Crimean-Congo Hemorrhagic Fever (CCHF) is a severe viral illness characterized by sudden onset fever, intense weakness, muscle aches, headache, dizziness, and severe bleeding. This zoonotic disease, transmitted to humans by ticks or through contact with infected animal blood or tissues, poses a significant threat to public health in various regions of the world.
In late October 2023, confirmation of the first detection of the virus was reported in the South of France, more specifically in the Eastern Pyrenees. Though no human case was detected, the presence of the virus in mainland Europe is still a concern to health officials and will be closely monitored for further spread. Out of a collection of more than 2000 ticks that were studied, around 100 tested positive for the virus.
With that in mind, let’s examine CCHF a little closer, how it came to be and what kind of threat it poses today.
Origins and Transmission
First identified in the Crimean Peninsula in 1944 and subsequently in the Congo in 1956, Crimean-Congo Haemorrhagic Fever derives its name from these two regions. The virus responsible for CCHF belongs to the Nairovirus genus within the Bunyaviridae family. The primary hosts of the virus are wild and domestic animals such as cattle, goats, and sheep. The tick species Hyalomma marginatum has been identified as one of the key vectors responsible for transmitting the virus to humans.
Causes of Crimean-Congo Haemorrhagic Fever
The transmission of CCHF to humans can occur through the bite of an infected tick or through direct contact with blood or tissues of infected animals during the slaughtering process or from contact with blood during healthcare procedures. Additionally, nosocomial (hospital-based) infection can occur, particularly among healthcare workers treating CCHF patients without adequate protective measures.
Crimean-Congo Haemorrhagic Fever Symptoms
The incubation period for CCHF ranges from one to three days. Initial symptoms include sudden onset fever, headache, severe muscle pain, and dizziness. As the disease progresses, patients may experience mood disturbances, sensory perception alterations, and in severe cases, haemorrhagic manifestations such as petechiae, ecchymosis, and mucosal bleeding. Without prompt and appropriate medical intervention, CCHF can lead to multi-organ failure with up to 30% mortality.
Diagnosis and Treatment
Laboratory tests, including enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR), are used to confirm CCHF infection. Timely diagnosis is crucial, as it facilitates the prompt initiation of available care but unfortunately there is currently no specific antiviral treatment for CCHF. Management primarily involves supportive therapy to address symptoms, maintain fluid balance, and manage any secondary complications.
Prevention is paramount in controlling the spread of CCHF. Public health efforts should focus on increasing awareness among communities living in endemic regions about the risk factors associated with the disease and the importance of avoiding direct contact with infected animals or their blood. Additionally, implementing effective tick control measures, such as the use of acaricides and the promotion of personal protective measures, can help reduce the risk of exposure to the virus.
Crimean-Congo Haemorrhagic Fever remains a significant global health concern in areas where the virus is endemic. Ongoing research aimed at developing effective antiviral treatments and vaccines, coupled with robust surveillance and public health interventions, is crucial for preventing the spread of CCHF and reducing its impact on human health and well-being. Heightened awareness, early detection, and appropriate preventive measures are essential in mitigating the risks associated with this potentially fatal disease.