{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T22:57:37Z","timestamp":1793314657645,"version":"4.5.0"},"update-to":[{"DOI":"10.1371\/journal.pntd.0009213","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T00:00:00Z","timestamp":1616025600000}}],"reference-count":29,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2021,3,8]],"date-time":"2021-03-08T00:00:00Z","timestamp":1615161600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Introduction<\/jats:title><jats:p>Crimean-Congo haemorrhagic fever (CCHF) is a tick-borne, zoonotic viral disease that causes haemorrhagic symptoms. Despite having eight confirmed outbreaks between 2013 and 2017, all within Uganda\u2019s \u2018cattle corridor\u2019, no targeted tick control programs exist in Uganda to prevent disease. During a seven-month-period from July 2018-January 2019, the Ministry of Health confirmed multiple independent CCHF outbreaks. We investigated to identify risk factors and recommend interventions to prevent future outbreaks.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>We defined a confirmed case as sudden onset of fever (\u226537.5\u00b0C) with \u22654 of the following signs and symptoms: anorexia, vomiting, diarrhoea, headache, abdominal pain, joint pain, or sudden unexplained bleeding in a resident of the affected districts who tested positive for Crimean-Congo haemorrhagic fever virus (CCHFv) by RT-PCR from 1 July 2018\u201330 January 2019. We reviewed medical records and performed active case-finding. We conducted a case-control study and compared exposures of case-patients with age-, sex-, and sub-county-matched control-persons (1:4).<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>We identified 14 confirmed cases (64% males) with five deaths (case-fatality rate: 36%) from 11 districts in western and central region. Of these, eight (73%) case-patients resided in Uganda\u2019s \u2018cattle corridor\u2019. One outbreak involved two case-patients and the remainder involved one. All case-patients had fever and 93% had unexplained bleeding. Case-patients were aged 6\u201336 years, with persons aged 20\u201344 years more affected (AR: 7.2\/1,000,000) than persons \u226419 years (2.0\/1,000,000), p = 0.015. Most (93%) case-patients had contact with livestock \u22642 weeks before symptom onset. Twelve (86%) lived &lt;1 km from grazing fields compared with 27 (48%) controls (OR<jats:sub>M-H<\/jats:sub>= 18, 95% CI = 3.2-\u221e) and 10 (71%) of 14 case-patients found ticks attached to their bodies \u22642 weeks before symptom onset, compared to 15 (27%) of 56 control-persons (OR<jats:sub>M-H<\/jats:sub>= 9.3, 95%CI = 1.9\u201346).<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusions<\/jats:title><jats:p>CCHF outbreaks occurred sporadically during 2018\u20132019, both within and outside \u2018cattle corridor\u2019 districts of Uganda. Most cases were associated with tick exposure. The Ministry of Health should partner with the Ministry of Agriculture, Animal Industry and Fisheries to develop joint nationwide tick control programs and strategies with shared responsibilities through a One Health approach.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pntd.0009213","type":"journal-article","created":{"date-parts":[[2021,3,8]],"date-time":"2021-03-08T18:36:07Z","timestamp":1615228567000},"page":"e0009213","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":36,"title":["Sporadic outbreaks of crimean-congo haemorrhagic fever in Uganda, July 2018-January 2019"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7351-3729","authenticated-orcid":true,"given":"Bernadette 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