Crimean–Congo hemorrhagic fever

Crimean–Congo hemorrhagic fever (CCHF) is a widespread tick-borne viral disease that is endemic in Africa, the Balkans, the Middle East and Asia. The virus is a member of the Bunyaviridae family of RNA viruses. It is a zoonotic disease carried by several domestic and wild animals. While clinical disease is rare in infected animals, it is severe in infected humans, with a mortality rate of 10-40%. Outbreaks of illness are usually attributable to Hyalomma tick bites or contact with infected animals or people.

Signs and symptoms

Typically, after a 1–3 day incubation period following a tick bite (5–6 days after exposure to infected blood or tissues), flu-like symptoms appear, which may resolve after one week. In up to 75% of cases, however, signs of hemorrhage appear within 3–5 days of the onset of illness in case of bad containment of the first symptoms: first mood instability, agitation, mental confusion and throat petechiae, then soon nosebleeds, and vomiting, and black stools. The liver becomes swollen and painful. Disseminated intravascular coagulation may occur as well as acute kidney failure and shock, and sometimes acute respiratory distress syndrome. Patients usually begin to show signs of recovery after 9–10 days from when the symptoms appear, however 30% of the cases result in death on the second week of the illness.