1887
  1. Home
  2. Eurosurveillance
  3. Volume 30, Issue 50, 18/Dec/2025
  4. Article
Outbreaks Open Access
Like 0
Download

Abstract

In June 2025, two autochthonous Crimean-Congo haemorrhagic fever cases were recorded in Greece; a fatal index case and a healthcare worker secondarily infected. With only one autochthonous case previously reported in Greece, in 2008, this event was unexpected and triggered a One Health response: cases investigation, contact tracing, infection prevention and control guidance, field investigation, preventive measures targeting vectors and possible animal hosts, as well as awareness-raising measures. Although Greece is non-endemic for Crimean-Congo haemorrhagic fever, some neighbouring countries are endemic, and this event underscores the need for enhanced surveillance, vigilance and multisectoral collaboration.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2025.30.50.2500717
2025-12-18
2026-02-07
/content/10.2807/1560-7917.ES.2025.30.50.2500717
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/30/50/eurosurv-30-50-2.html?itemId=/content/10.2807/1560-7917.ES.2025.30.50.2500717&mimeType=html&fmt=ahah

References

  1. Ergönül O. Crimean-Congo haemorrhagic fever. Lancet Infect Dis. 2006;6(4):203-14.  https://doi.org/10.1016/S1473-3099(06)70435-2  PMID: 16554245 
  2. Monsalve-Arteaga L, Alonso-Sardón M, Muñoz Bellido JL, Vicente Santiago MB, Vieira Lista MC, López Abán J, et al. Seroprevalence of Crimean-Congo hemorrhagic fever in humans in the World Health Organization European region: A systematic review. PLoS Negl Trop Dis. 2020;14(3):e0008094.  https://doi.org/10.1371/journal.pntd.0008094  PMID: 32119682 
  3. Messina JP, Pigott DM, Golding N, Duda KA, Brownstein JS, Weiss DJ, et al. The global distribution of Crimean-Congo hemorrhagic fever. Trans R Soc Trop Med Hyg. 2015;109(8):503-13.  https://doi.org/10.1093/trstmh/trv050  PMID: 26142451 
  4. European Centre for Disease Prevention and Control (ECDC). Cases of Crimean–Congo haemorrhagic fever in the EU/EEA, 2013–present. Stockholm: ECDC; 2022. Available from: https://www.ecdc.europa.eu/en/crimeancongo-haemorrhagic-fever/surveillance/cases-eu-since-2013
  5. Papa A, Maltezou HC, Tsiodras S, Dalla VG, Papadimitriou T, Pierroutsakos I, et al. A case of Crimean-Congo haemorrhagic fever in Greece, June 2008. Euro Surveill. 2008;13(33):18952.  https://doi.org/10.2807/ese.13.33.18952-en  PMID: 18761893 
  6. Celikbas AK, Dokuzoğuz B, Baykam N, Gok SE, Eroğlu MN, Midilli K, et al. Crimean-Congo hemorrhagic fever among health care workers, Turkey. Emerg Infect Dis. 2014;20(3):477-9.  https://doi.org/10.3201/eid2003.131353  PMID: 24564994 
  7. Mardani M, Rahnavardi M, Rajaeinejad M, Naini KH, Chinikar S, Pourmalek F, et al. Crimean-Congo hemorrhagic fever among health care workers in Iran: a seroprevalence study in two endemic regions. Am J Trop Med Hyg. 2007;76(3):443-5.  https://doi.org/10.4269/ajtmh.2007.76.443  PMID: 17360865 
  8. Yadav PD, Patil DY, Shete AM, Kokate P, Goyal P, Jadhav S, et al. Nosocomial infection of CCHF among health care workers in Rajasthan, India. BMC Infect Dis. 2016;16(1):624.  https://doi.org/10.1186/s12879-016-1971-7  PMID: 27809807 
  9. Tsergouli K, Karampatakis T, Haidich AB, Metallidis S, Papa A. Nosocomial infections caused by Crimean-Congo haemorrhagic fever virus. J Hosp Infect. 2020;105(1):43-52.  https://doi.org/10.1016/j.jhin.2019.12.001  PMID: 31821852 
  10. European Commission. Commission Implementing Decision 2018/945 of 22 June 2018 on the communicable diseases and related special health issues to be covered by epidemiological surveillance as well as relevant case definitions. Official Journal of the European Union. 2018;L170/1. Available from: https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32018D0945&from=EN#page=13
  11. Rodriguez LL, Maupin GO, Ksiazek TG, Rollin PE, Khan AS, Schwarz TF, et al. Molecular investigation of a multisource outbreak of Crimean-Congo hemorrhagic fever in the United Arab Emirates. Am J Trop Med Hyg. 1997;57(5):512-8.  https://doi.org/10.4269/ajtmh.1997.57.512  PMID: 9392588 
  12. Kumar S, Stecher G, Suleski M, Sanderford M, Sharma S, Tamura K. MEGA12: Molecular evolutionary genetic analysis version 12 for adaptive and green computing. Mol Biol Evol. 2024;41(12):msae263.  https://doi.org/10.1093/molbev/msae263  PMID: 39708372 
  13. World Health Organization (WHO). Clinical management of patients with viral haemorrhagic fever: a pocket guide for front-line health workers. Geneva: WHO; 2016. Available from: https://www.who.int/publications/i/item/9789241549608
