Crimean-Congo haemorrhagic fever

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.[1]Watts DM, Ksiasek TG, Linthicum KJ, et al. Crimean-Congo hemorrhagic fever. In: Monath TP, ed. The arboviruses: epidemiology and ecology. Boca Raton: CRC; 1988.[2]Hoogstraal H. The epidemiology of tick-borne Crimean-Congo hemorrhagic fever in Asia, Europe, and Africa. J Med Entomol. 1979;15:307-417. http://www.ncbi.nlm.nih.gov/pubmed/113533?tool=bestpractice.com 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%.[1]Watts DM, Ksiasek TG, Linthicum KJ, et al. Crimean-Congo hemorrhagic fever. In: Monath TP, ed. The arboviruses: epidemiology and ecology. Boca Raton: CRC; 1988.[3]Ergonul O. Crimean-Congo haemorrhagic fever. Lancet Infect Dis. 2006;6:203-14. http://www.ncbi.nlm.nih.gov/pubmed/16554245?tool=bestpractice.com [4]Sahak MN, Arifi F, Saeedzai SA. Descriptive epidemiology of Crimean-Congo hemorrhagic fever (CCHF) in Afghanistan: reported cases to National Surveillance System, 2016-2018. Int J Infect Dis. 2019 Nov;88:135-40. https://www.doi.org/10.1016/j.ijid.2019.08.016 http://www.ncbi.nlm.nih.gov/pubmed/31442628?tool=bestpractice.com 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.[3]Ergonul O. Crimean-Congo haemorrhagic fever. Lancet Infect Dis. 2006;6:203-14. http://www.ncbi.nlm.nih.gov/pubmed/16554245?tool=bestpractice.com 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).[1]Watts DM, Ksiasek TG, Linthicum KJ, et al. Crimean-Congo hemorrhagic fever. In: Monath TP, ed. The arboviruses: epidemiology and ecology. Boca Raton: CRC; 1988.[2]Hoogstraal H. The epidemiology of tick-borne Crimean-Congo hemorrhagic fever in Asia, Europe, and Africa. J Med Entomol. 1979;15:307-417. http://www.ncbi.nlm.nih.gov/pubmed/113533?tool=bestpractice.com [3]Ergonul O. Crimean-Congo haemorrhagic fever. Lancet Infect Dis. 2006;6:203-14. http://www.ncbi.nlm.nih.gov/pubmed/16554245?tool=bestpractice.com

BMJ talk medicine podcast: Crimean-Congo haemorrhagic fever Opens in new window