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Crimean-Congo Haemorrhagic Fever

Introduction

Crimean-Congo Haemorrhagic fever (CCHF) is an infection spread by tick bites that can cause a severe viral illness accompanied by bleeding.

Recommendations for Travellers

CCHF is extremely rare in travellers.  

The risk is higher in travellers to areas where the infection occurs who are:

  • at increased risk of tick bites, for example whilst camping, hiking, visiting farms/animal sanctuaries
  • involved in the care or slaughter of animals
  • healthcare workers who may be exposed to infected patients.

Travellers with an increased risk of infection should be aware of the disease and prevent transmission by:

  • tick-bite avoidance
  • following  appropriate infection control procedures if working in a health care setting
  • wearing gloves and other protective clothing while handling animals or their tissues, notably during slaughtering, butchering and culling procedures.

There is no vaccine available for use in the UK.

Overview of the Disease

The virus causing CCHF infects many types of animals, although does not cause illness in the animals. Ticks feeding on infected animals can transmit the infection to humans when they bite, or when these ticks are crushed with bare hands. CCHF is also transmitted to humans through direct contact with the blood and tissue of infected animals such as livestock or infected people.

The majority of cases occur in people involved in the livestock industry, for example, farmers, agricultural workers, slaughterhouse workers and veterinarians. Healthcare workers are at risk when caring for infected patients if appropriate infection control measures are not followed.

The Illness

The period of time between being exposed to infection and showing first symptoms of infection varies between 1 to 13 days. However, most infections have minimal or no symptoms.

In those who develop symptoms there is a sudden onset of fever and flu-like symptoms.  A few days later spontaneous bleeding, internal and external, may occur.  In 5–30% with symptoms, the infection is fatal.

Treatment

There is no specific treatment for CCHF.  Symptomatic patients require intensive supportive care in isolation units.

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