Outbreak Of Hemorrhagic Fever Research Articles

Mapping of Flood-Prone and Dengue Fever-Prone Areas in Tahtul Yaman Village, Pelayangan District, Jambi City

Floods are natural events that come suddenly with an uncertain periodicity, except for areas that often experience annual flooding, such as in Tahtul Yemen Village. This flood disaster can cause health problems that threaten society, one of which is the Dangue Hemorrhagic Fever (DHF) outbreak. This activity aims to carry out mapping of flood-prone areas and dengue-prone areas in Tahtul Yemen Village to provide education about the management and prevention of dengue fever in order to improve the health status of the community, especially those in vulnerable areas. This research is exploratory research with an ecological study research design using Geographic Information Systems (GIS). Based on data on flood-prone areas obtained from 12 RTs in Tahtul Yaman Village, 5 RTs had a high percentage of being affected by flooding, 4 RTs had a moderate percentage of being affected by flooding, and 3 RTs had a low percentage of being affected by flooding. Meanwhile, for dengue-prone areas, there are 7 RTs with a low percentage, 3 RTs with a medium percentage, and 2 RTs with a high percentage. In conclusion, it was found that in Tahtul Yaman Subdistrict areas prone to flooding with the highest dominance are in RT 11,12,5,9, and 7 and areas prone to Dengue Hemorrhagic Fever (DHF) are dominant in RT 7 and 9. It is recommended that the areas that have been mapped be included in prone to flooding and Dengue Hemorrhagic Fever (DHF) strengthen drainage systems, green infrastructure, and increase public awareness about disease prevention

Determinants of crimean-congo hemorrhagic fever (cchf) outbreaks: a retrospective analysis

Abstract Introduction Crimean-Congo Hemorrhagic Fever (CCHF), a viral tick-borne zoonotic disease with high mortality rates, poses a particular threat in Pakistan during religious event of Eid-ul-Azha as increased livestock contact. This study aims to analyze CCHF cases from three outbreaks, to identify transmission and disease patterns. Understanding these patterns can inform targeted interventions for future outbreaks. Methods A retrospective cross-sectional study was conducted to examine three CCHF outbreak investigations between July 2nd and August 12th, 2023 in Khyber Pakhtunkhwa, Pakistan. Multisectoral teams, including human and animal health departments, investigated these outbreaks. Data was collected through semi-structured case investigation tools. The healthcare providers, patients and family were subjects. During active case surveillance, 41 probable contacts were traced. Results Among positive cases, male predominance (71.4%) was observed. The highest proportion of cases occurred in the 15-29 year age group (42.9%, n = 6). Individuals involved in animal handling professions had the highest prevalence (50%, n = 7), followed by students (21.4%, n = 3). Common clinical manifestations included high-grade fever (100%), muscle pain (92.9%), and bleeding symptoms (85.7%), with 64.3% of cases reporting vomiting blood. The average recovery time was 7.1 days, while fatal cases had an average of 6.8 days from symptom onset to death. Recovery was observed in 64.3% of cases, with a mortality rate of 35.7%. Chi-square analysis showed significant associations between gender, occupation, and disease outcome (p < 0.05). Conclusions This study identified a higher risk of CCHF in males, young adults, and individuals involved in animal handling during outbreaks. Public health interventions targeting occupations, demographics, particularly education and protective measures for animal handlers during Eid-ul-Azha days, are crucial to mitigate future outbreaks Key messages • Young male adults, and individuals involved in animal handling are on greater risk of higher risk of CCHF infections in Khyber Pakhtunkhwa, Pakistan. • One Health community can leverage these findings to develop better prevention and control strategies through collaboration between human and animal health sectors.

Epidemiological analysis of event-based surveillance data of Crimean-Congo Hemorrhagic Fever (CCHF) outbreaks across Balochistan Province, Pakistan, from 2000 to August 2021

Epidemiological analysis of event-based surveillance data of Crimean-Congo Hemorrhagic Fever (CCHF) outbreaks across Balochistan Province, Pakistan, from 2000 to August 2021

The Role of Community Health Nurses in Handling Dengue Fever Outbreaks in Residential Areas

