Iraq: Elevated levels of Crimean-Congo hemorrhagic fever were reported nationwide through July

Event

Iraqi health officials have reported elevated Crimean-Congo hemorrhagic fever (CCHF) activity, with 273 cases reported Jan. 1-July 28. This is the highest yearly incidence in the country's history. Disease activity has been reported nationwide, with Dhi Qar Governate reporting the highest number of cases. As of July 28, 49 deaths are associated with the outbreak. Health officials suggest that the surge in cases is likely due to the absence of livestock spraying campaigns over the last two years that were disrupted during the COVID-19 pandemic. The report is the most complete information available as of Aug. 4.

Context

Crimean-Congo hemorrhagic fever (CCHF) is considered a year-round and nationwide threat in Iraq, though cases are infrequently reported.

CCHF is caused by a virus that commonly infects wild and domestic animals (cattle, sheep, and goats), but may also infect humans. The disease is transmitted through the bite of a tick, or through contaminated tissue or blood from infected humans or animals. Once a human is infected, the disease can spread among people through close personal contact. CCHF can also infect healthcare workers who fail to diagnose the disease and institute proper precautions. CCHF fatality rates for patients requiring hospitalization can range from 9-50 percent. Early treatment with the antiviral agent ribavirin can reduce fatality rates.

Advice

After being in areas where ticks may be present, bathe or shower as soon as possible, and conduct a full-body tick check using a hand-held or full-length mirror to view all parts of the body. As weather permits, wear clothing that covers arms and legs. Wear socks and avoid wearing sandals. Use an insect repellent containing DEET (around 35 percent) on clothing and exposed skin when outdoors. These precautions are especially important during the daytime. Contact a healthcare provider if a fever develops during or after being in Iraq, especially if you remember being bitten by a tick.