Msimang, VeerleWeyer, JacquelineLe Roux, ChantelKemp, AlanBurt, Felicity J.Tempia, StefanoGrobbelaar, Antoinette A.Moolla, NaazneenRostal, Melinda K.Bagge, WhitneyCordel, ClaudiaKaresh, William B.Paweska, Janusz TadeuszThompson, P.N. (Peter N.)2022-03-182022-03-182021-05Msimang, V., Weyer, J., Roux, C.L., Kemp, A., Burt, F.J., Tempia, S., et al. (2021) Risk factors associated with exposure to Crimean-Congo haemorrhagic fever virus in animal workers and cattle, and molecular detection in ticks, South Africa. PLoS Neglected Tropical Diseases 15(5): e0009384. https://doi.org/10.1371/journal.pntd.00093841935-2727 (print)1935-2735 (online)10.1371/journal.pntd.0009384http://hdl.handle.net/2263/84535SUPPLEMENTARY MATERIALS: S1 Data: Incidence. (XLSX)S2 Data: Multivardata. (XLSX)S1 Text: Questionnaire participant farmworker survey. (DOCX)S2 Text: Questionnaire private domestic farm survey. (DOC)Crimean-Congo haemorrhagic fever (CCHF) is a severe tick-borne viral zoonosis endemic to parts of Africa, Europe, the Middle East and Central Asia. Human cases are reported annually in South Africa, with a 25% case fatality rate since the first case was recognized in 1981. We investigated CCHF virus (CCHFV) seroprevalence and risk factors associated with infection in cattle and humans, and the presence of CCHFV in Hyalomma spp. ticks in central South Africa in 2017–18. CCHFV IgG seroprevalence was 74.2% (95%CI: 64.2– 82.1%) in 700 cattle and 3.9% (95%CI: 2.6–5.8%) in 541 farm and wildlife workers. No veterinary personnel (117) or abattoir workers (382) were seropositive. The prevalence of CCHFV RNA was significantly higher in Hyalomma truncatum (1.6%) than in H. rufipes (0.2%) (P = 0.002). Seroprevalence in cattle increased with age and was greater in animals on which ticks were found. Seroprevalence in cattle also showed significant geographic variation. Seroprevalence in humans increased with age and was greater in workers who handled livestock for injection and collection of samples. Our findings support previous evidence of widespread high CCHFV seroprevalence in cattle and show significant occupational exposure amongst farm and wildlife workers. Our seroprevalence estimate suggests that CCHFV infections are five times more frequent than the 215 confirmed CCHF cases diagnosed in South Africa in the last four decades (1981–2019). With many cases undiagnosed, the potential seriousness of CCHF in people, and the lack of an effective vaccine or treatment, there is a need to improve public health awareness, prevention and disease control.en© 2021 [Authors et al]. This is an open access article distributed under the terms of the Creative Commons Attribution License.Tick-borne virusEndemicAnimal welfareSouth Africa (SA)Crimean-Congo haemorrhagic fever (CCHF)Veterinary science articles SDG-03Veterinary science articles SDG-01SDG-03: Good health and well-beingSDG-01: No povertyArticle