Controlling Dengue Hemorrhagic Fever (DHF) outbreaks is a complex public health challenge that requires collaboration from various stakeholders, including community health nurses. This study aims to assess the role of these nurses in managing DHF outbreaks in residential areas. Using a descriptive qualitative approach, the research involved in-depth interviews with community health nurses and direct field observations to gather comprehensive data. The findings revealed that community health nurses are crucial in preventing and controlling DHF outbreaks. Their responsibilities include educating the community about DHF prevention, identifying and managing mosquito breeding sites, and implementing environmental interventions. They also play a vital role in early detection of DHF cases and coordinate with government and health institutions for effective prevention and control measures. Furthermore, community health nurses provide counseling and training to raise awareness about DHF dangers and promote preventive actions. They are instrumental in encouraging community participation in environmental management to reduce mosquito habitats. This study emphasizes the need for ongoing support and capacity building for community health nurses to enhance their effectiveness. In conclusion, collaboration among health workers, communities, and stakeholders is essential to control dengue outbreaks and minimize the disease's impact.

Application of spatial scan statistics on retrospective data to detect outbreaks of dengue hemorrhagic fever in Hai An and Duong Kinh districts, Hai Phong, 2020 - 2023

Dengue fever is an endemic disease that can lead to major outbreaks in Vietnam. This study aims to describe application of spatial scan statistics on retrospective data to detect outbreaks of dengue hemorrhagic fever in Hai An and Duong Kinh districts, Hai Phong, 2020 - 2023. The study analyzed aggregate dengue data covering 177 weeks (from Week 1/2020 to Week 20/2023). During the retrospective data period, 360 cases were reported from 14 wards of Hai An and Duong Kinh districts, of which 74 cases formed 5 clusters, with the remaining cases being sporadic. The clusters mainly occurred in November each year. Scan statistics should be systematically applied in monitoring dengue fever outbreaks, as the study results demonstrate that scan techniques can effectively detect clusters in the community.

The structure of the Lujo virus spike complex

Lujo virus (LUJV) is a human pathogen that was the cause of a deadly hemorrhagic fever outbreak in Africa. LUJV is a divergent member of the Arenaviridae with some similarities to both the “Old World” and “New World” serogroups, but it uses a cell-entry receptor, neuropilin-2 (NRP2), that is distinct from the receptors of OW and NW viruses. Though the receptor binding domain of LUJV has been characterized structurally, the overall organization of the trimeric spike complex and how NRP2 is recognized in this context were unknown. Here, we present the structure of the membrane-embedded LUJV spike complex determined by cryo-electron microscopy. Analysis of the structure suggested that a single NRP2 molecule is bound at the apex of the trimeric spike and that multiple subunits of the trimer contact the receptor. The binding of NRP2 involves an intriguing arginine-methionine interaction, which we analyzed using quantum mechanical modeling methods. We compare the LUJV spike structure with the only other available structure of a complete arenaviral spike, which is the Lassa virus. The similarities and differences between them shed light on Arenavirus evolution, inform vaccine design, and provide information that will be useful in combating future Arenavirus outbreaks.

Understanding the delay in identifying Sudan Virus Disease: gaps in integrated disease surveillance and response and community-based surveillance to detect viral hemorrhagic fever outbreaks in Uganda, September 2022

BackgroundEarly detection of outbreaks requires robust surveillance and reporting at both community and health facility levels. Uganda implements Integrated Disease Surveillance and Response (IDSR) for priority diseases and uses the national District Health Information System (DHIS2) for reporting. However, investigations after the first case in the 2022 Uganda Sudan virus outbreak was confirmed on September 20, 2022 revealed many community deaths among persons with Ebola-like symptoms as far back as August. Most had sought care at private facilities. We explored possible gaps in surveillance that may have resulted in late detection of the Sudan virus disease (SVD) outbreak in Uganda.MethodsUsing a standardized tool, we evaluated core surveillance capacities at public and private health facilities at the hospital level and below in three sub-counties reporting the earliest SVD cases in the outbreak. Key informant interviews (KIIs) were conducted with 12 purposively-selected participants from the district local government. Focus group discussions (FGDs) were conducted with community members from six villages where early probable SVD cases were identified. KIIs and FGDs focused on experiences with SVD and Viral Hemorrhagic Fever (VHF) surveillance in the district. Thematic data analysis was used for qualitative data.ResultsForty-six (85%) of 54 health facilities surveyed were privately-owned, among which 42 (91%) did not report to DHIS2 and 39 (85%) had no health worker trained on IDSR; both metrics were 100% in the eight public facilities. Weak community-based surveillance, poor private facility engagement, low suspicion index for VHF among health workers, inability of facilities to analyze and utilize surveillance data, lack of knowledge about to whom to report, funding constraints for surveillance activities, lack of IDSR training, and lack of all-cause mortality surveillance were identified as gaps potentially contributing to delayed outbreak detection.ConclusionBoth systemic and knowledge-related gaps in IDSR surveillance in SVD-affected districts contributed to the delayed detection of the 2022 Uganda SVD outbreak. Targeted interventions to address these gaps in both public and private facilities across Uganda could help avert similar situations in the future.

