Crimean–Congo hemorrhagic fever: Risk for emergence of new endemic foci in Europe?

During recent years, new foci of Crimean–Congo hemorrhagic fever (CCHF) have emerged in several Balkan countries, southwest Russia, and Turkey. Starting in 2002, Turkey experiences the largest ever recorded outbreak with more than 2500 cases. Potential reasons for the emergence or re-emergence of CCHF include climate changes which may have a significant impact on the reproduction rate of the vector Hyalomma ticks, as well as anthropogenic factors (e.g. changes in agricultural and hunting activities). Given the abundance of its vector, the numerous animals that can serve as hosts, and the favorable climate and ecologic parameters in other southern Europe Mediterranean countries, CCHF is an example of a vector-borne disease which may be knocking the door in this area. There are models which show probability of CCHF extending to other countries around the Mediterranean basin suggesting that the vector, veterinarian, and human surveillance should be enhanced.