Trends in Crimean–Congo Hemorrhagic Fever in Iraq, 2023–2025: A Descriptive Ecological Study of National Surveillance Data and Public Health Response Activities

Vollständiger Abstract

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ABSTRACT Background Crimean–Congo hemorrhagic fever (CCHF) remains a significant zoonotic and public health threat in endemic regions, including Iraq, which has experienced repeated outbreaks over the past decade. Recent surveillance data suggest evolving transmission dynamics influenced by climatic variability, ecological conditions, and the intensity of public health interventions. Objective This study aimed to describe the epidemiological trends of laboratory‐confirmed CCHF cases in Iraq from 2023 to 2025, characterize the distribution of cases across time and provinces, and assess the potential influence of seasonal factors and combined risk communication and community engagement (RCCE) interventions. Methods A descriptive ecological study was conducted using aggregated laboratory‐confirmed Crimean–Congo hemorrhagic fever (CCHF) surveillance data collected by the Iraqi Ministry of Health and supplemented with reports from the World Health Organization (WHO) and collaborating public health partners. Temporal and geographic distributions of confirmed cases reported during 2023–2025 were summarized descriptively. Public health response activities, including risk communication and community engagement (RCCE), vector control, laboratory strengthening, and clinical preparedness, were reviewed to provide epidemiological context. No analytical methods were performed to evaluate intervention effectiveness or infer causal relationships. Results Although Iraq remains endemic for CCHF, a marked reduction in confirmed cases was observed in 2024 and 2025 compared with 2023. The decline was particularly evident during early transmission periods and coincided with delayed seasonal onset, increased rainfall, and the early implementation of coordinated multisectoral prevention campaigns initiated in 2024/2025. Enhanced collaboration between human and veterinary health sectors, expanded laboratory diagnostic capacity, and intensified public awareness campaigns were temporally associated with this reduction. Conclusion The observed decline in CCHF burden during 2024/2025 compared with 2023 coincided with intensified multisectoral interventions, particularly strengthened RCCE activities. These findings underscore the critical role of early, coordinated, and climate‐sensitive public health responses, as well as sustained RCCE strategies, in mitigating CCHF transmission in the absence of a licensed human vaccine. Continued cross‐sectoral collaboration among human, animal, and environmental health systems is essential to prevent future outbreaks in Iraq.