Crimean-Congo hemorrhagic fever in Southeast of Iran Roya Alavi-Naini a, * , Ali Moghtaderi b , Hamid-Reza Koohpayeh a , Batool Sharifi-Mood a , Mohammad Naderi a , Malyhe Metanat a , Morteza Izadi a a Zahedan University of Medical Sciences, Boo-Ali Hospital, Zahedan, Iran b Zahedan University of Medical Sciences, Khatam-al-Anbia Hospital, Zahedan, Iran Accepted 23 July 2005 Available online 21 September 2005 KEYWORDS Crimean-Congo fever; Iran; Epidemiology Summary In June 1999, a cluster of patients with viral hemorrhagic fever were reported in central provinces of Iran. Similar cases were subsequently verified in other parts of Iran. During June 1999 to February 2004, a total of 255 patients were recorded in Southeast of Iran. The epidemiological features, clinical manifestations, treatment and outcome will be discussed. Q 2005 The British Infection Society. Published by Elsevier Ltd. All rights reserved. Introduction Crimean-Congo hemorrhagic fever is thought to be an old disease with reports from Southeastern Russia as early as the 12th century. The first well- documented outbreak of CCHF was reported in 1945 from the Western Crimea region of the former Soviet Union. 1 In June 1999, the Iran ministry of health was alerted about a cluster of viral hemorrhagic fever patients in Isfehan; similar cases were recognized in two other provinces (Golestan and Sistan-Balooche- stan) subsequently. Although CCHF patients are spread through out Iran, most are observed in those three major provinces which are endemic areas for CCHF. 2 From June 1999 to February 2004 a large series of patients were recorded from Sistan- Baloochestan, Southeast of Iran. The primary purpose of this study is to characterize the epidemiological features, clinical manifestations, treatment and outcome of the patients. Method Most of our source population which is about one million people, reside in the Zabol and Zahedan (the central city of the Sistan-Baloochestan province) cities, in the Southeast of Iran (Fig. 1). Zabol, the second largest city in the area, is located near the Western part of Afghanistan border and it lies at crossroads connecting Zahedan to Nimrooz Journal of Infection (2006) 52, 378–382 www.elsevierhealth.com/journals/jinf 0163-4453/$30.00 Q 2005 The British Infection Society. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.jinf.2005.07.015 * Corresponding author. Address: Department of Infectious Diseases, Boo-Ali Hospital, Zahedan University of Medical Sciences, Zahedan, Iran. Tel.: C98 541 3234551; fax: C98 541 3218848. E-mail address: ranaini@zdmu.ac.ir (R. Alavi-Naini).