Crimean-Congo Hemorrhagic Fever

Crimean-Congo Hemorrhagic Fever-CCHF –Tick Borne Viral Disease

Crimean-Congo hemorrhagic fever – CCHF is a widespread tick borne viral disease. The pathogenic virus is common in East and West Africa in the family of Bunyaviridae of RNA viruses. The disease was first considered in the Crimea in 1944 and was given the name Crimean hemorrhagic fever and was thereafter recognized in 1969 as the outcome of illness in the Congo which resulted in the prevailing name of the disease. The disease is found in Eastern Europe especially in

the former Soviet Union, all over the Mediterranean, in north-western China, Southern Europe, Central Asia, Africa, the Indian subcontinent and the Middle East. The multitude of the CCHF virus comprise of a wide range of wild and domestic animals like the sheep, cattle and goats and several birds are resistant to infection though ostriches are vulnerable and could show a high occurrence of infection in endemic areas.

Animals tend to get affected by the bite of infected ticks and the virus remains in the bloodstream for around a weeks after the infection enabling the tick animal tick cycle to progress when another tick tends to bite. Though the numbers of tick species have the potential of becoming infected with CCHF virus, ticks of the Hyalomma species are the principal vector

Signs & Symptoms 

The onset of this condition is sudden with early signs and symptoms which include headache, high fever, joint pain, back ache, stomach pain with vomiting. A flushed face, red eyes, red throat, and red spots – petechiae, on the palate are common in this condition.

The symptoms could also include jaundice and in more severe cases it could change in mood as well as sensory perception. Large areas of severe nosebleeds, bruising with uncontrolled bleeding at injection sites can be seen as the illness develops which begins around the fourth day of the illness and lasts for around two weeks.

The virus of this disease is transmitted to human by tick bites or through contact with the infected animal blood or tissues during and immediately after they are slaughtered and most of the cases have taken place in people who are involved in the livestock industry like the agricultural workers, veterinarians and slaughterhouse employees.

Person to person transmission could take place resulting from close contact with the secretion, blood, organs or other body fluids of infected persons. Besides this, hospital acquired infection could also occur due to negligence of sterilization of medical equipment, contamination of medical supplies and reuse of needles.

Diagnosis & Treatment 

The CCHF virus infection can be diagnosed with the help of various laboratory tests namely

• Antigen detection
• Enzyme-linked immunosorbent assay – ELISA
• Serum neutralization
• Reverse transcriptase polymerase chain reaction – RT-PCR assay
• Virus isolation by cell culture

Those with fatal disease and patients in the initial stage of their illness do not tend to develop adequate antibody response and hence diagnosis in them is done by virus or RNA detection in their tissue or blood samples.

The tests on these patient samples portray an extreme bio hazard risk and must be done under maximum biological control conditions and if samples are inactive, they could be manipulated in a basic bio safety environment. The supportive care with treatment of symptom is the main approach in managing this condition in people as there is no specific recognized treatment for this condition.