04 Apr 2022

Imported case of Crimean-Congo haemorrhagic fever to UK from Central Asia

A case of CCHF is confirmed in a traveller who had recently travelled to Central Asia Imported case of Crimean-Congo haemorrhagic fever to UK from Central Asia

The UK Health Security Agency has confirmed a case of Crimean Congo Haemorrhagic fever (CCHF) in England, in a woman who had recently travelled to Central Asia. This is only the third case of CCHF imported to the UK; the previous two imported cases were in 2012 and 2014 and there was no evidence of onward transmission from either [1].

CCHF is caused by a tick-borne virus which is endemic throughout Africa, Asia, the Middle East, Eastern and Southwestern Europe. The type of tick that transmits the virus is not established in the UK [1].

In areas where CCHF occurs, the virus can be transmitted to humans via the bite of an infected tick, or through direct contact with blood, tissues, or body fluids of infected animals. Most cases occur in people living in tick-infested areas with occupational exposure to livestock including farmers, slaughterhouse staff and vets.

Human-to-human transmission has been reported following close contact with blood, secretions, or other bodily fluids of infected persons. Cases have been reported in health workers caring for infected people [2,3].

The risk of CCHF for travellers in endemic areas is mainly due to tick bite exposure during outdoor activities [2].

In the United Kingdom (UK) there is no licensed human CCHF vaccine available [4].

Advice for travellers

CCHF does not spread easily between people. The overall risk to the public in the UK is very low. Health authorities in the UK are working to contact individuals who had close contact with the recently imported case [1].

The risk to the majority of those travelling to areas where CCHF is known or presumed to occur is very low, if the following precautions are followed [4]:

  • avoid areas where ticks are abundant at times when they are active
  • use tick repellents
  • check clothing and skin carefully for ticks and remove them with a recommended technique - see our insect and tick bite avoidance factsheet for details.
  • if working with animals in endemic areas, it is advised that you use tick repellents on skin and clothing, and wear gloves/protective clothing to prevent skin contact with infected tissues/blood [4].

Healthcare workers working in affected regions should wear appropriate Personal Protective Equipment (PPE) and discard waste according to local Infection Protection and Control (IPC) guidelines.

If you become unwell after travel abroad, you should seek advice from your GP or NHS111.

Advice for health professionals

Health professionals should remain alert for travellers returning from CCHF affected areas who develop symptoms compatible with CCHF.

Health professionals should practise strict universal precautions, including barrier nursing, when caring for patients presenting with haemorrhagic fever syndrome, including when there is suspicion of CCHF [5].

Hospital staff must observe adequate infection control procedures (barrier nursing). Contaminated needles, surgical instruments and body waste materials should be safely disposed of using appropriate decontamination procedures [4].

Guidance and information about high consequence infectious disease and their management in England and further information about CCHF is available from the UK Health Security Agency.

Resources

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Crimean-Congo haemorrhagic fever: raising awareness for travellers to endemic countries

International travellers are reminded of the risk of Crimean-Congo haemorrhagic fever when visiting countries where the infection occurs Read more

Middle East respiratory syndrome coronavirus (MERS-CoV) reminder

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