Crimean-Congo haemorrhagic fever (CCHF): category 5 contact information
Advice for people who have had very close contact with someone who has CCHF virus, or material contaminated with CCHF virus.
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You have been given this information sheet because you have had very close or direct contact with someone with Crimean-Congo haemorrhagic fever (CCHF). You should stay at home and away from other people for 14 days after your last exposure to CCHF and regularly check yourself for symptoms of 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 in affected countries
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:
- you are a household or overnight contact of a confirmed symptomatic case
or
- you have had significant exposure to material from a CCHF case, for example a needlestick injury or direct contact of mucous membranes or broken skin with a CCHF case or their body fluids (for example blood, vomit, faeces, urine, saliva) whilst they were symptomatic. This includes sexual contact.
Because of your level of exposure, you are at risk of developing CCHF. We would therefore like to closely monitor you for a period of 14 days from when you were last exposed to CCHF. You should also carry out the actions listed below to minimise the risk to you and others close to you.
What you need to do
Because you are at risk of developing CCHF, you should take the following actions for the 14 days from when you were last exposed to CCHF:
- self-isolate in private accommodation (unless an alternative arrangement has been agreed with UKHSA). See the information below on how to self-isolate
- 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 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
Depending on your exposure to CCHF, you may be offered an antiviral to prevent you from developing CCHF, or, if you do develop CCHF disease, to help to prevent you from becoming very sick. You should still report any symptoms that you develop, however mild, to your designated contact.
How to self-isolate
You should self-isolate for 14 days from when you were last exposed to CCHF. This means you should stay at home and not go to work, school or public areas. You should not travel, either within the UK or internationally.
You should self-isolate in a separate room from other members of your household, and avoid all contact with them, including sexual contact. You should sleep in a separate room to other people and use separate bathroom facilities for going to the toilet and for washing.
You should only leave your home if it is essential, for example in an emergency, for an urgent medical appointment, or for urgent health and wellbeing issues. You should also not have visitors to your home.
If you need help with groceries or other essentials, ask friends or family to drop your shopping off, or order online. Ask your friends, family or delivery drivers to leave your shopping at your front door to avoid contact with them.
Do not share items which you use, such as bedding, towels, wash cloths, toothbrushes, or razors. You should also use separate items for eating and drinking, such as cutlery, cups, or plates, to other people in your household.
Postpone any non-essential medical or dental treatment. You should discuss any essential treatment required with your designated contact before attending a healthcare facility.
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) , please remain at home. Take your temperature if you have not done this already. Phone your designated contact immediately (see below for details), who will arrange for you to be assessed by an appropriate clinician. If there is any delay in making contact, phone 111 reporting your recent contact with someone with CCHF. 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