Crimean-Congo haemorrhagic fever (CCHF): category 4 contact information
Advice for people who have come into direct contact with someone who has CCHF virus.
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You have been given this information sheet because you have had contact with someone with Crimean-Congo haemorrhagic fever (CCHF), or material contaminated with the virus that causes CCHF. You should follow the advice in this information sheet and check yourself for symptoms for 14 days after you had possible contact with CCHF. If you develop symptoms of CCHF within 14 days of your last exposure to CCHF, you should stay at home and call your designated contact immediately.
About CCHF
CCHF is a rare but serious disease caused by CCHF virus. CCHF is found across much of Africa, Central and Eastern Asia and Southern Europe. It is not normally found in the UK but has occasionally been found in patients who have caught it abroad and come to the UK.
How CCHF spreads
CCHF can spread by:
- direct contact with the organs, blood, secretions, or other bodily fluids of an infected person (including sexual transmission)
- contact with objects, such as needles or soiled clothing, that have been contaminated with infected secretions
- bites from infected ticks, or direct handling of infected ticks or livestock
CCHF is not spread through routine, social contact (such as shaking hands or sitting next to someone) with people who do not have symptoms. There is no evidence that CCHF can spread through the air.
It can take up to 14 days from when someone is exposed to the virus for symptoms to appear.
Symptoms of CCHF
It is possible for someone who has caught the CCHF virus to have no symptoms of infection, or only mild symptoms. However, CCHF can also cause severe symptoms and death.
Early symptoms of CCHF are often mild and non-specific and include fever, muscle aches, dizziness, backache or headache. Nausea, vomiting, diarrhoea and abdominal pain may also occur.
In more severe cases, symptoms may progress to bruising and/or bleeding. Multi-organ failure may develop in the most severe cases. Approximately 30% of clinically ill cases are fatal.
Preventing and treating CCHF
There is currently no licensed vaccine for CCHF. To avoid CCHF spreading between people, those caring for individuals with possible or suspected CCHF should avoid contact with the patient’s bodily fluids and should wear personal protective equipment (PPE).
Treatment for CCHF is with supportive care, including balancing fluids and electrolytes, maintaining a person’s oxygen status and blood pressure, and treating any co-infections. There are antiviral drugs which, if used early on after the start of symptoms may make the illness less serious for anyone infected. They do not prevent the illness altogether.
Your risk of developing CCHF
You reported that one or more of the following happened:
- you had direct contact with someone who had CCHF without appropriate PPE, or there was a breach in your PPE. This includes exposure to their body fluids, such as blood, vomit, faeces or saliva, or kissing and/or sexual contact
- your skin or mucous membranes were exposed to an environment potentially contaminated with the blood or body fluids of someone who had CCHF, including on clothing or bedding, without wearing appropriate PPE
- you had unprotected sexual contact with someone who previously had CCHF within 3 months of their illness
- you handled clinical or laboratory specimens from someone who had CCHF without adequate protection, for example without appropriate PPE or laboratory practices
We would like to monitor you for a period of 14 days from when you were last exposed to CCHF. This will mean that we can act quickly in case you do develop symptoms, reducing the risks to you and to others close to you.
What you need to do
Your family and household contacts are not at risk of catching CCHF from you if you do not have any symptoms.
You should take the following actions for the 14 days from when you were last exposed to CCHF:
- record your temperature and monitor yourself for other symptoms suggestive of CCHF twice per day at the same times each day
- report these temperatures to your designated contact (see below for contact details) by 12 noon each day. They will want to know whether your temperature is below, equal to, or above 37.5°C, and will arrange further evaluation as necessary. They will explain the local arrangements for accessing healthcare
- if you become ill with any of the symptoms listed above in between reporting to your designated contact, you should phone your designated contact immediately. See below for further information on what you should do if you become ill
- if you are a healthcare worker, you should not have any contact with patients for 14 days after your last exposure. You may need to speak to your line manager about options for redeployment to non-patient facing roles during this period. UKHSA will contact your occupational health department before you can return to a patient facing role
- it is important to avoid close contact with children aged under 18 (where possible; see information below), pregnant women, or those who have a weakened immune system for 14 days after your last exposure. You should avoid close contact with these people both within your household and others outside of your household. If your work involves direct contact with individuals who have a weakened immune system, pregnant women or children, speak to your line manager about options for re-deployment to other roles
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if you have direct contact with other people as part of your work, speak to your manager about possible options to reduce the amount of contact you have with other people for 14 days from when you were last exposed to CCHF, for example, In addition, for the 14 days from when you were last exposed to CCHF:
- if you do not have any symptoms, you may undertake the following travel:
- any length of trip by private car within the UK
- local travel on local commuter/public transport, principally for work. However, you should avoid having to travel by public transport if possible, and keep any trips you make as short as possible
- you should not travel internationally, or via air within the UK
- avoid situations where it would be impossible for you to self-isolate if you became ill (such as crowded public places)
- do not share towels, bed linen, toothbrushes or razors
- avoid sexual contact with other people
- you should postpone any non-essential medical or dental treatment, including vaccination. If you need essential medical or dental treatment, inform your healthcare provider about your exposure to CCHF
If there are children in the household
If you have a child or children in your household, or a child in your household is a close contact of someone with CCHF, you should take precautions to minimise direct contact with them as far as you can, while ensuring that you are meeting their care and wellbeing needs. Children who are contacts should always be given the care and contact they need to ensure their wellbeing.
If you have a holiday planned
If you have a holiday planned within the 14 days since you were last exposed to CCHF, you should not travel abroad.
Use of medicines such as aspirin, paracetamol or ibuprofen
Certain medicines, such as paracetamol, ibuprofen and aspirin, can reduce your body temperature during a fever (antipyretic) for up to 8 hours. Thermometer measurements may therefore show a lower temperature than would be expected for up to 8 hours after taking an antipyretic.
You must call your designated contact for further advice if you need to take an antipyretic medicine.
Please take your temperature before you take paracetamol, ibuprofen or aspirin, and if your temperature is 37.5°C or higher, you must call your contact immediately.
A temperature of 37.5°C or higher is always significant, whether you are taking one of these medicines or not, and must be reported urgently.
What to do if you become ill
If you are feeling unwell or develop any of the symptoms of CCHF (including a temperature of 37.5°C or higher) in the 14 days from when you were last exposed to CCHF, please stay at home. Take your temperature if you have not done this already. Phone your designated contact immediately, who will arrange for you to be assessed by an appropriate clinician. In an emergency, you should call 999 and tell them about your symptoms and your recent contact with CCHF.
Further information
More information about CCHF can be found on the following website:
UK Health Security Agency: Crimean-Congo haemorrhagic fever: origins, reservoirs, transmission and guidelines - GOV.UK