{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T16:12:02Z","timestamp":1779207122832,"version":"3.51.4"},"reference-count":62,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infectious Disease Reports"],"abstract":"<jats:p>Background: The impact of climate change on birds\u2019 migration and ticks\u2019 reservoir habits is contributing to the spread of Crimean\u2013Congo hemorrhagic fever (CCHF), caused by CCHF virus (CCHFV), to new continents and countries. CCHF is endemic to the Eastern Mediterranean Region, including Iraq, and is witnessing a substantial surge in confirmed cases with considerable disparity and gaps in managing CCHF cases. The increasing CCHF spread across Asia, Africa, and Europe, including Spain and Turkey, highlights the danger of its expansion. Developing high-confidence diagnostic criteria, identifying risk factors, and accurate predictors of CCHF outcomes are critical to managing suspected and confirmed cases of CCHF and to reducing the current case fatality rate of CCHF, which is the goal of this study. Methods: We completed a retrospective evaluation of 61 confirmed cases of CCHF in Basrah (Iraq). The cases were screened according to the clinical presentation, and CCHF cases were identified by ELISA and validated by PCR. Data was analyzed using SPSS version 22. T-tests, chi-square\/Fisher exact tests, and Pearson\u2019s correlation were used, with significance set at p &lt; 0.05 and high significance at p &lt; 0.01. Results: We found that repeated exposure to animals during animal slaughtering was a significant risk factor. In addition, 5% of the patients with confirmed CCHF, mainly from rural areas, reported exposure to rats. Clinical presentations included fever, headache, gastrointestinal problems, eye and orbital symptoms, and hemorrhagic complications. Predictors of death included advanced age, decreased platelet counts, and neuropsychiatric symptoms such as delusions and confusion. Conclusions: Our findings identify clinical and laboratory features of CCHF cases in Iraq, which will help to implement the most effective interventions to manage CCHF cases and protect the public in all Iraqi governorates. In summary, this study highlights a recent and significant rise in CCHF cases in Basrah Governorate, Iraq. Notably, 5% of confirmed cases reported contact with rats. The paper also proposes diagnostic criteria and identifies key predictors of mortality to support improved clinical management of CCHF. These findings underscore the urgent need for strengthened public health interventions, including enhanced infection prevention and control measures, increased awareness, and improved surveillance systems. The findings have important implications for improving control procedures, guiding therapeutic development, informing vaccine strategies, and supporting evidence-based policy alongside future research efforts.<\/jats:p>","DOI":"10.3390\/idr18030049","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T15:17:23Z","timestamp":1779203843000},"page":"49","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Characteristics, Risk Factors, and Predictors of Fatal Outcomes and Prolonged Hospitalization of Crimean\u2013Congo Hemorrhagic Fever Cases in Basrah, Iraq"],"prefix":"10.3390","volume":"18","author":[{"given":"Mohammed H.","family":"Al-Maliki","sequence":"first","affiliation":[{"name":"Basrah Teaching Hospital, Basrah Health Directorate, Basrah 61004, Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7690-6368","authenticated-orcid":false,"given":"Celine","family":"Tabche","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Public Health Education and Training, School of Public Health, Department of Primary Care and Public Health, Imperial College London, London W12 0BZ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alaa K.","family":"Mousa","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine and Basrah Teaching Hospital, University of Basrah, Basrah 61004, Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali R.","family":"Hashim","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, College of Medicine and Basrah Teaching Hospital, University