Silent killer strikes during Eid-Ul-Adha: Crimean-Congo hemorrhagic fever outbreak in Khyber Pakhtunkhwa, Pakistan,...

Crimean-Congo hemorrhagic fever virus (CCHFV) poses a significant public health threat, particularly in Khyber Pakhtunkhwa, Pakistan, where its prevalence and epidemiological distribution remain poorly documented. This study aimed to investigate the epidemiology, prevalence, and transmission dynamics of the 2023 CCHFV outbreak in Khyber Pakhtunkhwa during the Eid-ul-Adha season.

From April to July 2023, 109 suspected cases were enrolled. Laboratory confirmation was performed using real-time reverse transcription polymerase chain reaction (RT-PCR). Demographic, clinical, and epidemiological data were analyzed to identify high-risk groups and outbreak dynamics.

Out of the suspected cases, 15 (13.76 %) were confirmed CCHFV positive, with males comprising 80 % of cases (n = 12). The highest prevalence (33.33 %) was recorded in Peshawar district, and 53 % of cases had a history of animal exposure. A significant spike (5 cases) occurred in the 29th epidemiological week, following Eid-ul-Adha. Clinical symptoms included fever, body aches, confusion, and bleeding episodes. The case fatality rate (CFR) was 26.67 % (male-specific CFR: 33.33 %), while all female patients recovered.

These findings underscore the critical public health concern posed by CCHFV in Khyber Pakhtunkhwa. The heightened risk associated with Eid-ul-Adha, coupled with age and gender demographics, necessitates targeted awareness initiatives, preventive strategies, and strengthened surveillance during peak risk periods to mitigate transmission and prevent future outbreaks. However, it's important to acknowledge the study's limitations, such as the relatively small sample size, potential selection bias, and the absence of a control group.

Future research with larger sample sizes and more comprehensive data collection is essential to gain a deeper understanding of the epidemiology and transmission dynamics of CCHFV in this region.