Spread of Puumala Hantavirus to New Areas in a Large Croatian Outbreak of Hemorrhagic Fever with Renal Syndrome, 2021.

Background: The largest documented outbreak of hemorrhagic fever with renal syndrome occurred in Primorje-Gorski Kotar County, Croatia, in 2021, marking the first-time cases of hantavirus infection recorded outside of the known endemic region in the north of the county. Aim: To identify the factors contributing to the spread of the outbreak and to compare risk factors for acquiring hantavirus infection in the endemic and newly affected regions. Methods and Results: A total of 189 cases were confirmed by positive Puumala IgM/IgG antibodies (93.6%), and 13 probable cases were identified by clinical and epidemiological data (6.4%) using a structured questionnaire. Of the 179 cases with available clinical data, 59 (33.0%) were hospitalized. Three cases received hemodialysis, and no deaths were reported. Among 170 cases with information on exposures, 66 (38.8%) reported occupational risk. Cases in the northern part of county were more likely to have been infected in early spring (OR 27.1, 95% CI 2.93-250.7), to report seeing a rodent (OR 6.5; 95%CI 2.3-18.4), and to know someone with hemorrhagic fever with renal syndrome (HFRS) (OR 3.0; 95%CI 1.2-8.0) than cases from the southern part of the county. Data from Croatian Forests Ltd. suggested that an unusually good production of beech seeds in 2020 may have contributed to an increased rodent population in 2021. However, average temperature, rainfall, and humidity data from 2021 did not illustrate a significant difference from previous years (Kruskal-Wallis p = 0.837, p = 0.999, p = 0.108). Conclusion: The 2021 HFRS outbreak was likely fueled by an abundant rodent population and virus transmission in rodent hosts. Human activity, environmental factors, and the ensuing animal-human interactions have spread hantavirus infection from Croatia's mountainous region to a previously nonendemic coastal area with a Mediterranean climate.

The Role of Community Health Nurses in Overcoming Dengue Hemorrhagic Fever Outbreaks in Densely Populationd Housing

Densely populated housing often faces challenges in managing a healthy environment, which exacerbates the spread of Aedes Aegypti. Efforts to prevent Dengue Hemorrhagic Fever (DHF) can be carried out collaboratively between the community and nurses to suppress the spread of the disease. This research aims to explore the role of community nurses in dealing with dengue hemorrhagic fever outbreaks in densely populated housing areas. The research approach used in this research is a qualitative systematic literature review approach. The research results show that community nurses play an important role in empowering the community through the Larva Monitoring Officer (Jumantik) program to monitor and prevent dengue fever. Collaboration between the government, health workers and the community is very important to reduce the incidence of dengue fever significantly.

Tanzania's first Marburg Viral Disease outbreak response: Describing the roles of FELTP graduates and residents.

Viral Haemorrhagic Fever Outbreak presents a significant public health threat, requiring a timely, robust, and well-coordinated response. This paper aims to describe the roles of the Tanzania Field Epidemiology and Laboratory Training Program (TFELTP) graduates and residents in responding to Tanzania's first Marburg Viral Disease (MVD) outbreak. We performed a secondary data analysis using a range of documents, such as rosters of deployed responders and the TFELTP graduate and resident database, to count and describe them. Additionally, we conducted an exploratory textual analysis of field deployment reports and outbreak situational reports to delineate the roles played by the residents and graduates within each response pillar. A total of 70 TFELTP graduates and residents from different regions were involved in supporting the response efforts. TFELTP graduates and residents actively participated in several interventions, including contact tracing and follow up, sensitising clinicians on surveillance tools such as standard case definitions, alert management, supporting the National and Kagera Regional Public Health Emergency Operations Centres, active case search, risk communication, and community engagement, coordination of logistics, passenger screening at points of entry, and conducting Infection Prevention and Control (IPC) assessments and orientations in 144 Health Facilities. The successes achieved and lessons learned from the MVD response lay a foundation for sustained investment in skilled workforce development. FELTP Training is a key strategy for enhancing global health security and strengthening outbreak response capabilities in Tanzania and beyond.

