Crimean-Congo haemorrhagic fever
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GC: n

S: WHO – http://www.who.int/mediacentre/factsheets/fs208/en/ (last access: 3 September 2016); https://www.gov.uk/guidance/crimean-congo-haemorrhagic-fever-origins-reservoirs-transmission-and-guidelines (last access: 3 September 2016).

N: 1. CCHF was first described in the Crimea in 1944, among soldiers and agricultural workers, and in 1969 it was recognised that the virus causing the disease was identical to a virus isolated from a child in the Congo in 1956.
2. Crimean Congo haemorrhagic fever (CCHF) is a tick-borne viral disease with symptoms such as high fever, muscle pain, dizziness, abnormal sensitivity to light, abdominal pain and vomiting. Later on, sharp mood swings may occur, and the patient may become confused and aggressive.
3. Crimean-Congo haemorrhagic fever (CCHF) has a sudden onset, with high fever, chills, malaise, diffuse myalgia, photophobia, irritability, vertigo, and head-, limb-, and back-aches. Fever can last between 5 and 12 days and may be continuous or biphasic. Other frequent symptoms include abdominal pain, anorexia, nausea and vomiting, diarrhoea, bradycardia, hyperaemia and oedema of the face and neck, and conjunctival congestion. Leucopenia and thrombocytopenia are almost always present, as is proteinuria.
4. The haemorrhagic phase of the disease usually begins on day 4, with the most common manifestations being petechia, epistaxis, haemorrhaging of the gums, haematuria, bleeding from the vagina, and haemorrhaging of the gastric mucosa. When death occurs, it is usually due to shock brought on by the loss of blood, or by neurological complications, pulmonary haemorrhages, or incurrent infections. For those who do not succumb to the disease, the convalescence period begins about 15 to 20 days after the onset of illness. It is generally characterised by generalised weakness, weak pulse, and sometimes complete loss of hair. Additional sequelae can include polyneuritis, sweating, headache, vertigo, nausea, poor appetite, laboured breathing, poor vision, loss of hearing, and loss of memory. The case fatality rate is estimated to be between 30 and 50%.
5. In Europe cases of human infections have been reported from Albania, Armenia, Bulgaria, Kazakhstan, Kosovo, Russia, Serbia, Tajikistan, Turkey, Turkmenistan, Ukraine, and Uzbekistan. In June 2008, a first case was diagnosed in Greece.
6. Cultural Interrelation: NON-FATAL CASE OF CRIMEAN-CONGO HAEMORRHAGIC FEVER IMPORTED INTO THE UNITED KINGDOM (EX BULGARIA), JUNE 2014.

S: 1. https://www.gov.uk/guidance/crimean-congo-haemorrhagic-fever-origins-reservoirs-transmission-and-guidelines (last access: 3 September 2016). 2. http://ecdc.europa.eu/en/healthtopics/emerging_and_vector-borne_diseases/tick_borne_diseases/crimean_congo/pages/index.aspx (last access: 3 September 2016). 3 & 4. http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/crim-congo-eng.php (last access: 3 September 2016). 5. http://ecdc.europa.eu/en/healthtopics/emerging_and_vector-borne_diseases/tick_borne_diseases/crimean_congo/pages/index.aspx (last access: 3 September 2016). 6. http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20864 (last access: 3 September 2016).

GV: Crimean-Congo hemorrhagic fever

S: https://www.cdc.gov/vhf/crimean-congo/ (last access: 3 September 2016); http://www.ncbi.nlm.nih.gov/pubmed/15550268 (last access: 3 September 2016).

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CR: Crimean-Congo haemorrhagic fever virus, hemorrhagic fever, tick.