preventive and control measures and adherence of physicians to the standard case definition. METHODS This descriptive study reviewed all records of suspected and confirmed CCHF cases. Three types of data sources were used: the case investigation forms of all suspected cases, case sheets of all confirmed cases, and the laboratory results from the central public health laboratory. RESULTS The total number of suspected cases was 143. Most of the cases were males (59.4%), 15-45 years old (62.2%), and live in urban areas (58.7%). About three quarters of the cases (68.5%) did not fit the standard case definition adopted by Iraq Center of Disease Control. Most of the suspected cases were reported in Diwaniya province (20.3%). Nearly half of them (64, 44.7%) occurred in June. Only 7.0% (n=10) of suspected cases were positive when tested by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). One third of confirmed cases (3, 30.0%) occurred in Diwaniya province. During the 2018 epidemic wave, there were 10 confirmed cases with 8 deaths and 2 improved cases. CONCLUSIONS Despite the fact that CCHF is uncommon in Iraq, sporadic cases or outbreaks could occur. Recommendations: Given the known method of transmission, banning of random livestock slaughtering and the practice of raising livestock inside residential areas are expected to have a major role in CCHF infection control.