Crimean-Congo Fever (CCHF)

Acronyms Medical

Crimean -Congo fever is caused by viruses. The routes of infection are from animal to human or from human to human. The disease has numerous symptoms that affect the entire organism and range from harmless flu-like symptoms to serious complications. So far there is no vaccine against the disease, therapy with ribavirin is possible.

What is Crimean-Congo fever?

The Crimean-Congo fever virus belongs to the Bunyavirus family. The pathogens are present in grass-eating domestic and wild animals such as cows, rabbits, goats and sheep.

Crimean -Congo fever, or Crimean hemorrhagic fever, sometimes abbreviated by abbreviationfinder as CCHF (Crimean-Congo haemorrhagic fever), is a viral disease. It occurs mainly in south-eastern Europe (among others in Bulgaria, Hungary, Romania, Ukraine and Turkey), in the Middle East (in Syria, Iraq, Iran, Afghanistan) and in numerous countries in Africa and Asia.

The mortality rate is 2 to 50% and depends mainly on the virus strain. When death occurs due to Crimean-Congo fever, it occurs in the second week of illness. Death occurs as a result of multiple organ failure. The disease-causing virus was first isolated from human blood in 1956 in what is now the Republic of Congo.

At the same time, cases of the disease were documented on the Crimean peninsula in Ukraine. Because of this, the disease was given the name Crimean-Congo fever. When several people died from Crimean-Congo fever in the Black Sea region of Turkey in 2006, the disease was discussed again.


The Crimean-Congo fever virus belongs to the Bunyavirus family. The pathogens are present in grass-eating domestic and wild animals such as cows, rabbits, goats and sheep.

The disease is primarily transmitted by the Hyalomma tick. More than 30 tick species have already been identified as carriers. The Hyalomma ticks live in warm regions south of the Balkans. They are identified by their white and brown banded legs. The disease is transmitted from animals to humans not only through the bite of ticks, but also through direct contact with the flesh or blood of the infected animal.

The virus is transmitted among humans by smear infection (through infected bodily secretions such as urine, saliva, blood or stool), but droplet infection cannot be ruled out either.

Symptoms, Ailments & Signs

The Crimean-Congo fever initially runs without clear symptoms. After an incubation period of one day to two weeks, the first symptoms appear. Those affected initially feel ill and tired, typical are flu-like symptoms that rapidly increase in intensity.

In addition to fever and chills, there are muscle and body aches, headaches, upper abdominal pain and gastrointestinal complaints. Many patients suffer from nausea and vomiting, but also from diarrhea and vomiting blood. It can also cause irritability, mood swings, and depression.

Externally, the Crimean-Congo fever can be noticed by the characteristic reddening of the face. This occurs after three to five days and can spread to the conjunctiva and down the throat. Sometimes skin bleeding or swelling occurs. The most obvious sign is the puncture or bite site, which occurs when infected by animals and which swells and becomes inflamed as the disease progresses.

Symptoms increase in intensity over the first few days before slowly fading away after a week or two. Provided medical treatment is provided, the fever does not cause any serious complications. If there is no treatment, the disease can cause serious symptoms and ultimately lead to the death of the person affected.

Diagnosis & History

Symptoms of the disease appear suddenly after an incubation period of 1 to 13 days. The incubation period depends on the route of transmission. Infection from a tick bite causes symptoms a little quicker than human-to-human infection. The disease can have numerous signs.

In addition to general, flu-like symptoms, neurological, gastrointestinal and ophthalmological symptoms occur. The first symptom is fever, which lasts for 5 to 12 days. In addition to the fever, chills, irritability, enlarged lymph nodes, muscle and body aches, upper abdominal pain, headaches, depression, mood swings, nausea and vomiting can be observed.

Symptoms typical of the disease are facial edema, reddening of the face, throat and conjunctiva. Some of the patients suffer from complications in the form of a hemorrhagic course from the 3rd to 5th day. In the course of this, intestinal bleeding, blood vomiting and skin bleeding occur. The bleeding tendency increases in the affected patients. In a few cases, the Crimean-Congo fever is inapparent, i.e. without symptoms.

Since the disease is caused by viruses, diagnosis is made in laboratory facilities. The antibodies against the virus can be detected from the 6th day of the disease. Up to this point, the symptoms can become progressively worse, depending on the route of infection and the type of virus.


Crimean-Congo fever definitely needs to be examined and treated by a doctor. If left untreated, this condition can lead to the death of the affected person. They suffer from the usual symptoms and symptoms of influenza. There is a strong fever and further exhaustion. Not infrequently, the patients also suffer from chills and irritation.

Abdominal pain and headaches occur, which significantly reduce the patient’s quality of life. There may also be reddening of the face. It is not uncommon for skin bleeding or bloody vomiting to occur, which is often associated with panic attacks or sweating. The patient’s resilience is also reduced and those affected complain of mood swings or depression. Bleeding in the intestines is not uncommon.