of Basrah, Basrah 61004, Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zeenah","family":"Atwan","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Public Health Education and Training, School of Public Health, Department of Primary Care and Public Health, Imperial College London, London W12 0BZ, UK"},{"name":"Central Laboratory, Microbiology Department, College of Medicine, University of Basrah, Basrah 61004, Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hassan A.","family":"Farid","sequence":"additional","affiliation":[{"name":"Manchester Centre for Clinical Neurosciences, Salford Royal Hospital, Salford, Greater Manchester M6 8HD, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maitham G.","family":"Yousif","sequence":"additional","affiliation":[{"name":"College of Science, Al-Qadisiyah University, Al Diwaniyah 58001, Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1170-7039","authenticated-orcid":false,"given":"David","family":"Rawaf","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Public Health Education and Training, School of Public Health, Department of Primary Care and Public Health, Imperial College London, London W12 0BZ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nazik Haikaz","family":"Hasrat","sequence":"additional","affiliation":[{"name":"Training and Human Development Centre, Basrah Health Directorate, Basrah 61001, Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0615-0179","authenticated-orcid":false,"given":"Murtadha","family":"Almusafer","sequence":"additional","affiliation":[{"name":"Department of Surgery, College of Medicine, University of Basrah, Basrah 61004, Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anees K.","family":"Nile","sequence":"additional","affiliation":[{"name":"College of Medicine, Al-Nahrain University, Alkadhimiya, P.O. Box 70076, Baghdad 10072, Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8147-6040","authenticated-orcid":false,"given":"Riyadh","family":"Al-Hilfi","sequence":"additional","affiliation":[{"name":"Directorate of Public Health, Ministry of Health, Baghdad 10001, Iraq"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azeem","family":"Majeed","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Public Health Education and Training, School of Public Health, Department of Primary Care and Public Health, Imperial College London, London W12 0BZ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1146-0101","authenticated-orcid":false,"given":"Alessandra","family":"Scagliarini","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7191-2355","authenticated-orcid":false,"given":"Salman","family":"Rawaf","sequence":"additional","affiliation":[{"name":"WHO Collaborating Centre for Public Health Education and Training, School of Public Health, Department of Primary Care and Public Health, Imperial College London, London W12 0BZ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9142-4483","authenticated-orcid":false,"given":"Roaa","family":"Khafaji","sequence":"additional","affiliation":[{"name":"Independent Researcher, Chula Vista, CA 91910, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8171-8115","authenticated-orcid":false,"given":"Juan Carlos","family":"de la Torre","sequence":"additional","affiliation":[{"name":"Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA 92037, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0174-8454","authenticated-orcid":false,"given":"Haydar","family":"Witwit","sequence":"additional","affiliation":[{"name":"Department of Immunology and Microbiology, The Scripps Research Institute, La Jolla, CA 92037, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1093\/jmedent\/15.4.307","article-title":"The Epidemiology of Tick-Borne Crimean-Congo Hemorrhagic Fever in Asia, Europe, and Africa","volume":"15","author":"Hoogstraal","year":"1979","journal-title":"J. Med. Entomol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"233","DOI":"10.3181\/00379727-131-33847","article-title":"Antigenic Similarity between the Virus Causing Crimean Hemorrhagic Fever and Congo Virus","volume":"131","author":"Casals","year":"1969","journal-title":"Proc. Soc. Exp. Biol. Med."