Crimean-congo hemorrhagic fever outbreak affecting healthcare workers in pakistan; an urgent rising concern

Crimean-congo hemorrhagic fever outbreak affecting healthcare workers in pakistan; an urgent rising concern

Human macrophages infected with Egyptian Rousette bat-isolated Marburg virus display inter-individual susceptibility and antiviral responsiveness

Marburg virus (MARV) is a highly pathogenic filovirus and a causative agent of sporadic zoonotic viral hemorrhagic fever outbreaks with high case fatality rates. In humans, filoviruses like MARV and Zaire Ebola virus (EBOV) target, among others, innate immune cells like dendritic cells and macrophages (MΦs). Filovirus-infected dendritic cells display impaired maturation and antigen presentation, while MΦs become hyper-activated and secrete proinflammatory cytokines and chemokines. Our current understanding of human macrophage responses to MARV remains limited. Here, we used human monocyte-derived macrophages (moMΦs) to address how their phenotype, transcriptional profile, and protein expression change upon an in vitro infection with a bat isolate of MARV. Confirming its tropism for macrophages, we show that MARV induces notable shifts in their transcription distinct from responses induced by lipopolysaccharide (LPS), marked by upregulated gene expression of several chemokines, type I interferons, and IFN-stimulated genes. MARV infection also elicited pronounced inter-individually different transcriptional programs in moMΦs, the induction of Wnt signaling-associated genes, and the downregulation of multiple biological processes and molecular pathways.

Relation between the Pandemic COVID-19 and the outbreak of Crimean-Congo Hemorrhagic Fever in Iraq, 2023

Objective: This review examines the link between the COVID-19 pandemic and the outbreak of Crimean-Congo Hemorrhagic Fever (CCHF) in Iraq. Methods: We reviewed literature and data to explore potential associations between the two diseases. Results: No direct causative link between COVID-19 and increased CCHF cases in Iraq was found. However, changes in healthcare,agriculture, and human-animal interactions during the pandemic may have indirectly affected CCHF transmission. Conclusion: This review highlights the need for further research to confirm any connections between the COVID-19 pandemic and CCHFoutbreaks in Iraq. Understanding these links is crucial for effective public health responses to emerging infectious diseases.

Assessment of the integrated disease surveillance and response system implementation in health zones at risk for viral hemorrhagic fever outbreaks in North Kivu, Democratic Republic of the Congo, following a major Ebola outbreak, 2021

BackgroundThe Democratic Republic of the Congo (DRC) experienced its largest Ebola Virus Disease Outbreak in 2018–2020. As a result of the outbreak, significant funding and international support were provided to Eastern DRC to improve disease surveillance. The Integrated Disease Surveillance and Response (IDSR) strategy has been used in the DRC as a framework to strengthen public health surveillance, and full implementation could be critical as the DRC continues to face threats of various epidemic-prone diseases. In 2021, the DRC initiated an IDSR assessment in North Kivu province to assess the capabilities of the public health system to detect and respond to new public health threats.MethodsThe study utilized a mixed-methods design consisting of quantitative and qualitative methods. Quantitative assessment of the performance in IDSR core functions was conducted at multiple levels of the tiered health system through a standardized questionnaire and analysis of health data. Qualitative data were also collected through observations, focus groups and open-ended questions. Data were collected at the North Kivu provincial public health office, five health zones, 66 healthcare facilities, and from community health workers in 15 health areas.ResultsThirty-six percent of health facilities had no case definition documents and 53% had no blank case reporting forms, limiting identification and reporting. Data completeness and timeliness among health facilities were 53% and 75% overall but varied widely by health zone. While these indicators seemingly improved at the health zone level at 100% and 97% respectively, the health facility data feeding into the reporting structure were inconsistent. The use of electronic Integrated Disease Surveillance and Response is not widely implemented. Rapid response teams were generally available, but functionality was low with lack of guidance documents and long response times.ConclusionSupport is needed at the lower levels of the public health system and to address specific zones with low performance. Limitations in materials, resources for communication and transportation, and workforce training continue to be challenges. This assessment highlights the need to move from outbreak-focused support and funding to building systems that can improve the long-term functionality of the routine disease surveillance system.

