Crimean-Congo Haemorrhagic Fever Overview

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Questions and Answers

What is the primary vector responsible for transmitting the CCHF virus?

Mites of the genus Sarcoptes

Hard ticks of the genus Hyalomma (correct)

Ixodid ticks of the genus Rhipicephalus

Soft ticks of the genus Ornithodoros

Which of the following regions is NOT endemic to Crimean-Congo haemorrhagic fever?

Africa

Middle East

Balkans

Australia (correct)

What is the case fatality rate range for outbreaks of CCHF?

10–40% (correct)

50–70%

80–90%

1–5%

How does the CCHF virus primarily spread to humans?

Tick bites and contact with infected blood Signup and view all the answers

What animal species are primarily involved as hosts for the CCHF virus?

Cattle, sheep, and goats Signup and view all the answers

Which measure is recommended to prevent hospital-acquired CCHF infections?

Proper sterilization of medical equipment Signup and view all the answers

What type of virus is the CCHF virus classified as?

Nairovirus Signup and view all the answers

When was CCHF first reported in Iraq?

1979 Signup and view all the answers

What is a common characteristic of the livestock workers at higher risk for CCHF?

Involvement in animal husbandry and slaughtering Signup and view all the answers

Which family of viruses does the CCHF virus belong to?

Bunyaviridae Signup and view all the answers

What was the reported case fatality rate (CFR) for Crimean-Congo Hemorrhagic Fever in 2021?

39% Signup and view all the answers

What percentage of the confirmed CCHF cases in Iraq from January to May 2022 were laboratory-confirmed?

46% Signup and view all the answers

Which age group accounted for the majority of confirmed CCHF cases in Iraq in 2022?

15-44 years Signup and view all the answers

What is the typical incubation period for CCHF following a tick bite?

1-3 days Signup and view all the answers

Which of the following symptoms can occur early in the progression of CCHF?

Nausea and vomiting Signup and view all the answers

What is a common outcome for severely ill patients suffering from CCHF?

Rapid kidney deterioration Signup and view all the answers

How many cases of Crimean-Congo Hemorrhagic Fever were reported in Iraq during the first five months of 2022?

212 cases Signup and view all the answers

What two factors are common among most confirmed CCHF cases in Iraq within this timeframe?

Gender and occupation Signup and view all the answers

After how many days of illness may patients experience sudden liver failure?

Fifth day Signup and view all the answers

What is the mortality rate associated with Crimean-Congo Hemorrhagic Fever?

30% Signup and view all the answers

When does improvement typically begin in patients recovering from CCHF?

Ninth or tenth day after onset Signup and view all the answers

Which skin manifestation is characteristic of CCHF that is not typically seen in other viral hemorrhagic fevers?

Large ecchymoses Signup and view all the answers

Which of the following methods is NOT used for the diagnosis of CCHF?

Blood culture Signup and view all the answers

What is the main approach to managing CCHF infection?

General supportive care with symptom management Signup and view all the answers

Which symptoms did the 37-year-old patient NOT present with?

Joint pain Signup and view all the answers

In which condition was the chest X-ray showing bilateral lower and mid zone haziness?

Pleural effusion Signup and view all the answers

What was the outcome of administering ribavirin to the patient?

Improvement of condition Signup and view all the answers

What is a significant challenge in preventing CCHF infection in animals and ticks?

Unnoticed tick-animal-tick cycle Signup and view all the answers

Which statement about the control of ticks in livestock is accurate?

Tick control is realistic only in well-managed facilities Signup and view all the answers

Which formulations of ribavirin have shown effectiveness in treating CCHF?

Both oral and intravenous formulations Signup and view all the answers

What is the major limitation in the availability of vaccines for CCHF among humans?

Currently, no safe and effective vaccine is widely available. Signup and view all the answers

Which of the following is NOT a recommended measure to reduce tick-to-human transmission of CCHF?

Avoid wearing protective clothing. Signup and view all the answers

Which practice should be followed to mitigate animal-to-human transmission of CCHF?

Quarantine animals before they enter the food chain. Signup and view all the answers

What precaution should be taken by healthcare workers caring for patients with suspected CCHF?

Implement standard infection control precautions. Signup and view all the answers

Which community measure is essential for controlling CCHF transmission?