},{"key":"ref_3","first-page":"86","article-title":"Congo Virus: A Hitherto Undescribed Virus Occurring in Africa. I. Human Isolations\u2014Clinical Notes","volume":"44","author":"Simpson","year":"1967","journal-title":"East Afr. Med. J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.antiviral.2013.07.006","article-title":"Crimean-Congo Hemorrhagic Fever: History, Epidemiology, Pathogenesis, Clinical Syndrome and Genetic Diversity","volume":"100","author":"Bente","year":"2013","journal-title":"Antivir. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1099\/jgv.0.001485","article-title":"ICTV Virus Taxonomy Profile: Nairoviridae","volume":"101","author":"Garrison","year":"2020","journal-title":"J. Gen. Virol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"252","DOI":"10.3201\/eid2902.220677","article-title":"Crimean-Congo Hemorrhagic Fever, Spain, 2013\u20132021","volume":"29","author":"Carbonell","year":"2023","journal-title":"Emerg. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1016\/j.ijid.2017.02.018","article-title":"Current Status of Crimean-Congo Haemorrhagic Fever in the World Health Organization Eastern Mediterranean Region: Issues, Challenges, and Future Directions","volume":"58","author":"Abaidani","year":"2017","journal-title":"Int. J. Infect. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.antiviral.2016.09.013","article-title":"A Chronological Review of Experimental Infection Studies of the Role of Wild Animals and Livestock in the Maintenance and Transmission of Crimean-Congo Hemorrhagic Fever Virus","volume":"135","author":"Spengler","year":"2016","journal-title":"Antivir. Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1556","DOI":"10.1111\/tbed.14120","article-title":"Crimean-Congo Haemorrhagic Fever (CCHF) in Animals: Global Characterization and Evolution from 2006 to 2019","volume":"69","author":"Fanelli","year":"2022","journal-title":"Transbound. Emerg. Dis."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Adham, D., Abazari, M., Moradi-Asl, E., and Abbasi-Ghahramanloo, A. (2021). Pattern of Crimean-Congo Hemorrhagic Fever Related High Risk Behaviors among Iranian Butchers and Its Relation to Perceived Self-Efficacy. BMC Public Health, 21.","DOI":"10.1186\/s12889-021-10333-7"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1089\/vbz.2012.1061","article-title":"Pathogenesis of Crimean-Congo Hemorrhagic Fever","volume":"13","author":"Bodur","year":"2013","journal-title":"Vector Borne Zoonotic Dis."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.3201\/eid2008.131547","article-title":"Role of Migratory Birds in Spreading Crimean-Congo Hemorrhagic Fever, Turkey","volume":"20","author":"Leblebicioglu","year":"2014","journal-title":"Emerg. Infect. Dis."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"260","DOI":"10.3201\/eid1902.121193","article-title":"Crimean-Congo Hemorrhagic Fever Virus in Ticks from Migratory Birds, Morocco1","volume":"19","author":"Palomar","year":"2013","journal-title":"Emerg. Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/S0923-2516(07)80012-4","article-title":"Crimean-Congo Haemorrhagic Fever Virus Infection in Birds: Field Investigations in Senegal","volume":"145","author":"Zeller","year":"1994","journal-title":"Res. Virol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"81","DOI":"10.2174\/1874357901307010081","article-title":"A Case Report of Crimean Congo Hemorrhagic Fever in Ostriches in Iran","volume":"7","author":"Mostafavi","year":"2013","journal-title":"Open Virol. J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1186\/s13256-022-03303-z","article-title":"Vaginal Bleeding as a Sign of Crimean-Congo Hemorrhagic Fever Infection: A Case Report","volume":"16","author":"Qaderi","year":"2022","journal-title":"J. Med. Case Rep."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"7766","DOI":"10.1128\/JVI.02469-10","article-title":"Crimean-Congo Hemorrhagic Fever Virus Activates Endothelial Cells","volume":"85","author":"Moll","year":"2011","journal-title":"J. Virol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1097\/QCO.0b013e3282a56a0a","article-title":"Crimean-Congo Hemorrhagic Fever","volume":"20","author":"Vorou","year":"2007","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"640","DOI":"10.3201\/eid1804.111374","article-title":"Subclinical Infections with Crimean-Congo Hemorrhagic Fever Virus, Turkey","volume":"18","author":"Bodur","year":"2012","journal-title":"Emerg. Infect. Dis."