  14. Papa A, Markatou F, Maltezou HC, Papadopoulou E, Terzi E, Ventouri S, et al. Crimean-Congo haemorrhagic fever in a Greek worker returning from Bulgaria, June 2018. Euro Surveill. 2018;23(35):1800432.  https://doi.org/10.2807/1560-7917.ES.2018.23.35.1800432  PMID: 30180928 
  15. Maltezou HC, Papa A, Ventouri S, Tseki C, Pervanidou D, Pavli A, et al. A case of Crimean-Congo haemorrhagic fever imported in Greece: Contact tracing and management of exposed healthcare workers. J Infect Prev. 2019;20(4):171-8.  https://doi.org/10.1177/1757177419852666  PMID: 31428197 
  16. Vourvidis D, Tzouganatou G, Perdikaris S, Kofidou E, Martinez-Gonzalez B, Emmanouil M, et al. Ticks and tick-borne pathogens in wild animals and birds from two rehabilitation facilities in Greece. Pathogens. 2024;14(1):9.  https://doi.org/10.3390/pathogens14010009  PMID: 39860970 
  17. Schuster I, Chaintoutis SC, Dovas CI, Groschup MH, Mertens M. Detection of Crimean-Congo hemorrhagic fever virus-specific IgG antibodies in ruminants residing in central and western Macedonia, Greece. Ticks Tick Borne Dis. 2017;8(4):494-8.  https://doi.org/10.1016/j.ttbdis.2017.02.009  PMID: 28286143 
  18. Papa A, Kontana A, Tsioka K, Chaligiannis I, Sotiraki S. Molecular detection of Crimean-Congo hemorrhagic fever virus in ticks, Greece, 2012-2014. Parasitol Res. 2017;116(11):3057-63.  https://doi.org/10.1007/s00436-017-5616-6  PMID: 28920177 
  19. Papa A, Marklewitz M, Paraskevopoulou S, Garrison AR, Alkhovsky SV, Avšič-Županc T, et al. History and classification of Aigai virus (formerly Crimean-Congo haemorrhagic fever virus genotype VI). J Gen Virol. 2022;103(4):001734. PMID: 35412967 
  20. Hawman DW, Feldmann H. Crimean-Congo haemorrhagic fever virus. Nat Rev Microbiol. 2023;21(7):463-77.  https://doi.org/10.1038/s41579-023-00871-9  PMID: 36918725 
  21. World Health Organization (WHO). Infection prevention and control and water, sanitation and hygiene measures for Crimean-Congo haemorrhagic fever in health-care settings: operational guide. Geneva: WHO; 2024. Available from: https://www.who.int/publications/i/item/9789240093188
  22. Bartolini B, Gruber CE, Koopmans M, Avšič T, Bino S, Christova I, et al. Laboratory management of Crimean-Congo haemorrhagic fever virus infections: perspectives from two European networks. Euro Surveill. 2019;24(5):1800093.  https://doi.org/10.2807/1560-7917.ES.2019.24.5.1800093  PMID: 30722811 
  23. Güllü D, Yigci D, Baykam N, Çelikbaş AK, Yapar D, Akdoğan Ö, et al. Key predictors of mortality in Crimean-Congo haemorrhagic fever: a retrospective multicentre cohort study. Clin Microbiol Infect. 2025;S1198-743X(25)00403-3. PMID: 40849042 
  24. Papa A, Drosten C, Bino S, Papadimitriou E, Panning M, Velo E, et al. Viral load and Crimean-Congo hemorrhagic fever. Emerg Infect Dis. 2007;13(5):805-6.  https://doi.org/10.3201/eid1305.061588  PMID: 18044055 
  25. Fazlalipour M, Jalali T, Hewson R, Pouriayevali MH, Salehi-Vaziri M. Crimean-Congo haemorrhagic fever among healthcare workers in Iran 2000-2023, a report of National Reference Laboratory. BMC Infect Dis. 2024;24(1):1312.  https://doi.org/10.1186/s12879-024-10199-1  PMID: 39558265 
  26. Tsergouli K, Karampatakis T, Haidich AB, Metallidis S, Papa A. Nosocomial infections caused by Crimean-Congo haemorrhagic fever virus. J Hosp Infect. 2020;105(1):43-52.  https://doi.org/10.1016/j.jhin.2019.12.001  PMID: 31821852 
  27. Sahay RR, Shete AM, Yadav PD, Patil S, Majumdar T, Jain R, et al. Sequential determination of viral load, humoral responses and phylogenetic analysis in fatal and non-fatal cases of Crimean-Congo hemorrhagic fever patients from Gujarat, India, 2019. PLoS Negl Trop Dis. 2021;15(8):e0009718.  https://doi.org/10.1371/journal.pntd.0009718  PMID: 34460819 
Two autochthonous cases of Crimean-Congo haemorrhagic fever and the One Health response, Thessaly, Greece, 2025
