What are the symptoms of CCHF?

Not all Hyalomma ticks carry the CCHF virus, and most people who are bitten by a Hyalomma tick do not become ill. Still, CCHF can cause very serious illness. If you have a fever within 9 days after a Hyalomma tick bite, contact your GP. Make sure to mention that you were bitten by a Hyalomma tick. 

People who do have symptoms of CCHF will suddenly become ill 3 to 7 days after the bite. The first symptoms are:

• fever
• muscle pain
• feeling ill

Symptoms will often also include:

• headache
• drowsiness
• stomach pain
• joint pain

After 1 to 7 days from the first symptoms, some people become more seriously ill. They develop internal bleeding, with symptoms such as:

• small red dots that do not go pale if you press on them
• sudden bruises
• bloody nose
• spitting up blood
• black stool (poo)

Hospital admission may be necessary. If people who have CCHF become very seriously ill, their organs may stop working. Organ failure can lead to death.

How does CCHF spread?

People can contract CCHF from:

• a bite from an infected Hyalomma tick, also known as the Mediterranean Hyalomma, in a region where the virus is found
• contact with blood or other bodily materials from infected people or animals

The Hyalomma tick is two or three times larger than the sheep tick (Ixodes ricinus) that is common in the Netherlands. Hyalomma ticks are not generally found in the Netherlands. A single Hyalomma tick is occasionally found, but these individual ticks are most likely carried here by migratory birds or pets, such as dogs or horses, or sometimes brought along in clothing or baggage. The CCHF virus has not yet been found in the Netherlands. 

How can I prevent CCHF?

CCHF has not yet been found in people in the Netherlands who have travelled abroad. The risk of getting the disease here is very low. You could take steps to prevent tick bites in areas where the virus is found. Here is how to prevent illness from a tick bite:

• In wooded areas, stay on the paths whenever possible. Do not go into the bushes or tall grass.
• Wear closed shoes, long sleeves and trousers. Tuck the legs of your trousers into your socks. Ticks are easier to spot on light-coloured clothing.
• Wear clothing that has been treated with Permithrin insect repellent, or spray your clothing with a product containing DEET (diethyltoluamide) or icaridin.
• Apply insect repellent such as DEET or icaridin to exposed skin. Pregnant people and children under the age of two should not use any products whose DEET content exceeds 30%.
• Check your body and clothing for ticks after visiting green areas. Always remove the tick as soon as possible

It is important to avoid all contact with bodily fluids from infected people and animals. For example, if you find a tick, do not squash it between your fingers. 
There is no vaccine against CCHF.

Is there any treatment for CCHF?

People with severe symptoms caused by CCHF sometimes need to be treated in hospital. There is no specific medication to treat CCHF.

How common is CCHF?

Crimean-Congo haemorrhagic fever (CCHF) is a rare disease that has not yet been found in anyone in the Netherlands. According to the World Health Organization (WHO), about ten thousand to fifteen thousand people contract CCHF every year. Of those who contract the disease, one to two thousand people die every year. The latest figures from the EU European Union (European Union )/EEA were published in a  2022 report from the European Centre for Disease Prevention and Control (ECDC). At that time, there were two patients in Spain and two in Bulgaria. One patient in each of those countries died of the disease. 

The CCHF virus is found in large parts of the Middle East, Asia, Africa, Eastern Europe and Southeastern Europe. In recent years, a few people in Spain, Portugal and France have also contracted the disease. If you travel to these areas, you are very unlikely to get CCHF. The disease is occasionally found in people who live in these areas and work with animals or spend much of their time working in nature.

The virus is not generally found in the Netherlands. However, the tick that carries the virus could travel to the Netherlands by infesting a bird. So far, these ticks have been seen occasionally in Northern Europe, but the virus has not.