Crimean-Congo Hemorrhagic Fever

Abstract

Crimean-Congo hemorrhagic fever (CCHF), a tick-borne viral hemorrhagic fever, is a zoonotic infection that caused by CCHF virus (CCHFV) of the family Bunyaviridae, genus Nairovirus. Transmission occurs mainly by Hyalomma m. marginatum tick exposure. Blood and bloody excretions of the patients are highly infectious and contact of skin and mucous membrane may lead to CCHF transmission. CCHF was described firstly in the Crimean peninsula in 1944, in former So viet Union and in Kelkit Valley in 2002 in Turkey. By the year 2013, it has been notified in more than 30 countries of Asia, the Middle East, Southeastern part of Europe and Africa. The disease is characterized by fever and thrombocytopenia, in severe cases, hemorrhage and shock. Although, the case fatality rate for the infection is generally ranged from 10 to 50%, it was reported as 5% for Turkey. Main targets of CCHFV are immune cells and endothelium. Both innate and adaptive immunity are important for fighting against CCHFV in the host. Headache, fever, fatigue and muscle, joint pain, con junctival injection, facial hyperemia, thrombocytopenia, elevated liver enzymes, hepatomegaly and splenomegaly are the main symptoms and findings for CCHF. Hemorrhagic manifestations including ecchymosis, melena, hematochezia, hematemesis, and epistaxis are commonly seen in severe cases. Supportive treatment is essential and nowadays neither a special drug, nor safe vaccine for humans is available for the treatment and prevention of CCHF. In case of penetrating injury with contaminated material, the oral ribavirin prophylaxis may be offered after the area being washed with soapy water and ethanol. J Microbiol Infect Dis 2014; Special Issue 1: S1-S9