Crimean-Congo hemorrhagic fever

Crimean-Congo hemorrhagic fever is a tick-borne viral zoonosis with the potential of human-to-human transmission, affecting wide areas in Asia, Southeastern Europe, and Africa. Hemorrhagic manifestations constitute a prominent symptom of late stage disease with case fatality rates from 10% to 50%. The purpose of this article is to review recent literature on Crimean-Congo hemorrhagic fever with emphasis on its epidemiology and management.

Climate and environmental changes may affect Crimean-Congo hemorrhagic fever epidemiology and trigger community outbreaks. Risk factors for acquisition of infection have been well studied. In the hospital, high-risk activities include interventions for gastrointestinal bleeding and needle stick injuries. Reverse transcription-polymerase chain reaction may rapidly diagnose Crimean-Congo hemorrhagic fever with high sensitivity and specificity. Ribavirin is the only promising therapeutic agent currently available but case-control studies have not been conducted. Recently, the Mx proteins have been found to act against Crimean-Congo hemorrhagic fever virus and deserve further research.

Clinicians should be aware of the potential of importation of Crimean-Congo hemorrhagic fever cases from endemic areas and nosocomial transmission. Studies on the efficacy of ribavirin are needed.