{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T07:41:49Z","timestamp":1781250109162,"version":"3.54.1"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","license":[{"start":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T00:00:00Z","timestamp":1736726400000},"content-version":"vor","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Crimean-Congo hemorrhagic fever (CCHF) is an acute tick-borne disease with a case fatality rate of up to 40% in humans, posing a significant health threat. This study investigates the 2022\u201323 CCHF outbreaks in Iraq, the highest recorded to date, and analyzes potential factors at the human\u2013animal\u2013environmental interface. Data from the Iraqi government, the World Health Organization, and the World Bank were used to analyze CCHF trends and affecting factors. This included epidemiological reports, clinical data, tick infestation and seroprevalence studies, and climate data. Descriptive and statistical analyses examined case trends, geographic and demographic characteristics, clinical manifestations, risk factors, seasonal patterns, and influencing factors. A sudden rise in CCHF cases began in southern Iraq in April 2022 and expanded across all governorates, with a shift toward urban areas. Higher incidence was observed among males, aged 25\u201344, and those involved in slaughtering. The most common clinical manifestation was fever (97%), followed by hemorrhagic symptoms (54%). Bleeding from the gums or mouth and subcutaneous bleeding were more frequent in patients with fatal outcomes. Seasonal patterns showed peaks during spring and fall, correlating with tick activity and potentially exacerbated by climate change. Tick infestation and seroprevalence studies indicated a high prevalence of Hyalomma ticks and CCHF seropositivity among domestic animals in southern Iraq (60%), consistent with the distribution of CCHF human cases. Iraq\u2019s ongoing CCHF outbreak demands multidisciplinary One Health strategies. The Iraqi government has adopted such a control strategy, contributing to regional and global efforts to enhance pandemic preparedness.<\/jats:p>","DOI":"10.1093\/eurpub\/ckae147","type":"journal-article","created":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T09:01:18Z","timestamp":1736758878000},"page":"i6-i13","source":"Crossref","is-referenced-by-count":10,"title":["Epidemiological analysis and potential factors affecting the 2022\u201323 Crimean-Congo hemorrhagic fever outbreak in Iraq"],"prefix":"10.1093","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3434-5448","authenticated-orcid":false,"given":"Chiori","family":"Kodama","sequence":"first","affiliation":[{"name":"World Health Organization, Eastern Mediterranean Regional Office , Cairo,","place":["Egypt"]},{"name":"Global Health Institute, University of Geneva , Geneva,","place":["Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riyadh Abdulameer","family":"Alhilfi","sequence":"additional","affiliation":[{"name":"Directorate of Public Health, Ministry of Health , Baghdad,","place":["Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ihab","family":"Aakef","sequence":"additional","affiliation":[{"name":"Communicable Disease Control Center, Ministry of Health , Baghdad,","place":["Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adnan","family":"Khamasi","sequence":"additional","affiliation":[{"name":"World Health Organization, Country Office for Iraq , Baghdad,","place":["Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinan","family":"Mahdi","sequence":"additional","affiliation":[{"name":"Communicable Disease Control Center, Ministry of Health , Baghdad,","place":["Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hameeda Mohammed","family":"Hasan","sequence":"additional","affiliation":[{"name":"Communicable Disease Control Center, Ministry of Health , Baghdad,","place":["Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghad Ibrahim","family":"Khaleel","sequence":"additional","affiliation":[{"name":"Central Public Health Laboratory, Ministry of Health , Baghdad,","place":["Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazin Mahdi","family":"Naji","sequence":"additional","affiliation":[{"name":"Central Veterinary Laboratory, Ministry of Agriculture , Baghdad,","place":["Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noor Khalid","family":"Esmaeel","sequence":"additional","affiliation":[{"name":"Central Veterinary Laboratory, Ministry of Agriculture , Baghdad,","place":["Iraq"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sundus","family":"Haji-Jama","sequence":"additional","affiliation":[{"name":"World Health Organization, Eastern Mediterranean Regional Office , 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