Crimean-Congo haemorrhagic fever (CCHF) is an infectious disease caused by the Crimean-Congo haemorrhagic fever virus (CCHFV). The virus cycles between a wide range of domestic and wild animals, with humans infected via tick bites (Hyalomma species), crushing ticks or through contact with infected blood and tissues. Hyalomma ticks are not established in the UK but are present in countries across Africa, southern Europe, the Middle East, and western and south-central Asia. CCHF cases have been reported in over 30 countries across these regions and the number and geographical range of affected countries is expanding, with the first cases of local acquisition of CCHF reported in Spain (in 2013) and Portugal (in 2024). It is estimated that globally 10-15,000 human infections, including approximately 500 deaths, occur yearly, although this is likely to be an underestimate as many cases may go unrecognised.
For travellers, the risk of CCHF is very low. Imported cases are very rare and are more commonly reported in people who have worked in endemic rural areas in high-risk jobs, such as farmers, veterinarians, slaughterhouse workers, livestock owners and other people that work with animals. Cases are sometimes reported in healthcare workers, where adequate infection control precautions have not been taken.
CCHF disease can range from being asymptomatic (no symptoms) or mild (with fever, headache, diarrhoea and vomiting, sore eyes and confusion) through to haemorrhage (bleeding, bruising) and multi-organ failure and shock. The incubation period can be up to 14 days although is usually less (3 to 7 days). Most patients make a full recovery, but some may experience fatigue and malaise for many months. Reported overall case fatality rates have varied from 5% to more than 40%.
In fatal cases, death occurs from haemorrhage, multi-organ failure and shock. It is possible that many people who are infected do not have symptoms, making it difficult to know the true number of cases.
Prevention
There is currently no vaccine available for prevention against CCHF and no specific treatment.
Check our Country Information pages for destination-specific news and outbreaks.
All travellers to CCHF infected areas should:
- use tick bite avoidance measures to reduce bites from infected ticks
- ticks found on the skin should be removed carefully and promptly with a tick removal tool; avoid squashing a tick between your fingers
- avoid direct contact with the blood, tissues or body fluids of infected animals
- avoid direct contact with anyone with symptoms
UK travellers experiencing symptoms abroad should seek local medical advice as soon as possible.
Travellers returning to the UK from risk areas with symptoms should phone their GP for advice or call NHS 111. Returning travellers must remember to tell their doctor or health professional they travelled abroad recently and mention every country visited.