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Communicable Diseases Agency

Crimean-Congo Haemorrhagic Fever

Crimean-Congo haemorrhagic fever (CCHF) is a widespread disease transmitted through tick bites, endemic in Africa, the Balkans, the Middle East and Asian countries south of the 50th parallel north.

Last updated on 2 November 2026

What is Crimean-Congo Haemorrhagic Fever (CCHF)?

Crimean-Congo haemorrhagic fever (CCHF) is a widespread disease transmitted through tick bites, endemic in Africa, the Balkans, the Middle East and Asian countries south of the 50th parallel north. CCHF can cause severe illness and death. CCHF was first detected in 1944 in Crimea, among soldiers and agricultural workers. It is estimated that around 10,000 and 15,000 human infections, including approximately 500 fatalities, occur globally per year.

How is CCHF transmitted?

Ticks which naturally carry the CCHF virus transmit the virus.  The virus can infect a wide range of wild and domestic animals, including cattle, sheep and goats, through the bites of infected ticks.

Humans can get infected through tick bites or close contact with tissues and body fluids of infected animals. This may occur during and immediately after slaughter of animals such as cattle, sheep and goats.

Human-to-human transmission can occur through direct contact with blood, body fluids, or secretions from an infected person. Healthcare acquired infections can also occur through contaminated needles, other medical supplies or equipment.

What are the symptoms of CCHF? 

Symptoms of CCHF usually begin suddenly and may include:

  • High fever

  • Headache

  • Muscle aches, backache

  • Fatigue

  • Neck pain and stiffness

  • Sore eyes, sensitivity to light

  • Red eyes, flushed face

  • Cough, sore throat

  • Nausea, vomiting,

  • Diarrhoea, abdominal pain

  • Confusion or agitation

In severe cases, symptoms may worsen within 3-5 days after the illness begins and may include:

  • Small red or purple spots on the skin or inside the mouth (caused by bleeding into the skin or mouth surface)

  • Unexplained bruising

  • Bleeding from the nose, gums or other parts of the body

  • Yellowing of the skin or eyes (jaundice)

  • Confusion or reduced alertness

  • Serious complications, such as kidney or liver failure

CCHF can be life-threatening in severe cases. Most people who recover do so within a few weeks, although some may continue to experience prolonged fatigue and weakness.

What are the risk factors?

Risk factors include:

  • Recent travel to a country or region with an ongoing CCHF outbreak or where CCHF is endemic.

  • Contact with a person with confirmed or suspected CCHF, including exposure to their blood or other body fluids.

  • Contact with infected animals or animal products, including during slaughtering, butchering, or culling procedures.

  • Contact with items or surfaces contaminated with blood or other body fluids from an infected person, such as used needles or medical equipment.

How is CCHF treated?

There is no specific licensed antiviral treatment for CCHF. Investigational drugs may be used in the setting of clinical trials. Management of CCHF focuses on supportive care, including maintaining adequate hydration, oxygen levels and blood pressure, with blood product support where clinically indicated.  

How to prevent CCHF?

There are currently no licensed vaccines to prevent CCHF.

To reduce risk of CCHF, travellers visiting areas where CCHF is present are advised to take the following precautions:

  • Prevent tick bites. Avoid areas with high grass, dense vegetation or known tick infestations. Wear long sleeves, long trousers, covered footwear and light-coloured clothing to spot ticks easily. Use an effective repellent containing DEET, Picaridin or IR3535 as directed, and check your body and clothing for ticks after outdoor activities.

  • Remove attached ticks promptly and safely. Use fine-tipped tweezers to grasp the tick as close to the skin as possible and pull it out gently and steadily. Clean the bite area and wash your hands afterwards.  Avoid crushing ticks with bare fingers.

  • Avoid exposure to potentially infected animals. Avoid direct contact with the blood, body fluids or tissues of livestock, particularly cattle, sheep and goats. Avoid participating in animal slaughtering or butchering activities. If handling animals or animal tissues is unavoidable, wear appropriate protective clothing and gloves.

  • Avoid contact with persons suspected or confirmed to have CCHF.  In particular, avoid direct contact with their blood, body fluids and items potentially contaminated with these fluids. Avoid unnecessary visits to healthcare facilities or areas where CCHF patients are being managed.

  • Practise good personal hygiene. Wash hands regularly with soap and water or use alcohol-based hand sanitiser containing at least 60% alcohol, particularly after potential exposure to animals, ticks or ill persons, or their blood, body fluids and items potentially contaminated with these fluids.

If you develop symptoms of CCHF after travelling to an affected area or following possible contact with infected ticks, animals or persons, seek medical attention promptly. Inform your doctor of your recent travel history and any potential risk factors for exposure.

Please refer to Health Advice for Travellers for the full list of precautions to take when travelling.