CCHF

Crimean-Congo hemorrhagic fever (CCHF) is an acute viral zoonosis caused by Crimean-Congo hemorrhagic fever virus (CCHFV), a member of the family Nairoviridae. The disease has a wide geographic distribution, including parts of Africa, the Balkans, the Middle East, and Asia. Humans are infected primarily through bites of infected Hyalomma ticks, contact with blood or tissues of acutely infected livestock during slaughter, or direct contact with blood or bodily fluids of infected persons.

Transmission and pathogenesis are linked to ticks as principal vectors and animal hosts that amplify the virus. Human-to-human transmission can occur in healthcare or caregiving settings through exposure to infectious blood or fluids, underscoring the importance of infection control measures.

Clinical presentation typically begins with an incubation period of about 5 to 6 days after tick exposure or contact with infected material. Early symptoms are nonspecific and include high fever, myalgia, malaise, headache, and nausea. Gastrointestinal symptoms may follow, and some patients develop hemorrhagic manifestations such as petechiae, ecchymoses, epistaxis, or more severe bleeding. The illness can progress to shock and multi-organ failure in severe cases. Reported case fatality rates vary and can be as low as a few percent or rise to around 30%, influenced by factors such as healthcare access and management.

Diagnosis is based on laboratory testing, including RT-PCR for viral RNA in the acute phase and serology for IgM/IgG antibodies; virus isolation is hazardous and usually restricted to specialized laboratories. There is no widely licensed human vaccine. Treatment is primarily supportive care; ribavirin has been used in some cases, though evidence of its effectiveness is variable. Prevention focuses on tick avoidance, protective clothing, safe handling of animals, and strict infection control in healthcare settings to prevent nosocomial transmission.