Crimean-Congo haemorrhagic fever outbreak in Northern Senegal in 2022: Prevalence of the virus in livestock and ticks, associated risk factors and epidemiological implications.

Crimean-Congo haemorrhagic fever (CCHF) is a severe zoonotic arboviral disease that occurs widely in Eastern and Western Europe, Asia and Africa. The disease is becoming of growing public health importance in Senegal. However, analysis of tick infestation, CCHF virus (CCHFV) circulation extent and risk factors during ongoing outbreak are scarce. A thorough outbreak investigation was carried out during a CCHF outbreak in Podor (Northern Senegal) in August 2022. Ticks and blood samples were collected from animals (cattle, goats and sheep) randomly selected from confirmed CCHF human cases houses, neighbourhoods and surrounding villages. Blood samples were tested for CCHFV antibodies using a commercial enzyme-linked immunosorbent assay (ELISA) test. Tick samples were screened for CCHFV RNA by RT-PCR. Overall, tick infestation rate (TIR) and CCHFV seroprevalence of livestock were 52.12% (95% confidence interval (CI): 45.54%-58.64%) and 43.28% (95% CI: 36.33%-50.44%), respectively. The TIRs were 87.7% in cattle, 57.6% in sheep and 20.0% in goats. These rates were significantly associated with location, host species and tick control (p < 0.001) but not with animal age and sex (p > 0.7). CCHFV seroprevalence was 80.4% (95% CI: 67.57%-89.77%) in cattle, 35.4% (95% CI: 25.00%-47.01%) in sheep and 21.2% (95% CI: 12.11%-33.02%) in goats. Age, sex, location, animal host and presence of ticks were significantly associated to the presence of antibodies. The 950 ticks collected included among other species, Hyalomma impeltatum (48.84%) and H. rufipes (10.21%). Five pools of Hyalomma ssp. were found CCHFV RT-PCR positive. These infected ticks included 0.86% (4/464) of H. impeltatum collected on cattle and sheep and 1.03% (1/97) of H. rufipes collected on a sheep. To our knowledge, this is the first report on the extend of tick infestation and CCHFV infection in livestock during an outbreak in Senegal. The results highlight the risk of human infections and the importance of strengthening vector, animal and human surveillance as well as tick control measures in this area to prevent CCHF infections in humans.

Crimean-Congo Hemorrhagic Fever Virus Diversity and Reassortment, Pakistan, 2017-2020.

Sporadic cases and outbreaks of Crimean-Congo hemorrhagic fever (CCHF) have been documented across Pakistan since 1976; however, data regarding the diversity of CCHF virus (CCHFV) in Pakistan is sparse. We whole-genome sequenced 36 CCHFV samples collected from persons infected in Pakistan during 2017-2020. Most CCHF cases were from Rawalpindi (n = 10), followed by Peshawar (n = 7) and Islamabad (n = 4). Phylogenetic analysis revealed the Asia-1 genotype was dominant, but 4 reassorted strains were identified. Strains with reassorted medium gene segments clustered with Asia-2 (n = 2) and Africa-2 (n = 1) genotypes; small segment reassortments clustered with the Asia-2 genotype (n = 2). Reassorted viruses showed close identity with isolates from India, Iran, and Tajikistan, suggesting potential crossborder movement of CCHFV. Improved and continuous human, tick, and animal surveillance is needed to define the diversity of circulating CCHFV strains in Pakistan and prevent transmission.

Dengue Fever: A Harbinger of Hemorrhagic Fever Pandemics in a Changing World?

Dengue fever, a mosquito-borne viral illness, exhibits concerning parallels with hemorrhagic fever pandemics. This paper explores the rise of dengue in the context of climate change, urbanization, and evolving mosquito populations. We argue that these factors potentially position dengue as a stepping-stone towards more widespread hemorrhagic fever outbreaks. By analyzing limitations of current control methods, the paper proposes strategies for improved preparedness against not only dengue but also a potential hemorrhagic fever pandemic, highlighting the devastating economic and social consequences.

