Understanding the Dynamics and Enhancing Preparedness for Crimean-Congo Haemorrhagic Fever Virus in Portugal: Application of the Stockholm Paradigm and DAMA Protocol

Emerging and re-emerging zoonotic viruses transmitted by arthropods such as ticks, biting midges, and mosquitoes pose increasing public health concerns in Europe. Among these, Crimean-Congo haemorrhagic fever virus (CCHFV) stands out due to its high case fatality and expanding geographic range. In Portugal, growing ecological and climatic shifts, along with human and animal migration, create favourable conditions for the virus emergence. This review provides an overview of CCHFV epidemiology in Portugal, exploring the relevance of applying the Stockholm paradigm and the DAMA (Document, Assess, Monitor, Act) protocol as proactive tools for preparedness and mitigation. By incorporating ecological and evolutionary principles, these frameworks enable the anticipation of disease emergence and inform on targeted surveillance and response strategies. The integration of interdisciplinary approaches and early warning systems is crucial for strengthening One Health preparedness and ensuring timely action against CCHFV and other emerging vector-borne diseases in response to changing environmental conditions.