Two Human Infections with Diverse Europe-1 Crimean-Congo Hemorrhagic Fever Virus Strains, North Macedonia, 2024

Dejan Jakimovski , Kostadin Poposki, Marija Dimzova, Marija Cvetanovska, Fadil Cana, Ivana Bogdan, Alejandro Cabezas-Cruz, Brigitta Zana, Zsófia Lanszki, Zsófia Tauber, Tamás Görföl, Krisztián Bányai, Ágota Ábrahám, Pavle Banović, and Gábor Kemenesi

In a concerning development, North Macedonia has reported two new cases of Crimean-Congo hemorrhagic fever (CCHF) in 2024, marking the reappearance of the disease in the country after more than five decades. The patients, both male residents of rural areas, contracted the virus following tick bites. Genetic analyses revealed that the viral strains belong to the Europe-1 lineage, with evidence suggesting possible reassortment events involving strains from Turkey and Kosovo. These findings indicate that North Macedonia may serve as a convergence zone for diverse CCHF virus strains, underscoring the need for heightened surveillance and public health preparedness in the region.

For a detailed account of the cases and the genetic analyses conducted, refer to the full study published in the CDC's Emerging Infectious Diseases journal.