Crimean-Congo haemorrhagic fever is a notifiable condition.
Appropriate personal protective equipment should be used and the patient isolated.
Transmission to humans is primarily through the bite of an infected tick. Most cases occur in adults exposed to ticks during the course of their work. Human-to-human transmission occurs via contact with body fluids from infected patients.
Presents as a sudden-onset, severe illness with initial influenza-like symptoms, red eyes, and petechiae leading to signs of haemorrhage around day 4.
Supportive therapy is the standard of care, although some people may benefit from treatment with ribavirin.
Crimean-Congo haemorrhagic fever (CCHF) is a fatal viral infection caused by the CCHF virus which has been reported in parts of Africa, Asia, Eastern Europe, and the Middle East. The virus belongs to the genus Orthonairovirus in the Nairoviridae family (formerly Bunyaviridae) and causes severe diseases in humans, with a reported mortality rate of 3% to 40%. The geographical range of CCHF virus is the largest among tickborne viruses affecting humans. After dengue viruses, it is the most widespread of medically important arboviruses. Humans are infected through tick bites, through contact with a person in the acute phase of CCHF infection, or from viraemic livestock (through blood or tissue contact).
History and exam
Key diagnostic factors
- presence of risk factors
- macular or petechial rash
Other diagnostic factors
- abdominal pain
- residency in or recent travel to CCHF-endemic region
- history of tick exposure
- contact with infected body fluids
- occupational exposure
- contact with infected animals
- unprotected sexual contact with an infected individual
1st investigations to order
- reverse transcription-polymerase chain reaction (RT-PCR)
- malaria investigations
Investigations to consider
- coagulation studies
- serum creatinine and urea
- serum electrolytes
- lactate dehydrogenase
- creatinine phosphokinase
suspected or confirmed infection
Onder Ergonul, MD, MPH
Infectious Diseases and Public Health
Koç University School of Medicine
lnfectious Diseases and Clinical Microbiology Department
Turkish Society of Clinical Microbiology and Infectious Diseases
OE is the author of references cited in this topic.
Vanessa Raabe, MD, MSc
Adult and Pediatric Infectious Disease Fellow
VR declares that she has no competing interests.
Tom Fletcher, MBChB, MRCP, DTM&H
Wellcome Trust/MoD Research Fellow
Liverpool School of Tropical Medicine
TF receives Crimean-Congo haemorrhagic fever research funding from the Wellcome Trust and UK Surgeon General. He is a member of the WHO secretariat for Crimean-Congo haemorrhagic fever guideline development.
Ayşe Erbay, MD, MPH
Professor of Infectious Diseases
Faculty of Medicine
AE declares that she has no competing interests.
- Malaria infection
- Ebola virus infection
- Lassa fever
- Crimean-Congo haemorrhagic fever: origins, reservoirs, transmission and guidelines
- CDC health information for international travel (Yellow Book): viral hemorrhagic fevers
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