C rimean-Congo hemorrhagic fever (CCHF) occurs in Europe, Africa, the Middle East, and Asia (1). The virus is transmitted to humans through tick bites or direct contact with blood, secretions, or infected tissue of a viremic animal or person. The incubation period in humans is usually ≈5-6 days and hemorrhaging often occurs on the fourth or fifth day after onset of illness; ≈30% of human case-patients die. In Mauritania, CCHF was first documented in 1983 (2). Although several cases have been reported since, its current distribution is not well known. We report 2 cases of CCHF in 2019 in southern Mauritania. The first patient, a 51-year-old man, a cattle breeder who resided in Tintane, Hodh Elgharbi, was admitted to Kiffa Regional Hospital, Assaba, Mauritania, on June 17, 2019, for hemorrhagic syndrome. The patient began having symptoms, including abdominal pain, bloody diarrhea, and vomiting, 5 days prior. At admission, the patient was in a coma (Glasgow coma scale 8) and had a fever (temperature 41°C), epistaxis, gingivorrhagia, diffuse ecchymosis (Figure 1), pallor, rapid respiratory rate (20 breaths/min), and hypotension (60/40 mm Hg). Laboratory examinations showed severe anemia (3.5 mmol/L); leucocytosis (1.3 × 10 9 cells/L); severe thrombocytopenia (20 × 10 9 /L); prolonged prothrombin time (61%); and elevated urea (35 mmol/L), creatinine (2,298 µmol/L
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