Crimean Congo Hemorrhagic Fever
The first observed outbreak of Crimean Congo Hemorrhagic Fever (CCHF) was in the 1940s in the Crimean peninsula. The virus itself was later isolated in 1956 in the Republic of Congo. Later studies would show that isolated outbreaks all over Europe, the former USSR, and central Europe were all cases of CCHF.
CCHF is spread primarily by ticks of the genus Hyalomma. It can also be spread through contact with infected human and animal blood. At risk groups include health care workers and livestock industry workers. Most cases come from these two populations.
Clinical and Pathology
The incubation period for CCHF infection varies from three to seven days. The onset of symptoms is sudden. Initial symptoms include nausea, dizziness, fever, chills, headache, myalgia and malaise. Clinical signs include an enlarged liver. After three to six days, the onset of hemorrhage is observed with the presence of petechiae, blood in the urine, and bleeding from the mucosal membranes. Edema hemorrhage, and necrosis of internal organs can cause serious complications. There is a thirty percent fatality rate.
Prevention and Management
The most important method of prevention is avoiding contact with ticks. Staying out of tick-infested areas is ideal, and the next best is treating clothing with tick repellants (especially DEET). Workers in slaughterhouses, veterinarian’s offices, and farmers should take these precautions to prevent disease. It is also important to avoid direct contact with infected blood and tissue. Caregivers should practice barrier nursing, and ticks should not be crushed using bare hands. Care of patients involves supportive treatment and blood transfusions. Vaccines have been developed but not tested. Immune plasma has been used to treat CCHF patients, but its effects have not been studied with controls. Ribavirin has had good results in treatment, but, like the vaccine and immune plasma therapy, its efficacy has not been scientifically studied.
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