},{"key":"ref_20","first-page":"e61445","article-title":"Epidemiologic Features and Risk Factors for Crimean-Congo Hemorrhagic Fever in Dhi Qar Province, Iraq","volume":"16","author":"Panahi","year":"2024","journal-title":"Cureus"},{"key":"ref_21","first-page":"464","article-title":"Crimean-Congo Haemorrhagic Fever Virus in Iraq: Isolation, Identification and Electron Microscopy","volume":"24","author":"Tantawi","year":"1980","journal-title":"Acta Virol."},{"key":"ref_22","first-page":"85","article-title":"Congo\/Crimean Haemorrhagic Fever in Iraq","volume":"59","author":"Jurji","year":"1981","journal-title":"Bull. World Health Organ."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.ijregi.2023.01.007","article-title":"Large Outbreak of Crimean-Congo Haemorrhagic Fever in Iraq, 2022","volume":"6","author":"Alhilfi","year":"2023","journal-title":"IJID Reg."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.ijregi.2023.11.018","article-title":"Alarming Update on Incidence of Crimean-Congo Hemorrhagic Fever in Iraq in 2023","volume":"10","author":"Atwan","year":"2023","journal-title":"IJID Reg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"100588","DOI":"10.1016\/j.ijregi.2025.100588","article-title":"Crimean-Congo Hemorrhagic Fever, a Real Health Problem in Iraq?","volume":"14","author":"Abdulrahman","year":"2025","journal-title":"IJID Reg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"98","DOI":"10.22317\/jcms.v10i2.1473","article-title":"Relation between the Pandemic COVID-19 and the Outbreak of Crimean-Congo Hemorrhagic Fever in Iraq, 2023: Pandemic COVID-19 & Crimean-Congo Hemorrhagic Fever","volume":"10","author":"Ismael","year":"2024","journal-title":"J. Contemp. Med. Sci."},{"key":"ref_27","unstructured":"(2026, February 15). Agricultural Meteorological Network, Available online: https:\/\/www.agromet.gov.iq\/yearly_inv.php."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"100003","DOI":"10.5501\/wjv.v14.i1.100003","article-title":"Crimean-Congo Hemorrhagic Fever: Pathogenesis, Transmission and Public Health Challenges","volume":"14","author":"Karanam","year":"2025","journal-title":"World J. Virol."},{"key":"ref_29","first-page":"443","article-title":"The Relationship Between Crimean-Congo Hemorrhagic Fever and Climate: Does Climate Affect the Number of Patients?","volume":"57","author":"Duygu","year":"2018","journal-title":"Acta Clin. Croat."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e19593","DOI":"10.1016\/j.heliyon.2023.e19593","article-title":"Temporal Tendency, Seasonality and Relationship with Climatic Factors of Crimean-Congo Hemorrhagic Fever Cases (East of Turkey: 2012\u20132021)","volume":"9","author":"Alay","year":"2023","journal-title":"Heliyon"},{"key":"ref_31","first-page":"35","article-title":"The 2022 Crimean-Congo Hemorrhagic Fever Outbreak in Iraq","volume":"56","author":"Hussain","year":"2024","journal-title":"Austral J. Vet. Sci."},{"key":"ref_32","first-page":"9945089","article-title":"Determination of Seroprevalence and Risk Factors of Crimean\u2013Congo Haemorrhagic Fever (CCHF) in the Endemic Region in Turkey: A Population-Based Cross-Sectional Study","volume":"2021","author":"Duygu","year":"2021","journal-title":"J. Trop. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.ijid.2003.10.008","article-title":"Crimean-Congo Hemorrhagic Fever in Sistan and Baluchestan Province of Iran, a Case-Control Study on Epidemiological Characteristics","volume":"8","author":"Izadi","year":"2004","journal-title":"Int. J. Infect. Dis."