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Danai+Pervanidou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pervanidou Danai</a>, <a href="/search?value1=Sara+Georgiadou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Georgiadou Sara</a>, <a href="/search?value1=Elisavet+Stavropoulou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Stavropoulou Elisavet</a>, <a href="/search?value1=Aggelos+Stefos&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Stefos Aggelos</a>, <a href="/search?value1=Katerina+Tsioka&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Tsioka Katerina</a>, <a href="/search?value1=Chrysovalantou+Niki+Kefaloudi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kefaloudi Chrysovalantou Niki</a>, <a href="/search?value1=Nikolaos+Gatselis&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Gatselis Nikolaos</a>, <a href="/search?value1=Konstantinos+Makaritsis&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Makaritsis Konstantinos</a>, <a href="/search?value1=Demosthenes+Makris&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Makris Demosthenes</a>, <a href="/search?value1=Parisi+Kyriaki&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kyriaki Parisi</a>, <a href="/search?value1=Sofia+Chatzianastasiou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Chatzianastasiou Sofia</a>, <a href="/search?value1=Antonios+Maragkos&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Maragkos Antonios</a>, <a href="/search?value1=Theano+Georgakopoulou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Georgakopoulou Theano</a>, <a href="/search?value1=Dimitra+Paraskeva&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Paraskeva Dimitra</a>, <a href="/search?value1=Dimitrios+Paraskevis&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Paraskevis Dimitrios</a>, <a href="/search?value1=Olga+Papachristou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Papachristou Olga</a>, <a href="/search?value1=Styliani+Papatheodorou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Papatheodorou Styliani</a>, <a href="/search?value1=Spyridoula+Damaskou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Damaskou Spyridoula</a>, <a href="/search?value1=Varvara+Kaouna&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kaouna Varvara</a>, <a href="/search?value1=Smaragda+Sotiraki&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sotiraki Smaragda</a>, <a href="/search?value1=Anastasios+Saratsis&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Saratsis Anastasios</a>, <a href="/search?value1=Aggeliki+Liakata&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Liakata Aggeliki</a>, <a href="/search?value1=Dimitrios+Papasteriou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Papasteriou Dimitrios</a>, <a href="/search?value1=Evangelos+Kartsoulis&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kartsoulis Evangelos</a>, <a href="/search?value1=Zacharoula+Bogogiannidou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bogogiannidou Zacharoula</a>, <a href="/search?value1=Stamatia+Kokkali&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kokkali Stamatia</a>, <a href="/search?value1=Ioanna+Voulgaridi&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Voulgaridi Ioanna</a>, <a href="/search?value1=Styliani+Sarrou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Sarrou Styliani</a>, <a href="/search?value1=Konstantina+Stoikou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Stoikou Konstantina</a>, <a href="/search?value1=Styliani+Pappa&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pappa Styliani</a>, <a href="/search?value1=Ourania+Tsakalidou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Tsakalidou Ourania</a>, <a href="/search?value1=Varvara+Mouchtouri&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Mouchtouri Varvara</a>, <a href="/search?value1=Katerina+Marinou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Marinou Katerina</a>, <a href="/search?value1=Ilektra+A+Fragkou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Fragkou Ilektra A</a>, <a href="/search?value1=Dimitrios+Hatzigeorgiou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hatzigeorgiou Dimitrios</a>, <a href="/search?value1=Anna+Papa&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Papa Anna</a>, <a href="/search?value1=George+N+Dalekos&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Dalekos George N</a>, <a href="/search?value1=Christos+Hadjichristodoulou&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hadjichristodoulou Christos</a></span>. Two autochthonous cases of Crimean-Congo haemorrhagic fever and the One Health response, Thessaly, Greece, 2025. <a href="/content/ecdc">Euro Surveill.</a> 2025;30(50):pii=2500717. <a href="https://doi.org/10.2807/1560-7917.ES.2025.30.50.2500717" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2025.30.50.2500717</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 16 Sept 2025;&nbsp;&nbsp; <span class="generated">Accepted</span>: 15 Oct 2025 </span> </p>
/content/10.2807/1560-7917.ES.2025.30.50.2500717
/content/10.2807/1560-7917.ES.2025.30.50.2500717
Loading

Data & Media loading...

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error