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Crimean hemorrhagic fever
Last reviewed: 05.07.2025
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Crimean hemorrhagic fever (Crimean-Congo-Khazer hemorrhagic fever, Central Asian hemorrhagic fever, acute infectious capillary toxicosis, Crimean-Congo fever) is an acute viral natural focal infectious disease with a transmissible mechanism of pathogen transmission, characterized by fever, general intoxication, severe hemorrhagic syndrome and severe course. Crimean hemorrhagic fever is classified as a dangerous infectious disease.
ICD-10 code
A98.0. Crimean hemorrhagic fever (caused by Congo virus).
Epidemiology of Crimean hemorrhagic fever
The main natural reservoir of the Crimean hemorrhagic fever pathogen is ticks of the genus Hyalomma(H. pl. plumbeum, H. scupens, H. marginatus), Rhipicephalus (Rh. rossicus), Dermacentor (D. marginatus and D. reticulatus) and Boophilus (B. annulatus); as well as wild (hares, African hedgehogs) and domestic (sheep, goats, cows) animals. Humans become infected by transmission (through a tick bite), contact (when blood and bloody secretions of a patient with Crimean hemorrhagic fever come into contact with damaged skin and mucous membranes and when ticks are crushed) and airborne (in laboratory conditions). Susceptibility to Crimean hemorrhagic fever is high regardless of age, but men aged 20-50 (hunters, shepherds, veterinarians, livestock breeders, field workers) and also milkmaids, medical workers and persons involved in caring for patients: laboratory technicians working with blood: members of their families are more likely to get sick.
[ What causes Crimean hemorrhagic fever?
Crimean hemorrhagic fever is caused by an arbovirus of the Bunyaviridae family, genus Nairovirus: spherical or ellipsoidal shape, 90-105 nm in size; covered with a lipid-containing membrane with spikes. The virus genome contains 3 fragments (L-, M-, S-) of a single-stranded circular "minus" chain of RNA encoding transcriptase, nucleocapsid protein (N) and envelope glycoproteins (G1 and G2). The hemagglutinating ability of the causative agent of Crimean hemorrhagic fever is provided by one of the surface glycoproteins. The causative agent of CHF is able to reproduce in the cells of the brain and abdominal cavity of newborn white mice, in newborn white rats and in a culture of transplanted piglet kidney cells. After passage through a living organism, the virus increases virulence. The causative agent of Crimean hemorrhagic fever can be inactivated by disinfectant solutions, fat solvents (ether, paraformaldehyde, alcohol). At 45 C the virus dies within 2 hours, when boiled - instantly. It is well preserved in a frozen state.
Pathogenesis of Crimean hemorrhagic fever
Crimean hemorrhagic fever has not been studied sufficiently. After penetrating the human body, the virus multiplies in the vascular endothelium, epithelial cells of the liver, kidneys and in the reticuloendothelial system, causing vasculitis with predominant damage to the vessels of the microcirculatory bed. Then viremia develops, which corresponds to the initial period of the disease. According to PCR, viremia lasts 5-9 days. Its intensity correlates with the severity of the disease. As a result of the direct vasotropic effect of the virus, damage to the adrenal glands and hypothalamus, vascular permeability increases and disorders in the hemostasis system increase, which is clinically expressed by symptoms of hemorrhagic diathesis.
What are the symptoms of Crimean hemorrhagic fever?
Crimean hemorrhagic fever has an incubation period of 2-14 days (on average 3-5).
Crimean hemorrhagic fever without hemorrhagic syndrome can occur in mild and moderate forms; with hemorrhagic syndrome - in mild, moderate and severe forms. The course of the disease is cyclical and includes the following periods:
- initial period (prehemorrhagic);
- period of peak (hemorrhagic manifestations);
- period of convalescence and remote consequences (residual).
How is Crimean hemorrhagic fever diagnosed?
Clinical diagnosis of Crimean hemorrhagic fever is based on the symptoms of the disease:
- Crimean hemorrhagic fever has an acute onset with high temperature, hyperemia of the face and visible mucous membranes, spontaneous muscle and joint pain, intense headache, nausea, vomiting, bleeding gums, hemorrhagic enanthem on the mucous membranes, petechial rash with typical localization; hepatomegaly; bradycardia; hypotension; nasal, pulmonary, gastrointestinal, uterine bleeding: two-wave temperature curve.
- The presence of tick bite marks on the body.
- Epidemiological history (stay in a region endemic for Crimean hemorrhagic fever, contact with a patient with Crimean hemorrhagic fever).
- Seasonality.
What tests are needed?
How is Crimean hemorrhagic fever treated?
Crimean hemorrhagic fever is treated using specific, pathogenetic and symptomatic methods. Unreasonable prescription of medical manipulations that cause trauma to the skin and mucous membranes should be avoided. Treatment of Crimean hemorrhagic fever should be carried out under daily monitoring of the coagulogram and platelet count (2 times a day).
What is the prognosis for Crimean hemorrhagic fever?
Crimean hemorrhagic fever has a different prognosis, which depends on compliance with the principles of hospitalization, patient care, timely and comprehensive drug treatment, and prevention of complications. Late hospitalization and diagnosis, late treatment of Crimean hemorrhagic fever, incorrect or contraindicated transportation of patients during periods of severe bleeding can lead to death.