Review of the incidence of Crimean-Congo hemorrhagic fever for 18 years in 2005-2023 based on ProMED-RUS reports

Introduction: ProMED-mail Service in Russian (ProMED-RUS) informs readers about the most important events related to infectious diseases in the world with especial focus to countries of the former Soviet Union and other countries of the WHO European Region (WHO/EURO). There are several countries in WHO/EURO, which territories are endemic for Crimean-Congo hemorrhagic fever (CCHF). Objective: To estimate the incidence of CCHF in WHO/EURO region within 2005-2023 based on ProMED-RUS data. Methods and materials: We reviewed 345 ProMED-RUS CCHF reports published between 2005 and 2023. Comments from moderators were also taken into account. Results: According to ProMED-RUS, total of 2047 cases of CCHF were recorded during the observation period, including 60 deaths (CFR 2.8%) in the Southern and North Caucasus Federal Districts of Russia. During 2005-2023 cases of CCHF were registered in the Astrakhan, Volgograd, Stavropol, Rostov regions, the republics of Dagestan, Ingushetia, Kabardino-Balkaria, Kalmykia. The expansion of the epidemically active territory of the CCHF natural focus continues in Russia. Thus, in 2023, for the first time, 1 case of CCHF was registered in the Botlikh and Novolaksky districts of the Republic of Dagestan. In total, 26 cases of CCHF were identified in Russia in 2023 (25 endemic cases, 1 case was imported to Moscow from Georgia (lethal). The number of people infected with CCHF in RF in 2023 is 2.3 times less than in 2022 (59 cases), and 71.6% lower than the long-term average. In 2013-2022 this figure averaged 88.8 cases per year.There are 10-20 cases of CCHF registered in Kazakhstan annually, more than 297 in total. In 2023, 19 cases of CCHF were registered in the Republic of Kazakhstan: 6 cases in the each of Kyzylorda, Turkestan and Zhambyl regions, 1 case in the Aktobe region.Cases of CCHF were also recorded in Georgia (12 cases in 2023), Tajikistan (10 cases, 3 - fatal in 2007- 2009), Uzbekistan (7 cases in 2014-2022, 4 - fatal), Kyrgyzstan (imported from Kazakhstan in 2019). Case of CCHF was registered in Greece (2008). Since 2016 CCHF cases also started to record in Spain (8 cases, 3 - fatal). Annually CCHF cases (from 1 to 6) record in Bulgaria. In France (Corsica) in 2023 cases of CCHF were recorded in cattle (imported from Senegal). Discussion: The expansion of the epidemically active territory of the CCHF has been observed in recent years in the WHO/EURO, which probably connected with global warning, fitness of ticks and CCHV virus, intensification of people, and cattle migration. Conclusion: ProMED-RUS reports on CCHF in the countries of the former USSR and other countries of the WHO European Region contain relevant and useful information and allow to monitor the epidemiological situation of CCHF.