Crimean-Congo Hemorrhagic Fever Outbreak in Podor, Northern Senegal in 2022: Two Independent Emergences and Unprecedented Mortality.

Crimean-Congo hemorrhagic fever (CCHF) is a lethal zoonotic disease transmitted through tick bites and contact with infected animals or humans. As CCHF continues to expand worldwide, we report on the first severe outbreak in Senegal (Podor, Saint-Louis region) in 2022. We conducted a comprehensive outbreak investigation after a confirmed CCHF human case in Podor. This included sample collections from humans, animals, and ticks from the household and surrounding area. Human and animal samples were tested by ELISA for antibodies to CCHF virus and by reverse transcription polymerase chain reaction (RT-PCR) for CCHF virus RNA, whereas tick samples underwent CCHF RT-PCR only. Positive RT-PCR samples underwent viral genome sequencing for genetic characterization. We determined three CCHF human cases, with two deaths, as well as virus circulation in 11 ticks and in livestock, with an overall seroprevalence of 42.5%. CCHF IgG antibodies were detected in human contact cases, showing its prior prevalence in the area. Phylogenetic analyses revealed high genetic diversity within CCHF genotypes, with existence of reassortants and cocirculation of two different isolates from various origins in Mboyo and Nenette villages, where human cases were detected. The data showed a correlation between the strains identified in humans and ticks in each village, showing two independent emergences in Podor. The outbreak in Podor was probably because of the high abundance of animal hosts in this sylvopastoral area, the diversity of tick populations with the presence of the main CCHF vectors, and the increasing prevalence of CCHF virus. The surveillance in this area needs to be strengthened.