Published: 2019-11-27

Crimean-congo haemorrhagic fever: a global perspective

Nipin Kalal, Nimarta .


Crimean-Congo Haemorrhagic Fever (CCHF) is caused by infection with a tick-borne virus (Nairovirus) in the family Bunyaviridae, causing severe and often fatal haemorrhagic fever in humans. CCHF is pervasive, now found in Europe, Asia, Africa, the Middle East and the Indian subcontinent. CCHF spreads to humans either by tick bites or by contact with blood and tissues from infected animals or humans. CCHF outbreaks constitute a threat to public health services because of its epidemic potential, its high case fatality ratio (10-40%), and its potential for nosocomial outbreaks and its quandaries in treatment and prevention. It is characterized by sudden onset with initial sign symptoms including fever, chills, agitations, myalgia, headaches, vomiting, abdominal pain, arthralgia, ecchymosis, melena, haematuria, nose bleeding, vaginal bleeding, bradycardia, thrombocytopenia. It is diagnosed by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) assay, ELISA test, antigen detection tests. Overall supportive therapy is the mainstay of patient management in CCHF. Seriously ill patients require intensive care. Ribavirin for the treatment of CCHF cases it is most effective, if administered very soon after the onset of clinical signs (e.g., during the first 48 hours). Prevention should be taken which reduce risk of tick to human transmission and human to human transmission.


Clinical manifestations, Crimean-congo haemorrhagic fever, Crimean-congo haemorrhagic fever virus, Diagnosis, Epidemiology, Pathogenesis, Prevention, Treatment

Full Text:



CDC. Crimean-Congo Hemorrhagic Fever (CCHF), 2017. Available at: https://www. cdc. gov/ vhf/ crimean- congo/ index. Html. Accessed 15 September 2019.

WHO. Crimean-Congo haemorrhagic fever (CCHF), 2017. Available at: http://www. WHO. int/ csr/ disease/ crimean_ congoHF/en/. Accessed 15 September 2019.

WHO. Research and Development Blueprint for action to prevent epidemics, 2017. Available at: http://www? WHO. int/ blueprint/ en/. Accessed 15 September 2019.

WHO. Crimean-Congo haemorrhagic fever (CCHF), 2013. Available at: fever/en/. Accessed 15 September 2019.

Crimean-congo haemorrhagic fever, Available at standards/tahm/3.01.05CCHF.pdf. Accessed on 22 November 2019.

Al-Abri SS, Al Abaidani I, Fazlalipour M, Mostafavi E, Leblebicioglu H, Pshenichnaya N, et al. Current status of Crimean-Congo haemorrhagic fever in the World Health Organization Eastern Mediterranean Region: issues, challenges, and future directions. Inter J Infect Dis. 2017 May 1;58:82-9.

Mertens M, Schmidt K, Ozkul A, Groschup MH. The impact of Crimean-Congo hemorrhagic fever virus on public health. Antiviral Res. 2013 May 1;98(2):248-60.

Messina JP, Pigott DM, Golding N, Duda KA, Brownstein JS, Weiss DJ, et al. The global distribution of Crimean-Congo hemorrhagic fever. Transactions Royal Soc Tropical Med Hygiene. 2015 Jul 4;109(8):503-13.

Kizito S, Okello PE, Kwesiga B, Nyakarahuka L, Balinandi S, Mulei S, et al. Notes from the field: Crimean-Congo Hemorrhagic fever outbreak—central Uganda, august-september 2017. Morbidity Mortality Weekly Report. 2018 Jun 8;67(22):646-7.

Spickler AR. Crimean-Congo Hemorrhagic Fever, 2019. Available at: DiseaseInfo/factsheets.php. Accessed 15 September 2019.

10 Congo fever cases in Rajasthan, Gujarat in August. Available at: Accessed 22 September 2019.

Mazzola LT, Kelly-Cirino C. Diagnostic tests for Crimean-Congo haemorrhagic fever: a widespread tickborne disease. BMJ Global Health. 2019 Feb 1;4(Suppl 2):e001114.

Sharifi-Mood B, Metanat M, Alavi-Naini R. Prevalence of crimean-congo hemorrhagic Fever among high risk human groups. Inter J High Risk Behaviors Addiction. 2014 Mar;3(1):e11520.

Agravat VJ, Agarwal S, Piparva KG. Crimean-Congo haemorrhagic fever: an overview. Int. J. Res. Med. Sci. 2014 Apr;2(2):392-7.

WHO, 2018. Crimean-Congo haemorrhagic fever (CCHF). Available at: Accessed 15 September 2019.

Crimean-Congo Hemorrhagic Fever virus (CCHF). Directorate General of Health Services, Government of India. CD Alert. 2011 Jan;14(1).

Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, 2013. Available at: Accessed 17 September 2019.

Appannanavar SB, Mishra B. An update on Crimean Congo haemorrhagic fever. J Glob Infect Dis. 2011 Jul-Sep; 3(3):285-92.

Elaldı N, Kaya S. Crimean-Congo Hemorrhagic Fever. J Microbiol Infect Dis. 2014;1:S1-S9.

Mourya DT, Yadav PD, Shete AM, Gurav YK, Raut CG, Jadi RS, et al. Detection, isolation and confirmation of Crimean-Congo hemorrhagic fever virus in human, ticks and animals in Ahmadabad, India, 2010–2011. PLoS Neglected Tropical Dis. 2012 May 15;6(5):e1653.

Verma R, Khanna P, Prinja S, Rajput M. Crimean-Congo haemorrhagic fever: An outbreak in India. Australasian Medica J. 2011;4(11):589-91.

Crimean-Congo Hemorrhagic Fever (CCHF). Available at: Accessed 17 Sept 2019.