Crimean-Congo Hemorrhagic Fever · What Is It, Causes, Spread, Signs, Symptoms, and More

CCHF can be transmitted via ticks or bodily fluids. Ticks from the Hyalomma genus are responsible for transmitting the CCHFV to humans and animals. Sheep, cattle, and goats are particularly susceptible to infected tick bites. Small mammals and birds may also be carriers. Handlers are at risk of contracting the virus from the blood and tissue of infected animals.  

In addition to animal-to-human transmission, human-to-human transmission of CCHF is also possible. Infected individuals can transmit the virus to others through bodily fluids, such as blood. CCHF has also been transmitted in hospitals due to poor sanitation and improper sterilization methods.   

The spread of the CCHFV can be prevented through a variety of practices. Farm workers in endemic areas can use DEET (i.e., N, N-diethyl-m-toluamide), an effective insect repellent, to prevent tick bites. They may also be encouraged to wear protective clothing, such as long sleeves, pants, and boots. Avoiding contact with bodily fluids of animals may also be recommended for those working on farms or slaughterhouses. Healthcare workers should also be cautioned to wear personal protective equipment, like gloves, masks, and eyewear, when working with infected tissue and blood products.  

To diagnose Crimean-Congo hemorrhagic fever, a physical examination should be performed by a healthcare professional. Additional testing measures may be warranted depending on the individual’s medical history and symptoms. Blood tests may be necessary to detect the virus's antigens or RNA, or antibodies targeting it. An ELISA (i.e., enzyme-linked immunosorbent assay) is a laboratory test that can detect antibodies against CCHFV or the viral antigen in an individual’s blood. An RT-PCR (i.e., reverse transcriptase polymerase chain reaction) may also be used to detect viral RNA. 

Baseline laboratory work typically includes complete blood count (CBC) and comprehensive metabolic panel (CMP). A CBC can determine whether lymphocytes (i.e., a type of immune cell) are elevated, indicating an ongoing infection. Meanwhile, a CMP can identify electrolyte abnormalities, kidney problems, or liver dysfunction. 

Currently, there is no definitive cure or vaccine against CCHF, and management relies on supportive care.  Supportive care may include fluid and electrolyte replacement, oxygenation or ventilatory support, and pain medication (e.g., acetaminophen), among others. Depending on their hemodynamic stability, individuals may also require blood pressure support or blood products, including erythrocytes (i.e., red blood cells), platelets (i.e., blood components involved in blood clotting), or fresh frozen plasma (i.e., the liquid portion of blood). Some studies have also shown that ribavirin, an antiviral drug, is effective in treating individuals with Crimean-Congo hemorrhagic fever. Therefore, the World Health Organization (WHO) recommends distributing ribavirin to anyone infected. The virus is often fatal, and recovery is typically slow in those who survive. 

When cases of CCHF are diagnosed, they should be reported to the international community, such as the World Health Organization, so that measures may be put into place to prevent further spread. The CCHFV is a Biosafety Level 4 pathogen, meaning healthcare workers must follow strict procedures. Healthcare workers must wear a positive pressure suit and pass through chemical showers when leaving infected areas. Airflow is also regulated and contained. Infected individuals should be located in isolation rooms with biocontainment procedures to prevent nosocomial (i.e., originating in a hospital) spread. For those at significant risks, such as healthcare workers, ribavirin may be administered prophylactically.  

Crimean-Congo hemorrhagic fever is a type of viral hemorrhagic fever transmitted via infected tick bites or contact with bodily fluids from infected animals or other individuals. Crimean-Congo hemorrhagic fever virus belongs to the Orthonairovirus genus, within the Nairoviridae family and Bunyaviridae order. It has been found in several countries worldwide, including Eastern Europe, the Mediterranean region, China, Africa, and India. 

During the first few days after infection, an individual may experience headache, high fever, nausea, abdominal pain, and joint pain, followed by nosebleeds, petechiae, and ecchymoses that can result in lethal bleeding. Diagnosis is achieved through testing viral particles or antibodies to the virus in the blood. Treatment primarily relies on supportive therapy, including fluid replacement, blood pressure support, and respiratory support. Some studies have also suggested that ribavirin may have a beneficial effect.