Doctors are closely watching about 200 people in Spain
after a patient at a hospital in Madrid
died of Crimean-Congo hemorrhagic fever, the first time the disease has been found in Western Europe
in someone who had not traveled to an endemic area.
The patient apparently caught the virus after being bitten by a tick, and then passed it to a nurse before he died. It has been known for five years that some ticks in Spain harbored the virus.
Crimean-Congo hemorrhagic fever is fatal in about 30 percent of cases, according to the World Health Organization. It is normally found in Africa
, the Middle East
, the Balkans and Central Asia south of Kazakhstan
. It killed 20 people in Pakistan this year.
It usually strikes herders, slaughterhouse workers and others in contact with tick-covered animals, but it can also be passed in human blood and bodily fluids.
Most of the people now under observation in Spain are health care workers who treated the 62-year-old man who died or the intensive care nurse who cared for him.
Although Crimean-Congo fever behaves somewhat like Ebola, it is not in the same viral family. It is a bunyavirus, related to Rift Valley fever and hantaviruses.
Testing patient samples is considered an “extreme biohazard risk,” according to the World Health Organization. There is no licensed vaccine for people or animals.
The man, who died Aug. 25, had said he was bitten by a tick while walking in the country outside the town of Ávila.
ProMED-mail, an infectious-disease alert service, noted that a West African strain of the fever was first isolated from ticks feeding on Spanish red deer in 2011. A ProMED moderator speculated that it had come north from Africa in tick nymphs carried by migratory birds.
The nurse was reported to be in stable condition. On Saturday, two more people in Spain were isolated on suspicion that they had the virus.