IAMAT |International Association of Medical Assistance to Travellers| IAMAT |International Association of Medical Assistance to Travellers|

Crimean-Congo Hemorrhagic Fever

Photo By: Jackie Garces

Crimean-Congo Hemorrhagic Fever is an infection caused by Crimean-Congo Hemorrhagic Fever Virus (CCHFV), a Nairovirus belonging to the Bunyaviridae family. It is a zoonosis – an animal disease that can spread to humans – primarily affecting wild animals and domestic livestock. Humans become ill with CCHF when they are bitten by infected ticks or when coming into contact with infected animal blood or tissues.


The virus is typically found in Southern and Eastern Europe, Central Asia, Africa, Southeast Asia, and the Middle East. Travellers undertaking outdoor activities such as camping or hiking, especially during the peak transmission season from Spring to Fall, are at greater risk. Crimean-Congo Hemorrhagic Fever is an occupational disease among healthcare practitioners, agricultural workers, abattoir employees, and veterinarians.

Serological evidence suggests the presence of Nairovirus causing CCHF in Armenia, Azerbaijan, Bangladesh, Benin, Bosnia & Herzegovina, Botswana, Burkina Faso, Cameroon, Central African Republic, Republic of Congo, Cote d'Ivoire, Croatia, Egypt, Ethiopia, Gabon, Gambia, Georgia, Greece, Guinea, Guinea-Bissau, Hungary, India, Iraq, Kenya, Macedonia, Madagascar, Moldova, Namibia, Nigeria, Oman, Romania, Saudi Arabia, Senegal, South Sudan, Sudan, Syria, Tanzania, Turkmenistan, Uganda, Ukraine, and Zimbabwe.


Usually symptoms appear 1 to 9 days after the tick bite. If coming in direct contact with infected animal blood or tissues, symptoms usually appear after 5 or 6 days. Initial symptoms include a sudden high fever, aching muscles, abdominal, back and joint pain, headache, vomiting, diarrhea, dizziness, sore eyes and throat, and red spots on the palate (roof of the mouth). Other symptoms may include jaundice, mood swings, confusion, aggression, and sensitivity to light. The infection progresses to hemorrhaging (bruising, nosebleeds, blood in the urine and feces, and bleeding from the gums) which usually starts 2 to 4 days after the initial symptoms and lasts approximately two weeks. Crimean-Congo Hemorrhagic Fever may be fatal. Treatment includes supportive care of symptoms and eliminating secondary infections.


Travellers who hike, camp, or undertake outdoor activities in wooded regions of endemic areas should take measures to prevent tick bites.

There is no effective commercially available vaccine or preventive medication against Crimean-Congo Hemorrhagic Fever.

Crimean-Congo Hemorrhagic Fever Virus images, life cycle, and distribution maps:

Infection Landscapes


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Information last updated: October 08, 2020.

Crimean-Congo Hemorrhagic Fever cases were recently confirmed in:

Travel Health Journal