Possible Drivers of Crimean-Congo Hemorrhagic Fever Virus Transmission in Kosova

Crimean-Congo hemorrhagic fever (CCHF) has long been a disease of concern in Kosova; however, little is known about the enzootic cycles of the virus in this country. Since the first documented case in 1954, sporadic cases and occasional outbreaks have been recorded with cases more consistently reported following the conflict in 1999. CCHF virus exists in enzootic cycles between wild animal species and ticks. The infection rates within ticks and hence the exposure to humans is determined by both the biology and seasonal dynamics of ticks, and the population dynamics and structure of the wild animals. These, in turn, are affected by complex interactions between climatic variables, changes in agricultural practices, land management, and wild animal density. If we are to understand the spatial and temporal occurrence of human disease, we must understand the ecology of the virus in nature. This article discusses the possible ecological, societal, political, and economic drivers that may impact the enzootic cycle of the virus and contribute to an increase in virus amplification and/or human exposure to infected ticks in Kosova.