Crimean-Congo Haemorrhagic Fever CCHF

What is Crimean-Congo Haemorrhagic Fever?

Crimean-Congo Haemorrhagic Fever (CCHF) is one of several infectious haemorrhagic fevers and is caused by the Crimean-Congo haemorrhagic fever virus. This virus is transmitted to humans through the bite of infected ticks, particularly those of the Hyalomma genus, or through direct handling and preparation of fresh carcasses of infected animals, usually domestic livestock. It can also be acquired through nosocomial transmission (from treatment in a hospital).

The risk for travellers getting CCHF is very low, but this risk is increased for health-care workers and for anyone engaging in animal researchers.

How do you get Crimean-Congo Haemorrhagic Fever?

CCHF is transmitted to humans through the bite of infected ticks. It may be transmitted person to person through exposure to contaminated blood and patient secretions, primarily in hospital settings. Butchering of infected animals may also lead to human infection.

Susceptibility and Resistance

Everyone is susceptible to CCHF, but life-long immunity usually results after recovery from an infection.

Incubation Period

The incubation period for Crimean-Congo Haemorrhagic Fever is 3-12 days.

What are the Symptoms?

CCHF begins with the sudden appearance of fever, weakness, fatigue, irritability, headache and loss of appetite, along with severe pain in the arms and legs. There may be vomiting, diarrhoea and abdominal pain. A tiny haemorrhagic rash begins in the mouth, chest and abdomen and spreads to the rest of the body. Bleeding may occur from the gums, nose, lungs, intestines, uterus, and in the urine. Heavy bleeding occurs only in the most severe cases associated with liver damage. The fever continues for 5 to 12 days and recovery is prolonged. Between 2 to 50 percent of people with CCHF die depending on the severity of the illness.

Preventative Measures

Avoid tick bites by removing any ticks as soon as possible, paying close attention to the arm pits, in and around the ears, behind the knee, in the groin area, and underneath hair.  Inspect the skin after being in tick habitats, such as woods, forests, scrub brush, etc.  

Avoid handling and preparing fresh carcasses of infected domestic livestock.

Treatment

There is no specific treatment for CCHF. There is a vaccine used in Eastern Europe and Russia but it is not available in North America. The use of an anti-viral medicine called ribavirin, as well as the administration of antibodies from a recovering patient, may be useful.

Where Does It Commonly Occur?

CCHF occurs in Kazakhstan, Uzbekistan, southern Russia, Albania, Bosnia, Herzegovina, Bulgaria, Iraq, the Arabian Peninsula, northern India, Pakistan, western China and tropical and southern Africa.