AN OUTBREAK OF CRIMEAN-CONGO HEMORRHAGIC-FEVER IN THE UNITED-ARAB-EMIRATES, 1994-1995

A multi-faceted investigation was conducted in the United Arab Emirate s to characterize the epidemiologic and ecologic factors underlying an outbreak of Crimean-Congo hemorrhagic fever (CCHF) noted in November 1994 among abattoir workers. A chart review was conducted among hospit alized suspected cases of viral hemorrhagic fever with onset between J anuary 1994 and March 1995 coupled with serologic testing of available specimens for the presence of virus antigen and IgG and IgM antibodie s by ELISA. Livestock handlers and animal skin processors were intervi ewed and tested for the presence of IgG antibody. Sera from imported a nd domestic ruminants were examined for antibody for CCHF virus, and t icks collected from these animals were tested with an antigen-capture ELISA. Thirty-five suspected cases of CCHF were identified (case fatal ity = 62%). Livestock market employees, abattoir workers, and animal s kin processors accounted for 16 (57%) of 28 cases with known occupatio nal status. Serologic evidence of past asymptomatic infection was note d in 12 (4%) of 291 livestock and abattoir workers but in none of the controls. Nineteen (7%) of 268 animals were positive for CCHF virus an tibodies by ELISA including 12 ruminants from Somalia and Iran and fiv e indigenous camels. One Hyalomma impeltatum and two H. excavatum from Somali cattle and one H. anatolicum from a Somali goat were positive for CCHF virus antigen.