turkey's yozgat province, with one death. as of august 2008, a total of 50 deaths were reported for the year thus far in various cities in turkey due to cchf. in 2003, 38 people were infected with cchf in mauritania, including 35 residents of nouakchott. in september 2010, an outbreak was reported in pakistan's khyber pakhtunkhwa province. poor diagnosis and record keeping caused the extent of the outbreak to be uncertain, though some reports indicated over 100 cases, with a case-fatality rate above 10%. in january 2011, the first human cases of cchf in india was reported in sanand, gujarat, india, with 4 reported deaths, which included the index patient, treating physician and nurse. as of may 2012, 71 people were reported to have contracted the disease in iran, resulting in 8 fatalities. in october 2012, a british man died from the disease at the royal free hospital in london. he had earlier been admitted to gartnavel general hospital in glasgow, after returning on a flight from kabul in afghanistan. in july 2013, seven people died of cchf in the karyana village of babra, gujarat, india. in august 2013, a farmer from agago, uganda was treated at kalongo hospital for a confirmed cchf infection. the deaths of three other individuals in the northern region were suspected to have been caused by the virus. another unrelated cchf patient was admitted to mulago hospital on the same day. the ministry of health announced on the 19th that the outbreak was under control, but the second patient, a 27-year-old woman from nansana, died on the 21st. she is believed to have contracted the virus from her husband, who returned to kampala after being treated for cchf in juba, south sudan. in june 2014, cases were diagnosed in kazakhstan. ten people, including an ambulance crew, were admitted on to hospital in southern kazakhstan with suspected cchf. in july 2014 an 8th person was found to be infected with cchf at hayatabad medical complex (hmc), pakistan. the eight patients, including a nurse and 6 afghan nationals, died between april and july 2014. as of 2015, sporadic confirmed cases have been reported from bhuj, amreli, sanand, idar and vadnagar in gujarat, india. in november 2014, a doctor and a labourer in north gujarat tested positive for the disease. in the following weeks, three more people died from cchf. in march 2015, one more person died of cchf in gujarat. as of 2015, among livestock, cchf was recognized as "widespread" in india, only 4 years after the first human case had been diagnosed. in august 2016, the first local case of cchf in western europe occurred in western spain. a 62-year-old man, who had been bitten by a tick in spain died on august 25, having infected a nurse. the tick bite occurred in the province of ávila, 300 km away from the province of cáceres, where cchf viral rna from ticks was amplified in 2010. as of july 2017 it was unclear what specific ecology led to the spanish cases. in august 2016, a number of pakistani news sources raised concerns regarding the disease. between january and october 2016, cchf outbreaks in pakistan were reported with highest numbers of cases and deaths during august 2016, just before the festival of eid-al-adha (held on september 13–15 in 2016). it was hypothesized that the festival could play an important part as people could come into contact with domestic or imported animals potentially infected with cchf virus. the pakistani nih showed there was no correlation, and that cchf cases have coincided with the peak tick proliferation during the preceding 8–10 years. in 2017, the general directorate of public health in turkey published official records of infections and casualties involving cchf between 2008 and 2017. cases declined form 1,318 in 2009 to 343 in 2017 alongside a lowered mortality rate. cases are concentrated in rural areas of the southern black sea region, central anatolia region, and eastern anatolia region during early summer months. on february 2, 2020, an outbreak was reported in mali involving fourteen cases and seven deaths, days before the covid-19 pandemic in africa. in may 2020, a single case was reported in mauritania. in 2022, an outbreak occurred in iraq. between 1 january and 22 may, 212 cases of cchf were reported to the who. of the 212 cases, 115 were suspected and 97 laboratory confirmed. twenty seven deaths were recorded, of which 13 were in laboratory confirmed cases. history in ancient celtic settlements in the upper danube area in germany, the cchf virus was detected in archaeological blood samples, indicating that it was endemic at the time. the virus may have evolved around 1500–1100 bc. it is thought that changing climate and agricultural practices around this time could be behind its evolution. in the 12th century a case of a hemorrhagic disease reported from what is now tajikistan may have been the first known case of crimean–congo hemorrhagic fever. in 1944, roughly 200 soviet military agricultural workers were infected by crimean hemorrhagic fever (chf), leading to experiments showing a tick-borne viral etiology. in february 1967, virologists john p. woodall, david simpson, ghislaine courtois and others published initial reports on a virus they called the congo virus. in 1956, the congo virus had first been isolated by physician ghislaine courtois, head of the provincial medical laboratory, stanleyville, in the belgian congo. strain v3010, isolated by courtois, was sent to the rockefeller foundation virus laboratory (rfvl) in new york city and found to be identical to another strain from uganda, but to no other named virus at that time. in june 1967, soviet virologist mikhail chumakov registered an isolate from a fatal case that occurred in samarkand in the catalogue of arthropod-borne viruses. in 1969, the russian strain, which chumakov had sent to the rfvl, was published to be identical to the congo virus. in 1973, the international committee on taxonomy of viruses adopted crimean–congo hemorrhagic fever virus as the official name. these reports include records of the occurrence of the virus or antibodies to the virus from ebola greece, portugal, south africa, madagascar (the first isolation from there), the maghreb, dubai, saudi arabia, kuwait and iraq.