Seroprevalence of Bas-Congo virus in Mangala, Democratic Republic of the Congo: a population-based cross-sectional study

Bas-Congo virus (BASV), an emerging tibrovirus, was associated with an outbreak of acute haemorrhagic fever in Mangala, Democratic Republic of the Congo, in 2009. In 2012, neutralising antibodies to BASV were detected in the lone survivor and one of his close contacts. However, subsequent serological and molecular surveys were unsuccessful as neither BASV antibodies nor its RNA were detected. In this study, we determined the seroprevalence of BASV infection in Mangala 13 years after the initial outbreak. We conducted a population-based serological survey from Jan 17 to Jan 23, 2022. Consenting individuals at least 5 years of age, living in Mangala for at least 4 weeks, and who had no contraindication to venepuncture were enrolled. Participants were interviewed using a pre-tested questionnaire for sociodemographic and clinical characteristics. We supplemented the collected serum samples with 284 archived samples from Matadi and Kinshasa. All samples were tested for antibodies to BASV and other tibroviruses using a pseudovirus-based neutralisation test. Among the 267 individuals from Mangala, the prevalence of BASV antibodies was 55% (95% CI 49-61; n=147). BASV seropositivity odds significantly increased with age (5·2 [95% CI 2·1-12·9] to 83·9 [20·8-337·7] times higher in participants aged 20 years or older than participants aged 5-19 years). Some occupational categories (eg,farmer or public servant) were associated with seropositivity. Only nine (6%) of 160 samples from Matadi and one (<1%) of 124 samples from Kinshasa had neutralising antibodies to BASV. Moreover, we also detected neutralising antibodies to other tibroviruses-Ekpoma virus 1, Ekpoma virus 2, and Mundri virus-in 84 (31%), 251 (94%), and 219 (82%) of 267 Mangala samples; 14 (9%), 62 (39%), and 120 (75%) of 160 Matadi samples; and six (5%), five (4%), and 33 (27%) of 124 Kinshasa samples, respectively. Human infection with BASV and other tibroviruses seems common in Mangala, although no deadly outbreak has been reported since 2009. Exposure to BASV might be highly restricted to Mangala and the increasing prevalence of neutralising antibodies with age suggests regular contact with the virus in this city. Altogether, our findings suggest that human infection with tibroviruses could be common in the study areas and not associated with deadly haemorrhagic or debilitating syndromes. Japan Agency for Medical Research and Development (AMED) and Japan International Cooperation Agency (JICA) under the Science and Technology Research Partnership for Sustainable Development (SATREPS) and Japan Program for Infectious Diseases Research and Infrastructure from AMED.

Epidemic survey of Crimean-Congo hemorrhagic fever infections in the Iraqi population during 2022

The primary cause of the Crimean-Congo hemorrhagic fever (CCHF) is a virus spread by ticks. The rate of frequency of case mortality is 10–40%, which is spurred on by the CCHF virus, which also produces severe viral hemorrhagic fever outbreaks. The current study can be viewed as an epidemiological survey of CCHF infections in Iraq, with the goal of better understanding block virus transmission and preventing the risk of contracting the disease. Approximately 1370 blood samples from suspect patients were taken and separated; then, the serum was processed to remove viral RNA and tested for CCHF infection using specialized kits. Results revealed 382 (27.9%) positive cases, including 76 (19.9%) positive patients with dying compared to 306 (80.1%) who experienced cures. Findings showed a significant incidence of more than 50% of the positive cases having contact with animals and raw meat, 33% slaughtering, and 36% tick bites. Furthermore, 125 (32.7%) homemakers and 64 (16.8%) butchers had the most significant infection percentage. With 42.4% of all infections, Thiqar province had the most infected patients, followed by Misan with 9.7%, then Wasit and Babil. With 27.2% of all infections, May had the most CCHF-positive infections, followed by June and July. In conclusion, in response to the initial wave counterattack in southern Iraq, public health interventions on the veterinarian side should be implemented; these should eliminate, or at least decrease, the impact of a second wave. Illegal trading practices must be controlled if zoonotic diseases like CCHF are to stop spreading. Keywords: CCHF, Iraqi provinces, RT-PCR, tick bites, zoonotic disease.

The Outbreak of Crimean-Congo hemorrhagic fever (CCHF) in Al-Hsseiniya District /Karbala province in Iraq: A control strategy

The Outbreak of Crimean-Congo hemorrhagic fever (CCHF) in Al-Hsseiniya District /Karbala province in Iraq: A control strategy