},{"key":"ref_34","first-page":"115","article-title":"Antibodies to Crimean-Congo Haemorrhagic Fever Virus in Domestic Animals in Iraq: A Seroepidemiological Survey","volume":"8","author":"Tantawi","year":"1981","journal-title":"Int. J. Zoonoses"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Omoga, D.C.A., Tchouassi, D.P., Venter, M., Ogola, E.O., Osalla, J., Kopp, A., Slothouwer, I., Torto, B., Junglen, S., and Sang, R. (2023). Transmission Dynamics of Crimean-Congo Haemorrhagic Fever Virus (CCHFV): Evidence of Circulation in Humans, Livestock, and Rodents in Diverse Ecologies in Kenya. Viruses, 15.","DOI":"10.3390\/v15091891"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.ijid.2016.02.1008","article-title":"Possible Sexual Transmission of Crimean-Congo Hemorrhagic Fever","volume":"45","author":"Pshenichnaya","year":"2016","journal-title":"Int. J. Infect. Dis."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Sahay, R.R., Shete, A.M., Yadav, P.D., Patil, S., Majumdar, T., Jain, R., Nyayanit, D.A., Kaushal, H., Panjwani, S.J., and Upadhyay, K.J. (2021). Sequential Determination of Viral Load, Humoral Responses and Phylogenetic Analysis in Fatal and Non-Fatal Cases of Crimean-Congo Hemorrhagic Fever Patients from Gujarat, India, 2019. PLoS Neglected Trop. Dis., 15.","DOI":"10.1371\/journal.pntd.0009718"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.ijid.2004.02.007","article-title":"Bi-Annual Surge of Crimean-Congo Haemorrhagic Fever (CCHF): A Five-Year Experience","volume":"9","author":"Sheikh","year":"2005","journal-title":"Int. J. Infect. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1099\/vir.0.014878-0","article-title":"Towards an Understanding of the Migration of Crimean-Congo Hemorrhagic Fever Virus","volume":"91","author":"Mild","year":"2010","journal-title":"J. Gen. Virol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"156","DOI":"10.4103\/0300-1652.153409","article-title":"Report of Nine Cases of Crimean-Congo Haemorrhagic Fever From Iran","volume":"56","author":"Ayatollahi","year":"2015","journal-title":"Niger. Med. J."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"129","DOI":"10.7861\/clinmedicine.16-2-129","article-title":"Viral Arthritis","volume":"16","author":"Marks","year":"2016","journal-title":"Clin. Med."},{"key":"ref_42","first-page":"161","article-title":"Hematological Aspects of Crimean-Congo Hemorrhagic Fever","volume":"26","author":"Duru","year":"2009","journal-title":"Turk. J. Haematol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1111\/j.1469-0691.2006.01445.x","article-title":"Analysis of Risk-Factors among Patients with Crimean-Congo Haemorrhagic Fever Virus Infection: Severity Criteria Revisited","volume":"12","author":"Ergonul","year":"2006","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1016\/j.ajo.2008.11.014","article-title":"Ocular Findings in Patients with Crimean-Congo Hemorrhagic Fever","volume":"147","author":"Engin","year":"2009","journal-title":"Am. J. Ophthalmol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e0032","DOI":"10.5041\/RMMJ.10393","article-title":"An Evaluation of the Different Serum Markers Associated with Mortality in Crimean-Congo Hemorrhagic Fever","volume":"11","author":"Tekin","year":"2020","journal-title":"Rambam Maimonides Med. J."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e14775","DOI":"10.1111\/ijcp.14775","article-title":"Crimean-Congo Haemorrhagic Fever-Induced Liver Injury: A Systematic Review and Meta-Analysis","volume":"75","author":"Rathore","year":"2021","journal-title":"Int. J. Clin. Pract."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"104516","DOI":"10.1016\/j.bjid.2025.104516","article-title":"Crimean-Congo Hemorrhagic Fever: Strategies for Diagnosis at Initial Admission","volume":"29","year":"2025","journal-title":"Braz. J. Infect. Dis."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Khafaji, R., Khafaji, S.S., Ubayis, R.S., Witwit, S.R., Witwit, E., Jawad, A., Mosnier, L.O., de la Torre, J.C., and Witwit, H. (2026). Meta-Analyses and Meta-Regression Analyses Revealed That Crimean\u2013Congo Hemorrhagic Fever Disease Associates with Coagulopathy Independently of Thrombocytopenia. Zoonotic Dis., 6.","DOI":"10.64898\/2026.01.24.26344481"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e89","DOI":"10.1016\/j.ijid.2011.06.005","article-title":"Evaluation of Factors Predictive of the Prognosis in Crimean-Congo Hemorrhagic Fever: New Suggestions","volume":"16","author":"Ozturk","year":"2012","journal-title":"Int. J. Infect. Dis."