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The Crimean–Congo hemorrhagic fever (CCHF) virus is a tickborne pathogen that causes a severe febrile illness with hepatitis and coagulopathy. It has been known to be present in Africa, Asia, the Middle East, and southeastern Europe. In 2010, CCHF viral sequences were identified in ticks in Spain, and now two patients there with clinical disease have been identified.
The first patient presented in August 2016 with high fever, abdominal pain, and diarrhea 4 days after receiving a tick bite following a walk in fields in central-western Spain. The patient rapidly developed purpuric lesions, coagulopathy, as well as fulminant hepatic, respiratory, and renal failure. He died on the ninth day of illness.
The second patient was a nurse who had assis…