Introduction

In the world of zoonotic diseases—those transmitted from animals to humans—few are as dangerous and underreported as Crimean-Congo Hemorrhagic Fever (CCHF). This viral disease, caused by the Crimean-Congo Hemorrhagic Fever Virus (CCHFV), is endemic in many parts of Asia, Africa, the Middle East, and Eastern Europe, where livestock rearing is a central component of the economy and culture.



Veterinarians, farmers, butchers, and livestock handlers are at particular risk due to their close contact with potentially infected animals and ticks. This article aims to offer an in-depth look at the disease, modes of transmission, symptoms, risk groups, prevention, and control strategies—especially tailored for veterinarians and livestock professionals.

Understanding Crimean-Congo Hemorrhagic Fever

What is CCHF?

Crimean-Congo Hemorrhagic Fever (CCHF) is a severe viral hemorrhagic fever in humans, characterized by sudden onset of high fever, dizziness, muscle aches, and internal bleeding. The virus belongs to the Nairovirus genus in the Bunyaviridae family.

Origin and History

First identified in the Crimean Peninsula in 1944 and later linked to similar cases in the Congo in 1969, the disease was named "Crimean-Congo Hemorrhagic Fever." Over time, sporadic outbreaks have occurred, highlighting the need for urgent awareness and education.


2. Epidemiology and Geographic Distribution

Where is CCHF Found?

CCHF is endemic in more than 30 countries, primarily:

Africa: South Africa, Egypt, Sudan

Asia: Pakistan, Afghanistan, Iran, India, Iraq

Middle East: Turkey, Saudi Arabia, Oman

Europe: Russia, Bulgaria, Albania, Kosovo

 Animal Hosts

Livestock animals such as cows, goats, sheep, and buffalo serve as amplifying hosts. Although they don’t show symptoms, they play a critical role in maintaining the virus in nature.

 Transmission of CCHFV

Ticks: The Primary Vector

Ticks of the genus Hyalomma are the primary vectors of CCHFV. They carry the virus and transmit it through bites to animals and humans.

 Animal-to-Human Transmission

Humans may become infected through:

Handling blood or tissues of infected livestock

Assisting with animal births

Slaughtering or butchering animals without protective gear

 Human-to-Human Transmission

CCHFV can also spread through contact with blood, secretions, or body fluids of infected persons, especially in hospital settings.

Why Are Veterinarians at Risk?

 Direct Animal Contact

Veterinarians are constantly exposed to blood, bodily fluids, and secretions during diagnosis, treatment, and surgery—major risk factors for transmission.

Exposure to Ticks

Working in the field increases the risk of tick bites, particularly during tick season when infestations are high.

4.3 Needle Stick Injuries

Frequent use of syringes and needles, often under less-than-ideal conditions, exposes vets to accidental punctures and infection.

Clinical Signs and Symptoms in Humans

Early Symptoms (Days 1-3)

Sudden high fever

Severe headache

Fatigue

Dizziness

Muscle pain (especially in the legs and back)

Advanced Symptoms (Days 4-5)

Nausea and vomiting

Abdominal pain

Petechiae (small red spots under the skin)

Bleeding from gums, nose, or injection sites

Liver dysfunction

Kidney failure in severe cases

 Diagnosis and Testing

 Laboratory Testing

Because symptoms overlap with other diseases like dengue and malaria, accurate lab tests are essential:

RT-PCR: Detects viral RNA

ELISA: Identifies antibodies (IgM, IgG)

Virus Isolation: Conducted in high-containment labs

Sample Collection Safety

Medical and veterinary personnel should wear gloves, face shields, and gowns when collecting and handling samples.

Treatment and Management

 No Specific Antiviral Treatment

There is no approved antiviral treatment for CCHF, although Ribavirin has shown some benefit in early stages.

 Supportive Therapy

Intravenous fluids

Painkillers

Blood transfusions in case of hemorrhage

Monitoring of liver and kidney function

 Hospitalization and Isolation

Patients must be isolated to prevent nosocomial (hospital-acquired) transmission, and healthcare workers must follow strict barrier nursing protocols.

Prevention and Control

 Personal Protection for Veterinarians

Wear disposable gloves, face shields, and coveralls

Use disposable needles and syringes only once

Disinfect instruments thoroughly

Avoid tick-infested areas or use repellents (DEET)

 Animal Husbandry Practices

Regular tick control on livestock using acaricides

Avoid handling animals with open wounds

Quarantine newly purchased animals

Safe Slaughtering Practices

Wear gloves, aprons, and boots

Disinfect knives and surfaces with bleach

Dispose of animal waste properly

 Occupational Safety Measures

 Hospital Guidelines

Isolation rooms with negative air pressure

PPE kits for doctors and lab staff

Proper disposal of sharps and biological waste

 Field Veterinary Safety

Field kits with repellents, gloves, disposable overalls

Awareness sessions for rural veterinary staff

Mobile health monitoring for early symptom

The Role of Public Awareness

 Importance of Education

People working in agriculture, veterinary care, and slaughterhouses must be educated about the risks of CCHF.

Community Engagement

Posters and videos in local languages

Radio and TV programs during peak tick season

Distribution of tick repellents and PPE in rural areas

 Case Study: CCHF in Pakistan

In Pakistan, sporadic cases of CCHF surface every year, particularly around Eid-ul-Adha, when large numbers of animals are slaughtered. The virus is often transmitted from infected animals to butchers, slaughterhouse workers, and veterinarians.

A 2023 outbreak in Balochistan claimed several lives, highlighting the urgent need for better awareness and protective practices in both urban and rural settings.

Global and Local Surveillance Programs

 WHO Initiatives

The World Health Organization tracks CCHF outbreaks and provides technical support to endemic countries.

 Local Government Actions

Governments must implement:

Surveillance programs for early detection

Training sessions for rural health and veterinary workers

Distribution of PPE to at-risk occupations

 Myth-Busting CCHF

Myth: CCHF only affects animals.

Fact: Animals are carriers; humans can suffer fatal illness.

Myth: Boiling milk kills CCHF.

Fact: The virus is not transmitted through milk consumption.

Myth: Only doctors are at risk.

Fact: Veterinarians, farmers, and butchers are high-risk groups.

 Conclusion: Stay Safe, Stay Informed

CCHF is a deadly yet preventable disease. For veterinarians and livestock handlers, awareness and protective measures are the first line of defense. By following strict hygiene protocols, using disposable protective equipment, and staying alert for early symptoms, you can protect yourself and your community.

Let’s not wait for the next outbreak. Let’s act now—because prevention is not just better than cure, it’s often the only option we have.

Key Safety Tips for Veterinarians (Recap)

✅ Avoid tick bites by using repellents and wearing full-body clothing

✅ Use disposable gloves, syringes, and needles

✅ Disinfect all equipment and work areas

✅ Educate farmers and livestock owners

✅ Report and isolate suspected cases early

✅ Follow national health guidelines