Silent public threat: Crimean-Congo hemorrhagic fever outbreak spikes during Eid-al-Adha in Afghanistan (Reported cases to National Surveillance System, 2015-2024).

Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral disease with a Case Fatality Ratio (CFR) of 10-40 %. It spreads from livestock to humans primarily through tick bites. It is crucial to monitor the peak months of this endemic disease in Afghanistan. Currently, the country is grappling with a potential national outbreak of CCHF, facing limitations in both diagnostic and preventive measures. Therefore, this study aims to describe CCHF prevalence during spike months (June-September) from 2015 to 2024, coinciding with Eid-al-Adha, and assess CCHF familiarity among inhabitants in eight regions of Afghanistan. We have analyzed the National Surveillance System data (2015-2024) on retrospective basis. A structured questionnaire was developed to assess CCHF knowledge among inhabitants of eight regions. Data analysis included percentages, frequencies, chi-square tests, using SPSS and power BI. The national surveillance system recorded 1796 CCHF confirmed cases with 238 deaths during spike months from 2015 to 2024. The highest number of Reported cases was in 2023 (734 cases, 78 deaths), followed by 2022 (221 cases). During Eid-al-Adha months from 2015 to 2024, there were 804 CCHF cases and 176 deaths, with the most in 2023 (313 cases, 78 deaths) and the fewest in 2015 (7 cases, 2 deaths). A survey of 1440 inhabitants (80 % male, 20 % female) across eight regions of Afghanistan showed knowledge of CCHF varied within regions. Correct responses were highest in the central region (394/815), followed by north (336/760). Incorrect responses were highest in central highlands (1039/1440), followed by west (450/881), indicating limited knowledge despite annual spikes in cases. The surge in CCHF outbreaks during Eid-al-Adha in Afghanistan underscores the challenge posed by limited knowledge of the disease. Uncontrolled animal movement and self-slaughter during Eid festival emphasize the urgent need for targeted public health strategies by relevant ministries.

Hamdard E ，Zahir A ，Karwand B ，Nazari ZU ，Shi F ... -  《-》

Defining the optimum strategy for identifying adults and children with coeliac disease: systematic review and economic modelling.

Elwenspoek MM ，Thom H ，Sheppard AL ，Keeney E ，O'Donnell R ，Jackson J ，Roadevin C ，Dawson S ，Lane D ，Stubbs J ，Everitt H ，Watson JC ，Hay AD ，Gillett P ，Robins G ，Jones HE ，Mallett S ，Whiting PF ... -  《-》

Knowledge, perception and attitude about Crimean-Congo Haemorrhagic Fever (CCHF) among veterinary students and professionals of Spain.

The Crimean-Congo haemorrhagic fever (CCHF) is a tropical viral zoonosis first reported in Spain with 17 detected cases since 2010-2024. Health professionals, including veterinarians, play a crucial role in controlling and preventing this disease. This study aimed to analyse and compare the knowledge, perceptions, and attitudes of veterinary students and professionals in Spain regarding CCHF and zoonoses in general. Additionally, the study highlighted the value of epidemiological surveys as a tool for identifying knowledge gaps related to specific diseases. A cross-sectional survey was conducted from January to April 2024 among 4th and 5th-year veterinary students, Masters and Doctorate students, and veterinarians from the public and private sectors using a validated online questionnaire. A total of 135 individuals participated, 80.7 % professionals and 19.3 % students. The study found that 76.9 % of students and 64.2 % of veterinarians had good or very good knowledge of CCHF, yet significant gaps remained, particularly in epidemiology and diagnosis. Notably, only 34.8 % had good or very good knowledge of the disease's situation in Spain, and many respondents felt their training and the information provided by official sources were inadequate. Additionally, the perception of infection risk from pets and attitudes towards preventing zoonoses through medication, vaccination, or regular analysis were concerning. Despite CCHF being an emerging disease in Spain, this survey-the first in Spain and Europe-reveals that veterinarians' knowledge and attitudes in affected regions are not as advanced as needed, underscoring the importance of targeted epidemiological surveys on the knowledge of the disease.

Bañuls P ，Galán-Relaño Á ，Romero-Salmoral A ，Gómez-Gascón L ，Tarradas C ，Astorga Márquez RJ ，Luque I ，Huerta B ... -  《-》

Crimean Congo hemorrhagic fever virus exposure among febrile patients, cattle herders, and cattle herds in Cameroon.

Crimean Congo hemorrhagic fever (CCHF) is a tick-borne disease with high fatality rates and an expansive geographic distribution, yet disease prevalence data in Cameroon is lacking. This study aimed to determine CCHF virus (CCHFV) seroprevalence and tick distribution among cattle herders and febrile patients in West and Centre Cameroon. Two cross-sectional serological studies of human and cattle were conducted from October to December 2021 and from June to July 2022, which included the collection of ticks. Enzyme-linked immunosorbent assay (ELISA) were used to detect anti-CCHFV antibodies, while a knowledge, attitudes, and practice (KAP) survey assessed tick and tickborne disease related knowledge and behaviors among herders. Tick identification used morphological keys. The KAP survey showed adequate tick knowledge (94.5 %) among herders but poor understanding of disease transmission, with favorable attitudes towards tick control (24.7 %) but inadequate implementation. Rhipicephalus annulatus (64.1 %) predominated among the 1,296 ticks collected during each rainy season. Among cattle, 27.4 % were seropositive, and seropositivity was associated with specific villages, cattle age (>4 years), and female sex. Herders had a 17.8 % seroprevalence, while febrile patients had 8.3 %, with higher rates in those >20 years old for both groups. Self-reported tick removal by herders after contact and grazing may increase CCHFV exposure. This study confirms CCHFV circulation in rural West Cameroon and unexpected exposure risk in Yaounde, highlighting the need for active entomological surveillance and preventive measures in transhumance and cattle market activities. Establishing an occupation-based surveillance system can help identify CCHFV hotspots to prevent outbreaks.

Simo FBN ，Teagho UCS ，Atako SM ，Lontsi BT ，Owona BVA ，Demanou M ，Wondji CS ，Kamgang B ，Burt FJ ，Ryan SJ ，Makoah NA ，Dinglasan RR ，Moundipa PF ... -  《-》

Tobacco Product Use and Associated Factors Among Middle and High School Students - National Youth Tobacco Survey, United States, 2021.

Gentzke AS ，Wang TW ，Cornelius M ，Park-Lee E ，Ren C ，Sawdey MD ，Cullen KA ，Loretan C ，Jamal A ，Homa DM ... -  《MMWR SURVEILLANCE SUMMARIES》