Crimean-Congo Hemorrhagic Fever Virus for Clinicians-Epidemiology, Clinical Manifestations, and Prevention

Abstract

Crimean-Congo hemorrhagic fever (CCHF) is a tickborne infection that can range from asymptomatic to fatal and has been described in >30 countries. Early identification and isolation of patients with suspected or confirmed CCHF and the use of appropriate prevention and control measures are essential for preventing human-to-human transmission. Here, we provide an overview of the epidemiology, clinical features, and prevention and control of CCHF. CCHF poses a continued public health threat given its wide geographic distribution, potential to spread to new regions, propensity for genetic variability, and potential for severe and fatal illness, in addition to the limited medical countermeasures for prophylaxis and treatment. A high index of suspicion, comprehensive travel and epidemiologic history, and clinical evaluation are essential for prompt diagnosis. Infection control measures can be effective in reducing the risk for transmission but require correct and consistent application.

Keywords: Crimean-Congo hemorrhagic fever; bunyavirus; countermeasure; treatment; vaccine; vector-borne infections; viral hemorrhagic fever; viruses.

Figure 1

Geographic distribution of CCHF and Hyalomma spp. ticks. CCHF, Crimean-Congo hemorrhagic fever.

Figure 2

Crimean-Congo hemorrhagic fever case definitions, modified from Ergonul et al. (1). ALT, alanine aminotransferase; AST, aspartate aminotransferase; CCHF, Crimean-Congo hemorrhagic fever; CCHFV, CCHF virus; LDH, lactate dehydrogenase.

Figure 3

Classic clinical disease course of Crimean-Congo hemorrhagic fever. ALT, alanine aminotransferase; AST, aspartate aminotransferase; DIC, disseminated intravascular coagulation; PLT, platelet count; PTSD, posttraumatic stress disorder; WBC, white blood cell count.