Norman Francesca F, Arce Octavio A, Díaz-Menéndez Marta, Belhassen-García Moncef, González-Sanz Marta
National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, CIBERINFEC, Madrid, Spain; Universidad de Alcalá, Madrid, Spain.
High Level Isolation Unit. Infectious Diseases Department, Hospital Central de la Defensa "Gómez Ulla", Madrid, Spain.
Travel Med Infect Dis. 2025 Mar-Apr;64:102806. doi: 10.1016/j.tmaid.2025.102806. Epub 2025 Jan 25.
The World Health Organization has identified Crimean-Congo hemorrhagic fever (CCHF) as a priority disease for research and development in emergency contexts. The epidemiology of CCHF is evolving and this review highlights travel-associated cases and focuses on the need for a One Health approach in Europe.
For this narrative review, two searches were performed in PubMed and Google Scholar for the period 1980-October 2024. The first search identified travel-associated CCHF cases globally, additional cases were identified in the ProMED mail database and through healthmap.org. The second search, with a focus on the European region, aimed to analyse reports of CCHF virus (CCHFV) detected in ticks, CCHF seroprevalence studies in animals and/or humans, and autochthonous CCHF cases.
Seventeen cases of imported CCHF, the majority acquired in Africa, were identified. Importation to European countries accounted for eight of the cases. Most patients presented with fever and hemorrhagic manifestations and the estimated case fatality rate was 35 %. In the WHO European region, at least 13 countries have reported ticks infected with different genotypes of CCHFV; 17 countries were found to have animals/humans with positive CCHF serology. Finally, 16 countries in the WHO European region have notified human cases of CCHF. The Russian Federation, Turkey, and several former USSR countries are considered highly endemic, followed by the Balkanic region, with sporadic cases emerging in Bulgaria, Greece, Spain, and recently Portugal.
Travel-associated CCHF is infrequent. However, given the recently reported increased geographical distribution in ticks and animals in the European region, additional human cases may be anticipated in the near future. Europe receives over half of all international tourist arrivals annually, so healthcare professionals should be aware of risk factors and current protocols for the management of suspected and confirmed cases.
世界卫生组织已将克里米亚-刚果出血热（CCHF）确定为紧急情况下研究与开发的重点疾病。CCHF的流行病学正在演变，本综述重点介绍了与旅行相关的病例，并着重探讨了欧洲采用“同一健康”方法的必要性。
对于本叙述性综述，在1980年至2024年10月期间在PubMed和谷歌学术上进行了两次检索。第一次检索确定了全球与旅行相关的CCHF病例，在国际传染病协会疫情预警邮件数据库（ProMED mail）和通过健康地图网站（healthmap.org）又发现了其他病例。第二次检索重点关注欧洲区域，旨在分析在蜱虫中检测到的CCHF病毒（CCHFV）报告、动物和/或人类的CCHF血清流行率研究以及本地CCHF病例。
确定了17例输入性CCHF病例，其中大多数在非洲感染。有8例输入到了欧洲国家。大多数患者出现发热和出血表现，估计病死率为35%。在世卫组织欧洲区域，至少有13个国家报告了感染不同基因型CCHFV的蜱虫；发现17个国家的动物/人类CCHF血清学呈阳性。最后，世卫组织欧洲区域有16个国家报告了人类CCHF病例。俄罗斯联邦、土耳其和几个前苏联国家被认为是高流行地区，其次是巴尔干地区，保加利亚、希腊、西班牙以及最近的葡萄牙出现了散发病例。
与旅行相关的CCHF并不常见。然而，鉴于最近报告欧洲区域蜱虫和动物的地理分布增加，预计在不久的将来可能会出现更多人类病例。欧洲每年接待的国际游客超过全球总数的一半，因此医疗保健专业人员应了解危险因素以及疑似和确诊病例的现行管理方案。