As a rule, Crimean-Congo fever can be treated relatively well with the help of medication. There are no particular complications. With early treatment, most of the symptoms can be reduced, resulting in a positive course of the disease. At the same time, the life expectancy of the patient is not reduced.

When should you go to the doctor?

Since Crimean-Congo fever has a high mortality rate, a doctor’s visit should be made as soon as possible as soon as various health problems appear. They include fever, nausea and vomiting. A doctor should be consulted in the event of a headache, body aches or any other diffuse pain experience. Cramps, limitations of the musculoskeletal system or disturbances in concentration and attention must be examined and treated.

Those affected suffer from muscle complaints, various functional disorders and problems with digestion. If you vomit blood, you have a worrying condition. A doctor’s visit is required immediately. Signs such as chills, a general feeling of being unwell and discoloration of the facial skin are also noticeable. If the person concerned suffers from a drop in the usual level of performance, sleep disorders or abnormalities in the heart rhythm, a doctor should be consulted. Crimean-Congo fever occurs primarily in people who are in Asia, the Middle East, south-eastern Europe or Africa. Therefore, residents or visitors to these regions in particular should consult a doctor if they suffer from the irregularities described.

If existing symptoms increase in scope and intensity or if new symptoms develop, a doctor should be consulted. If individual functional systems of the organism fail, an ambulance is required. In the event of a circulatory collapse or loss of consciousness, there is an acute need for action. Since there is danger to life, those present must take first aid measures and call an ambulance.

Treatment & Therapy

The treatment is primarily aimed at securing the vital functions. During the risk of infection, the infected patients are cared for in an isolation ward. There is currently no vaccine against Crimean-Congo fever, but treatment is possible. This is done with ribavirin, a nucleoside analogue that can fight DNA and RNA viruses. The effectiveness of ribavirin has not yet been conclusively assessed.

Outlook & Forecast

As with many diseases that primarily occur in the Third World, the prognosis for Crimean-Congo fever depends heavily on the quality of medical care. The previously regional Crimean-Congo hemorrhagic fever (CCHF) is transmitted by ticks.

A rather mild course of the disease often leads to a good prognosis. In this case, patients have few symptoms. But the Crimean-Congo fever can also take a serious or even fatal course. So far, Germany has not been affected by the Crimean-Congo fever. However, other European countries such as Greece, Turkey, Albania, Bulgaria or Serbia have already reported a small number of people affected. Therefore, some deaths from this fever have already been reported in the European press.

If medical care ensures professional treatment of Crimean-Congo fever, the prognosis is quite good. The problem, however, is that Crimean-Congo fever is sometimes confused with other tick-borne diseases in areas with poor infrastructure. It is precarious if Crimean-Congo fever is confused with tick-borne encephalitis (TBE) or Lyme disease . With such a misdiagnosis, the infection is usually treated incorrectly or too late. This worsens the prognosis, especially if the Crimean-Congo fever is severe. So far there is no protective vaccine against Crimean-Congo hemorrhagic fever. However, protection against ticks is possible.


The first and most important preventive measure is protection against ticks. This is done by wearing closed, light-colored clothing and using deterrents. These protective measures must always be observed, especially when staying in countries where the occurrence of Hyalomma ticks has been proven. In any case, it is recommended to check the whole body for ticks and remove the ticks if necessary.


In most cases of Crimean-Congo fever, the aftercare measures are severely limited. First and foremost, the disease must be recognized by a doctor at an early stage so that further complications or further symptoms do not arise. An early diagnosis has a positive effect on the further course and can also prevent a further deterioration of the symptoms.

The affected person should therefore consult a doctor at the first signs and symptoms of Crimean-Congo fever. After an infection, contact with other people should be avoided in any case, so that infection does not occur. The disease itself is usually treated with medication.

It is always important to ensure that the dosage is correct and that it is taken regularly in order to permanently relieve the symptoms. If anything is unclear or if you have any questions, always consult a doctor first. The sufferer should definitely rest and take care of his body with this disease. Strenuous or stressful activities should be avoided. If Crimean-Congo fever is not treated in time or adequately, the life expectancy of those affected may be reduced.

You can do that yourself

If the Crimean-Congo fever is suspected, the person concerned should go to the nearest hospital immediately. Due to the risk of infection, infected patients must be treated in an isolation ward.

After the acute phase of the disease is over, similar measures apply as for other infectious diseases. The affected person needs bed rest in order to survive the after-effects of the disease. In addition, he should drink plenty of fluids and pay attention to a gentle diet. Water and tea as well as chicken broth and rusks have proven their worth. A suitable home remedy is a tea made from elderflower, yarrow and linden blossom, because these medicinal plants support the immune system and make the body sweat. In consultation with the doctor, calf wraps can be used. Also homeopathic remediessuch as belladonna or aconite help against the typical fever symptoms.

If the Crimean-Congo fever has not completely subsided after a week, the doctor must be informed. There may be a serious complication that the person affected cannot treat themselves. In the case of depressive moods, an extended conversation with friends or a walk in the fresh air can already help. If in doubt, a therapist should be consulted.