Crimean-Congo Haemorrhagic Fever case reported in Spain – Know all about it

New Delhi: Spain confirmed a case of Crimean-Congo haemorrhagic fever on July 21, 2022. A middle-aged man has been admitted to hospital in Spain’s Castile and Leon region after being diagnosed with Crimean-Congo haemorrhagic fever (CCHF), authorities said. 

According to a report by news agency Reuters, the man was initially admitted to a local hospital in Leon because he started showing symptoms of Crimean-Congo haemorrhagic fever after being bitten by a tick, and was later transferred to another hospital on a military plane. 

Local health authorities said in a statement that he has a tick bite and remains in a “stable condition”, despite the clinical severity that this pathology implies. 

What is Crimean-Congo haemorrhagic fever?

According to the World Health Organistaion (WHO), Crimean-Congo haemorrhagic fever (CCFH) is a viral haemorrhagic fever usually transmitted by ticks. It can also be contracted through contact with viraemic animal tissues (animal tissue where the virus has entered the bloodstream) during and immediately post-slaughter of animals. CCHF outbreaks constitute a threat to public health services as the virus can lead to epidemics, has a high case fatality ratio (10-40%), potentially results in hospital and health facility outbreaks, and is difficult to prevent and treat. 

How is Crimean-Congo Haemorrhagic Fever virus transmitted?

The virus is primarily transmitted to people from ticks and livestock animals. Human-to-human transmission can occur resulting from close contact with the blood, secretions, organs or other bodily fluids of infected persons. Agricultural workers, veterinarians, and slaughterhouse workers are susceptible to infection. 

What are the signs and symptoms of Crimean-Congo Haemorrhagic Fever?

CCHF symptoms can hit hard and fast. Some of the early symptoms of the disease include fever, muscle ache, dizziness, neck pain, backache, headache, sore eyes and photophobia (sensitivity to light). There may also be nausea, vomiting, diarrhoea, abdominal pain and sore throat, followed by sharp mood swings and confusion. After two to four days, the agitated mental symptoms may be replaced by sleepiness, depression and feeling of extreme tiredness. There is usually evidence of hepatitis, and severely ill patients may experience rapid kidney deterioration, sudden liver failure or pulmonary failure after the fifth day of illness.

History of Crimean-Congo Haemorrhagic Fever

The name ‘Crimean-Congo haemorrhagic fever’ comes from the deadly virus first being identified in Crimea in 1944, and given the name Crimean hemorrhagic fever. In 1969, it was recognised as the cause of illness in the Congo, resulting in the current name of the infection. CCHF is endemic in Africa, the Balkans, the Middle East and Asia, in countries south of the 50th parallel north.

What treatment is avaliable for Crimean-Congo Haemorrhagic Fever?

According to WHO, general supportive care with treatment of symptoms is the main approach to managing CCHF in people. The antiviral drug ribavirin has been used to treat CCHF infection with apparent benefit. Both oral and intravenous formulations seem to be effective.

Is there any vaccine available to treat Crimean-Congo Haemorrhagic Fever?

There is no vaccine available for either people or animals.

How to reduce the risk of infection in people?

WHO has listed a number of ways to reduce infection in people. 

Reducing the risk of tick-to-human transmission:

  • wear protective clothing (long sleeves, long trousers);
  • wear light coloured clothing to allow easy detection of ticks on the clothes;
  • use approved acaricides (chemicals intended to kill ticks) on clothing;
  • use approved repellent on the skin and clothing;
  • regularly examine clothing and skin for ticks; if found, remove them safely;
  • seek to eliminate or control tick infestations on animals or in stables and barns; and
  • avoid areas where ticks are abundant and seasons when they are most active.

Reducing the risk of animal-to-human transmission:

  • wear gloves and other protective clothing while handling animals or their tissues in endemic areas, notably during slaughtering, butchering and culling procedures in slaughterhouses or at home;
  • quarantine animals before they enter slaughterhouses or routinely treat animals with pesticides two weeks prior to slaughter.

Reducing the risk of human-to-human transmission in the community:

  • avoid close physical contact with CCHF-infected people;
  • wear gloves and protective equipment when taking care of ill people;
  • wash hands regularly after caring for or visiting ill people.