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Volume 30, Number 5—May 2024
CME ACTIVITY - Synopsis

Crimean-Congo Hemorrhagic Fever Virus for Clinicians—Epidemiology, Clinical Manifestations, and Prevention

Maria G. FrankComments to Author , Gretchen Weaver, Vanessa Raabe1, and State of the Clinical Science Working Group of the National Emerging Pathogens Training and Education Center’s Special Pathogens Research Network2
Author affiliations: Denver Health and Hospital Authority, Denver, Colorado, USA (M.G. Frank); University of Colorado School of Medicine, Denver (M.G. Frank); University of Massachusetts Chan Medical School, Worchester, Massachusetts, USA (G. Weaver); New York University Grossman School of Medicine, New York, New York, USA (V. Raabe)

Main Article

Table

Clinical phases of Crimean-Congo hemorrhagic fever*

Clinical phase Duration Clinical features Laboratory features
Incubation
 3–7 d (3–5 d after tick bite, 5–7 d after exposure to blood or tissue)
 Not applicable
 Normal-mildly decreased PLT
Prehemorrhagic
 1–7 d
 Fever, headache, myalgia, dizziness, nausea, vomiting, diarrhea, hyperemia of upper body, conjunctivitis
 Viremia (positive PCR), mild leukopenia, mild thrombocytopenia, elevated CK, mild elevation of AST, ALT, and LDH
Hemorrhagic
 Begins at day 3–5 of illness
 Petechial rash (skin, conjunctiva, mucosa), large cutaneous ecchymoses, gastrointestinal and genitourinary bleeding, hepatosplenomegaly, if fatal (days 5–14 of illness) secondary to MOF, bleeding, shock
DIC
 Decreasing viremia, in most cases resolved by day 9 of illness, positive serum IgM against CCHFV, leukopenia, anemia, profound thrombocytopenia, marked elevation of AST, elevation of ALT, elevated PT, aPTT, D-dimer and FDP, schistocytes
Convalescence Up to 1 y Weakness, malaise, hair loss, anorexia, polyneuritis, impaired memory, vision impairment, hepatic and renal insufficiency Thrombocytosis, slow decrease in AST and ALT, slow resolution of renal and liver function, positive serum IgG against CCHFV

*ALT, alanine aminotransferase; aPTT, activated partial thromboplastin time; AST, aspartate aminotransferase; CCHFV, Crimean-Congo hemorrhagic fever virus; CK, creatine phosphokinase; DIC, disseminated intravascular coagulation; FDP, fibrinogen degradation products; LDH, lactate dehydrogenase; MOF, multiorgan failure; PT, prothrombin time.

Main Article

1Current affiliation: Pfizer Inc., New York, New York, USA. These materials reflect only the personal views of the author and may not reflect the views of her employer.

2Members of this group are listed at the end of this article.

Page created: March 07, 2024
Page updated: April 23, 2024
Page reviewed: April 23, 2024
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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