![]() Although the likelihood of virus exposure within the general population is low ( 12) because of a predominantly urban lifestyle, greater accuracy in risk prediction may lead to more effective preventive measures for the at-risk population ( 13).ĬCHFV has been detected in several species of ticks, but the major CCHFV reservoirs and vectors are considered to be Hyalomma spp. Identifying spatiotemporal virus transmission hotspots may provide information for surveillance and prevention strategies to reduce exposure to CCHFV. Because no vaccine is available, humans in or near CCHFV-endemic areas are advised to take precautions when spending time in nature (or tick-prone areas), including limiting skin exposure, applying tick repellents, and thoroughly inspecting the skin after field activities. Since then, 12 human cases (4 deaths) have been reported in Spain ( 10, 11). Those changes are the most likely underlying reason for the emergence of CCHF in Spain.Įxposure to CCHFV on the Iberian Peninsula (mainland Spain and Portugal) was first evidenced in humans in Portugal in 1985 ( 8), but the first confirmed clinical case was reported in 2016 in Spain ( 9). Climate change and landscape transformations have affected the abundance and spatial range of CCHFV animal hosts and vectors ( 6), strongly influencing CCHFV transmission dynamics ( 7) and modifying the likelihood of disease emergence and re-emergence ( 4). In the 21st century, the geographic range and incidence of confirmed CCHF cases have markedly increased ( 2). Veterinarians, farmers, hunters, environmental rangers, and abattoir personnel are at highest risk for infection ( 4).ĬCHFV is prevalent in Africa, eastern Europe, the Middle East, and across central Asia to western China ( 5). Cases of CCHF are associated with rural areas. Although some outbreaks are associated with high case-fatality rates, most (≈90%) human infections are asymptomatic or cause mild illness ( 2). ![]() Humans can become infected by the bite of a CCHFV-infected tick or through direct contact with virus-contaminated tissues or blood ( 3). ![]() CCHFV infections in animals are mainly asymptomatic, which complicates detection of the virus and increases the risk for human infection. Clinical disease is restricted mainly to humans, but the virus can infect a wide range of animal species ( 2). The World Health Organization considers CCHF one of the highest priority diseases because of its epidemic potential, its high case-fatality rate (10%–40%), and its difficult prevention and treatment ( 1). Our study provides insight into CCHFV ecology that is useful for preventing virus transmission.Ĭrimean-Congo hemorrhagic fever (CCHF) is a tickborne zoonosis caused by CCHF virus (CCHFV). To map CCHFV exposure risk, we projected the model at a 1 × 1-km spatial resolution. Model validation showed 99.7% specificity and 10.2% sensitivity for identifying CCHFV circulation areas. The best-fitted statistical model indicated that the most significant predictors of virus exposure risk were cattle/horse density and the normalized difference vegetation index. CCHFV antibodies detected in 84 samples confirmed low CCHFV prevalence in small domestic ruminants in the region. To assess CCHFV exposure spatial distribution, we analyzed serum from 2,440 sheep and goats by using a double-antigen ELISA and modeled exposure probability with environmental predictors by using generalized linear mixed models. To estimate the determinants of spatial variation in Crimean-Congo hemorrhagic fever virus (CCHFV) transmission and to create a risk map as a preventive public health tool, we designed a survey of small domestic ruminants in Andalusia, Spain.
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