Engaging communities to disseminate health practices. Signup and view all the answers

What is a recommended practice when caring for individuals infected with CCHF?

Wear gloves and protective equipment while caring for them. Signup and view all the answers

What is the most effective way to eliminate ticks from clothing?

Applying approved acaricides on clothing. Signup and view all the answers

When is it safest to handle animals in relation to CCHF prevention?

Wear protective clothing during handling practices. Signup and view all the answers

What is an important step for the community when addressing CCHF risks?

Providing accurate health information to the community. Signup and view all the answers

What supervision should be ensured when handling samples from suspected CCHF patients?

Only trained staff should handle biological samples. Signup and view all the answers

Study Notes

Haemorrhagic Fevers

Viral haemorrhagic fevers (VHFS) are diseases caused by viruses such as Arenaviridae, Bunyaviridae, Filoviridae, and Flaviviridae
Crimean-Congo haemorrhagic fever (CCHF) is a widespread disease caused by a tick-borne virus (Nairovirus) of the Bunyaviridae family

Crimean-Congo Haemorrhagic Fever (CCHF)

CCHF is endemic in Africa, the Balkans, the Middle East, and some Asian countries
The CCHF virus causes severe viral haemorrhagic fever outbreaks, with a case fatality rate of 10-40%
The hosts of the CCHF virus include wild and domestic animals such as cattle, sheep, and goats

Transmission

The CCHF virus is transmitted to people either by tick bites or through contact with infected animal blood or tissues, including during and immediately after slaughter
The majority of cases occur in people involved in livestock, agriculture, slaughterhouses, and veterinary work
Human-to-human transmission can occur through close contact with the blood, secretions, organs, or bodily fluids of infected people
Hospital-acquired infections can occur through improper sterilization of medical equipment, reuse of needles, and contamination of medical supplies

CCHF Virus Epidemiology

CCHF is endemic in regions south of the 50th parallel north
Iraq has reported cases since 1979
A significant number of cases, including 13 deaths (CFR 39%), were reported in 2021

CCHF Virus Ecology

The CCHF virus is maintained in nature transovarially and transstadially.
Ixodid (hard) ticks are a reservoir and vector. Hyalomma ticks are the primary vector.
Ticks feed on various wild and domestic animals, which act as amplification hosts for the virus.

Incubation Period

The incubation period varies based on transmission method
Tick bite: 1-3 days (max 9 days)
Contact with infected blood/tissues: 5-6 days (max 13 days)

Signs and Symptoms

Symptoms onset is sudden, with fever, myalgia, dizziness, and neck pain; headache, sore eyes, photophobia
Early signs also include nausea, vomiting, diarrhea, abdominal pain and sore throat
Agitation may be followed by sleepiness, depression and lassitude
Abdominal pain may be localized in the upper right quadrant, with detectable hepatomegaly
Other findings include tachycardia, lymphadenopathy, and a petechial rash on internal mucosal surfaces and skin (progressing to ecchymoses)
Possible evidence of hepatitis and rapid kidney deterioration, sudden liver failure, or pulmonary failure can occur after the 5th day of illness
The mortality rate is approximately 30%, with death occurring in the second week of illness
In recovered patients, improvement typically commences during days 9 or 10 post-onset

Diagnosis

CCHF infection is diagnosed via several laboratory tests including enzyme-linked immunosorbent assay (ELISA), antigen detection, serum neutralization, reverse transcriptase polymerase chain reaction (RT-PCR), and virus isolation via cell culture

Treatment

General supportive care with treatment of symptoms is the main approach
Ribavirin, antiviral drug, can be an effective treatment if given early

Prevention

Prevention efforts should focus on several aspects, including controlling the virus in animals and ticks
No vaccine is widely available
Public health efforts should focus on awareness of risk factors and measures to reduce exposure to the virus.
Controlling infection in health-care settings involves implementing standard infection control precautions; these include basic hand hygiene, use of personal protective equipment, safe injection practices and safe burial practices
Samples from suspected CCHF patients need to be handled by trained staff in equipped labs.

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Description

This quiz explores the key aspects of Crimean-Congo Haemorrhagic Fever (CCHF), a serious viral disease caused by the Nairovirus. The content covers its transmission, endemic regions, and the impact on humans and animals. Test your knowledge on this critical health topic and understand the significance of VHFs.