Crimean-Congo Hemorrhagic Fever

M Yadollahie


Crimean-Congo hemorrhagic fever (CCHF) is a hemorrhagic fever caused by a tick-borne virus. The disease was first described as hemorrhagic diseases in 1944 in the Crimea and later in 1969 in the Congo, hence the current name of the disease.

CCHF is endemic in many countries in Africa, Europe and Asia, and during 2001, cases or outbreaks have been recorded in Kosovo, Albania, Iran, Pakistan, and South Africa. The geographical distribution of the virus—like that of its tick vector—is widespread. Evidence of CCHF virus has been found in Africa, Asia, the Middle East and Eastern Europe.

Q1: Where is CCHF found?

CCHF is found in eastern and southern Europe, the Mediterranean region, in northwestern China, central Asia, Africa, the Middle East, and the Indian subcontinent.


Q2: How do humans become infected with CCHF and how is the disease spread?

Humans become infected with CCHF from a tick bite or direct contact with blood or other infected tissues from livestock. It is mainly an occupational disease; agricultural workers, slaughterhouse workers, veterinarians and health care workers in endemic areas are people most at risk to contract the infection. Infection occurs through the skin, aerosol and by ingestion.


Q3: What are the symptoms of CCHF?

One to three days after infection the illness started with sudden onset of high-grade fever and nonspecific symptoms such as headache, aching muscles, dizziness, neck pain and stiffness, gastric pain and vomiting. Red eyes and throat, and flushed face are common. The patient may also develop bruise (ecchymosis), yellowish discoloration of the whites of the eyes (the sclera) and the skin (jaundice or icterus), mood swings and aggressive behavior. With progression of the illness, the patient developed bleeding from the injection sites, bloody feces (due to gastrointestinal bleeding), bloody urine, nosebleeds and also gum bleeding.


Q4: Are there complications after recovery?

In the second week of the illness in hospital the mortality rate is about 30%. Those patients who get well, do not generally develop any specific complications.


Q5: How is the disease prevented?

In endemic areas, the most important preventive action to be taken is to establish measures to avoid bites from infected ticks and control direct contact with infected blood or tissues. Use of insect repellents containing DEET, wearing gloves and other protective clothing by at risk people like agricultural workers and others working with animals, are recommended. Avoiding any direct contact with the blood and body fluids of livestock or patients with signs of infection is also recommended. Unpasteurized milk should not be drunk. In meat, CCHF virus is usually inactivated by post-slaughter acidification. The virus is destroyed by cooking.

Cite this article as: Yadollaie M. Crimean-Congo hemorrhagic fever. The International Journal of Occupational and Environmental Medicine 2012;3:153-4.

 pISSN: 2008-6520
 eISSN: 2008-6814

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