Crimean-Congo hemorrhagic fever virus: new outbreaks, new discoveries.

Crimean-Congo hemorrhagic fever (CCHF) is a fatal viral infection described in Asia, Africa and Europe. Humans become infected through the bites of ticks, by contact with a patient with CCHF during the acute phase of infection, or by contact with blood or tissues from viremic livestock. The occurrence of CCHF closely approximates the known world distribution of Hyalomma spp. ticks. The novel studies of phylogenetic analyses reveal the interesting relations between the strains from distant outbreaks. The clinical features show common dramatic progress characterized by hemorrhage, myalgia, and fever. Besides the direct infection of endothelium, indirect damage by viral or virus mediated host-derived soluble factors that cause endothelial activations and dysfunction occur. In diagnosis, enzyme linked immunoassay and real-time reverse transcription-polymerase chain reaction are used. Early diagnosis is critical for the patient and potential nosocomial infections. Supportive therapy is the essential part of the case management. Ribavirin was suggested as an effective drug in recent studies, and it was found to be beneficial. The health care workers are under serious risk of transmission of the infection, particularly during the follow-up of the patient, with hemorrhages from the nose, mouth, gums, vagina, and injection sites.