Congo-Crimean Hemorrhagic Fever
Congo-Crimean Hemorrhagic Fever is a tick-borne viral infection, a Nairovirus in the Bunyaviridae family that naturally affects Eastern Europe, Africa, the Middle East, and Central Asia. Outside of its hosts, the virus is fragile, and is sensitive to ultraviolet light, disinfectants, detergents, lipid solvents, and dry heat at 56 degrees Celsius. Inside the tick vector and animal reservoirs, the virus is highly stable. The ixodid (hard) ticks remain lifelong carriers of the CCHF virus.
History of Congo-Crimean Hemorrhagic Fever
The first case of Congo-Crimean Hemorrhagic Fever was discovered in the Crimea in 1944 by Russian scientist Mikhail Chumakov. Later, a case was discovered in the Congo in 1956. In 1967, Dr. DI Simpson and colleagues described 12 cases of CCHF in Africa and suggested that the two geographically distant cases of fever in Africa and the Crimea may have been the same disease. Dr. J. Casals showed that the two cases were serologically indistinguishable.
In the 1980s, several cases of Congo-Crimean Hemorrhagic Fever were discovered in the Republic of South Africa. In November 1983, a 46-year-old man who owns a farm near Bronkhorstspruit, northeast of Pretoria, and kept cattle experienced symptoms of fever, headache, a rash, and epistaxis (nose bleeds). In February 1984, another farmer from Danielskuil, west of Kimberley in the Cape Province, also became ill with CCHF.
In 1984, four victims acquired the CCHF viral agent from a farm in Frankfort, Orange Free State province in South Africa. All four were admitted to the hospital in May 1984 with fever, headache, and dizziness. A 23-year-old farm worker died of the disease. The other three patients survived but recovery was slow. A fifth victim assisted the veterinarian with autopsies of two cows that had died on the same farm. The 70-year-old man did not remember when his symptoms began but recovered from the viral infection. The farm had purchased 46 cows in January 1984, and two cows had died of illness by March 1984.
Since the 1980s, sporadic outbreaks of CCHF have occurred in the virus' endemic regions. In November 1996, workers in an ostrich abbatoir located in Oudtshoorn, Western Cape Province, South Africa, were infected with the CCHF virus. In 2001, roughly 35 cases were reported to the World Health Organization (WHO) along the Pakistan-Afghanistan border. In Mauritania between February and August 2007 reported 38 cases of CCHF with a 28.6% case-fatality ratio. In 2007, reports suggested that over 220 cases of CCHF infection were discovered in the South Federal District in South Russia.
Congo-Crimean Hemorrhagic Fever as a Biological Weapons Agent
The Congo-Crimean Hemorrhagic Fever virus is an easily manufactured and infectious potential biological agent. There have been no reports that CCHF virus have been aerosolized or weaponized. Potential uses of CCHF virus as a biological agent would be difficult to distinguish from natural outbreaks.
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