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/j.ijid.2007.09.010","article-title":"Clinical and Laboratory Features of Crimean-Congo Hemorrhagic Fever: Predictors of Fatality","volume":"12","author":"Cevik","year":"2008","journal-title":"Int. J. Infect. Dis."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"496","DOI":"10.1080\/20477724.2021.1878450","article-title":"Association Between Severity Grading Score and Acute Phase Reactants in Patients with Crimean Congo Hemorrhagic Fever","volume":"115","author":"Bozkurt","year":"2021","journal-title":"Pathog. Glob. Health"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"419","DOI":"10.5578\/mb.20239934","article-title":"The Role of Blood Urea Nitrogen and C-Reactive Protein and Their Ratios to Albumin in Predicting Mortality in Crimean-Congo Hemorrhagic Fever","volume":"57","year":"2023","journal-title":"Mikrobiyol. Bul."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"268","DOI":"10.3201\/eid2902.220976","article-title":"Changing Disease Course of Crimean-Congo Hemorrhagic Fever in Children, Turkey","volume":"29","author":"Oygar","year":"2023","journal-title":"Emerg. Infect. Dis."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1016\/j.jcv.2015.12.006","article-title":"Crucial Parameter of the Outcome in Crimean Congo Hemorrhagic Fever: Viral Load","volume":"75","author":"Hasanoglu","year":"2016","journal-title":"J. Clin. Virol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.antiviral.2007.11.002","article-title":"Treatment of Crimean-Congo Hemorrhagic Fever","volume":"78","author":"Ergonul","year":"2008","journal-title":"Antivir. Res."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"686","DOI":"10.4065\/mcp.2011.0012","article-title":"Antimicrobial Prophylaxis in Adults","volume":"86","author":"Enzler","year":"2011","journal-title":"Mayo Clin. Proc."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1093\/cid\/ciae524","article-title":"Choosing Wisely: Effectiveness and Safety of Antibiotic Prophylaxis in Close Contacts of Invasive Group A Streptococci Infection","volume":"80","author":"Birck","year":"2025","journal-title":"Clin. Infect. Dis."},{"key":"ref_58","first-page":"27","article-title":"High-Dose Methylprednisolone in Children with Crimean-Congo Haemorrhagic Fever","volume":"40","author":"Dilber","year":"2010","journal-title":"Trop. Dr."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"3938","DOI":"10.1182\/blood-2024-203948","article-title":"Randomised Controlled Trial of High Dose Dexamethasone and Methylprednisolone in Immune Thrombocytopenia (HDMI Trial)","volume":"144","author":"Mishra","year":"2024","journal-title":"Blood"},{"key":"ref_60","doi-asserted-by":"crossref","unstructured":"AASLD\/IDSA HCV Guidance Panel (2015). Hepatitis C Guidance: AASLD-IDSA Recommendations for Testing, Managing, and Treating Adults Infected with Hepatitis C Virus. Hepatology, 62, 932\u2013954.","DOI":"10.1002\/hep.27950"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"e799","DOI":"10.1016\/j.ijid.2013.02.030","article-title":"Ribavirin Is Not Effective against Crimean-Congo Hemorrhagic Fever: Observations from the Turkish Experience","volume":"17","author":"Ceylan","year":"2013","journal-title":"Int. J. Infect. Dis."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Reniers, G., Araya, T., Berhane, Y., Davey, G., and Sanders, E.J. (2009). Implications of the HIV Testing Protocol for Refusal Bias in Seroprevalence Surveys. BMC Public Health, 9.","DOI":"10.1186\/1471-2458-9-163"}],"container-title":["Infectious Disease Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2036-7449\/18\/3\/49\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T15:46:47Z","timestamp":1779205607000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2036-7449\/18\/3\/49"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,19]]},"references-count":62,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["idr18030049"],"URL":"https:\/\/doi.org\/10.3390\/idr18030049","relation":{},"ISSN":["2036-7449"],"issn-type":[{"value":"2036-7449","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,19]]}}}