International surveillance and control of Crimean-Congo hemorrhagic fever outbreaks

Abstract

Crimean-Congo hemorrhagic fever virus (CCHFV) is a zoonotic virus transmitted by ticks that cause severe outbreaks in humans, but causes no disease in ruminants, its amplifying host [2, 5, 7, 14]. Although CCHFV is not pathogenic to animals, the disease is an important viral hemorrhagic fever (VHF) because of its high case fatality rate (CFR) (up to 50%), its potential for nosocomial transmission, and the difficulties in treatment and prevention. CCHF is endemic in all of Africa, Asia, the Balkans, and the Middle East, south of the 50°north latitude due to the geographical limitations of its primary tick vector, Hyalomma spp. ticks (Fig. 22-1). In these endemic areas, ecological changes, poverty, social instability, insufficient medical equipment, and absence of standard infection control practices have contributed to increased transmission of the virus. CCHF outbreaks have constituted a threat to public health services because of this increased transmission in its natural environment, in the community, and in the hospital setting. In addition, CCHF is a VHF of special regional concern, and as such, should be considered for notification to the World Health Organization (WHO) under the revised International Health Regulations (IHR 2005) adopted in May 2005 [6].