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Epidemic Control Toolkit
for community volunteers
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Crimean-Congo haemorrhagic fever (CCHF)
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Crimean-Congo haemorrhagic fever (CCHF)

Last update: 2025-05-09

Key facts

  • The Crimean-Congo haemorrhagic fever (CCHF) virus causes severe viral haemorrhagic fever outbreaks.
  • Its outbreaks have a case fatality rate of up to 40%.
  • CCHF is endemic in many countries in Africa, the Middle East, Asia, and Eastern Europe.
  • There is no CCHF vaccine for humans or animals.

Transmission: vector-borne (ticks)

  • The virus is mainly transmitted to people through bites from infected ticks
  • Handling or butchering of infected animals, particularly livestock including cattle, sheep, and goats
  • Close contact with the blood, secretions, organs or other bodily fluids of infected persons
  • Transmission at healthcare facilities can also occur due to improper infection control and prevention practices

Most vulnerable to contracting the disease

  • Farmers, abattoir workers, and veterinarians due to increased exposure to livestock and ticks (which often infest the livestock animals)
  • People residing in or visiting areas where CCHF is endemic are at higher risk, particularly during tick activity seasons.
  • Healthcare workers, especially if proper protective measures are not followed while caring for an infected patient

Most vulnerable to severe disease

  • Elderly
  • People with pre-existing health issues, including weakened immune systems
  • Pregnant women

Symptoms 

  • Sudden onset of fever 
  • Dizziness 
  • Muscle pain 
  • Backache 
  • Neck pain and stiffness 
  • Photophobia (sensitivity to light) 
  • Diarrhea 
  • Sore eyes 
  • Sore throat 
  • Vomiting 
  • Headache 
  • Nausea 
  • Abdominal pain 
  • Mood swings 
  • Confusion 

Severe symptoms 

  • Jaundice (yellow skin and/or mucosae) 
  • Liver enlargement 
  • Bleeding from the skin, internal organs, and other body openings 
  • Severe bruising and uncontrolled bleeding 

What can you do to prevent and control an epidemic?

Reservoir control and prevention

  • Identify and isolate suspected livestock

Personal protection and hygiene

  • Promote handwashing with soap, especially:
    • After caring for or visiting sick people
    • After handling or slaughtering sick animals
  • Promote the use of:
    • personal protective equipment (PPE) when caring for sick people or when touching sick or dead animals, specifically gloves and mask
    • gloves and other protective clothing while handling animals or their tissues in endemic areas, particularly during slaughtering, butchering and culling procedures in abattoirs or at home
  • Discourage people from:
    • Unnecessary touching of sick or dead animals or things that might have been contaminated by their blood or body fluids
    • Close physical contact with CCHF-infected people
  • Encourage farmers and abattoir workers to quarantine animals before they enter slaughterhouses and routinely treat animals with pesticides two weeks prior to slaughter.

Vector control and prevention

  • Initiate elimination of ticks
    • Promote the use of approved acaricides (chemicals made to kill ticks) on clothing
  • Prevent tick bites by encouraging people to:
    • Use personal protection (application of repellents, wearing long sleeved clothes, wearing of light coloured clothing to aid the detection of ticks on clothes)
    • Regularly examine their clothes and skin for ticks; and promptly and safely remove it
    • Avoid areas where ticks are abundant and seasons when ticks are most active

Monitoring the community and identifying sick people  

  • Identify community members who have suspected CCHF infection based on the community case definition

Treatment and management

  • Rapidly detect and refer cases to health facilities early
  • Support contact tracing and follow-up of contacts
  • Provide psychosocial support to the sick person and their family members  

Social mobilisation and behaviour change

  • Find out the specific advice being given by health and other relevant authorities  
  • Model following this advice and inform community members of current health practice advice  
  • Offer support and encouragement to follow the advice  
    • Try to gain understanding about if and why health practice advice is not being followed  
    • With the guidance of your supervisor and health authorities, work with communities to overcome barriers to following health advice and recommended practices  

Immunization

  • Currently, there are no vaccines for CCFH 

Mapping and community assessment

  • Make a map of the community.
  • Mark the following information on the map:
    • How many people have fallen sick with CCHF? Where?
    • How many people have died? Where? When?
    • Who and where are the vulnerable people?
    • Where are the local health facilities and services? (include traditional healers)
  • Record the following information on the back of the map:
    • When did people start to fall sick with CCHF disease?  
    • How many people live in the affected community?  
      • How many are children under five years old?
      • Which people in the community have contact with livestock and ticks?
    • Do people cook meat thoroughly before eating it?
    • Are there handwashing facilities in the community, at animal markets and other areas where livestock is slaughtered? Are soap and water always available?
    • What are the community’s habits, practices and beliefs about handling and slaughtering animals, especially animals that are sick or dead?
    • What are the community’s habits, practices and beliefs about repellents and sprays?
    • What are the community’s habits, practices and beliefs about caring for and feeding sick people? Consider any differences in roles and responsibilities between men and women.
      • When babies and infants are sick, do women continue to breastfeed them?
    • Are children badly affected by the CCHF? Are there other groups (specific ages, occupations, geographic areas, etc.) that are badly affected?  
    • Is a social mobilization or health promotion programme in place?
    • Which sources do people use/trust the most for information?
      • Are there rumours or misinformation about CCHF? What are the rumours? 

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