ORCID

Abstract

Background: Crimean–Congo haemorrhagic fever(CCHF) is a severe illness characterised by fever,bleeding and high case-fatality rates. The disease iscaused by CCHF virus (CCHFV), transmitted by ticksand infectious body fluids and tissues. Aim: After CCHFwas diagnosed in three persons in 2023, we aimed toinvestigate the presence of antibodies against CCHFVin healthcare workers (HCW), sheep and goats, andof CCHFV in ticks, in an area in North Macedonia andcharacterise virus strains. Methods: In 2023, we collected blood samples from HCWs involved in treating CCHF patients and sera and ticks from sheep andgoats in the village in North Macedonia where theindex case resided. The blood samples were analysedby ELISA. Ticks were tested for presence of CCHFV, andthe virus from a CCHF case was sequenced. Results:Samples from four of 52 HCWs and 10 of 17 small ruminants had antibodies against CCHFV. The virus was not detected from any of the 24 Rhipicephalus bursa ticks. The virus strain from the index case clustered withregional strains within the Europe-1 lineage (genotypeV) group and was closest to strains from Kosovo‡.Conclusion: This report shows CCHFV is endemic inNorth Macedonia. Raising awareness of the risk factors and educating people about the measures they can take to reduce exposure to the virus is important.Healthcare workers need to be aware of the disease.Early detection, robust diagnostic methods, surveillance and collaborative efforts are necessary to prevent and control CCHF in the affected regions.

Publication Date

2025-01-30

Publication Title

Eurosurveillance

Volume

30

Issue

4

ISSN

1560-7917

Acceptance Date

2024-08-08

Deposit Date

2025-06-24

Funding

The work was supported by the National Research, Development and Innovation Office, grant number: RRF-2.3.1-21-2022-00010 National Laboratory of Virology. The research was performed in collaboration with the Hungarian Centre for Genomics and Bioinformatics at the Szent\u00E1gothai Research Centre of the University of P\u00E9cs. We would like to express our gratitude to the Institute of Public Health of North Macedonia, especially to the Laboratory of Virology, for their confirmation of the CCHFV infection. We are also deeply thankful to the team responsible for conducting the initial phase of the field epidemiology investigation and contact tracing. Furthermore, we extend our gratitude to the Centre of Public Health in Skopje for their diligent efforts in carrying out the contact tracing after the confirmation of Case 2 and 3. Lastly, our sincere thanks go out to the entire team at the Clinic for Infectious Diseases and Febrile Conditions in Skopje, as well as the Clinical Hospital in Shtip, for their dedicated contributions.

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