Crimean Congo Hemorrhagic Fever Virus for Clinicians-Virology, Pathogenesis, and Pathology

Abstract

Crimean-Congo hemorrhagic fever (CCHF), caused by CCHF virus, is a tickborne disease that can cause a range of illness outcomes, from asymptomatic infection to fatal viral hemorrhagic fever; the disease has been described in >30 countries. We conducted a literature review to provide an overview of the virology, pathogenesis, and pathology of CCHF for clinicians. The virus life cycle and molecular interactions are complex and not fully described. Although pathogenesis and immunobiology are not yet fully understood, it is clear that multiple processes contribute to viral entry, replication, and pathological damage. Limited autopsy reports describe multiorgan involvement with extravasation and hemorrhages. Advanced understanding of CCHF virus pathogenesis and immunology will improve patient care and accelerate the development of medical countermeasures for CCHF.

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

Figure

Flowchart showing an abbreviated proposed pathway for Crimean-Congo hemorrhagic fever virus pathogenesis. CCHFV, Crimean-Congo hemorrhagic fever virus; DC, dendritic cell; DIC, disseminated intravascular coagulation; EC, endothelial cell; IL, interleukin; LN, lymph nodes; MCP, monocyte chemoattractant protein; MO, macrophage; MOF, multiorgan failure; SAT, saliva-assisted transmission; TNF, tumor necrosis factor; VE, vascular endothelium.