Donostia Hospital receives a patient with Crimean-Congo de León hemorrhagic fever

Health workers attend to a patient in the infectious disease unit. / efa

It is about a middle-aged man who has a tick bite and remains stable in severity

Aitor Ansa

The University Hospital of Donostia receives a patient with Crimean-Congo de León hemorrhagic fever in its infectious diseases unit. The patient, a middle-aged man who has a tick bite and remains stable in severity, was transferred on Thursday to an air ambulance from the
Ponferrada Regional Hospital It lacks a high biological security unit to prevent the spread of this disease.

The transfer protocols were launched yesterday, when the epidemiology section of the territorial health service of the Junta de Castilla y León confirmed the case. The Ministry of Health then called in different units, after which the University Hospital of Donostia, one of the few centers in the state prepared to treat this type of disease, gave the green light to receive the patient.

Crimean-Congo hemorrhagic fever is caused by a virus, the main transmission mechanism of which is the bite of the tick of the genus “Hyalomma”, although it can also be transmitted from person to person through contact with the patient’s blood or fluids, which can happen especially to healthcare personnel when they are not properly protected.

In Spain, the first detection of the virus dates back to 2010 in ticks in Cáceres. The first human cases were diagnosed in 2016 (1 case due to a bite in Ávila and another secondary case due to contagion in the healthcare environment from the first); in 2018 there were 2 other cases (1 in Badajoz and another in Salamanca), in 2020 3 cases were reported in Salamanca and in 2021 2 other cases (Salamanca and León). In addition, another case was identified retrospectively, corresponding to 2013, which would constitute the first human case described to date.

Crimean-Congo hemorrhagic fever.  What is it and what are the symptoms?

There is no specific treatment, although early diagnosis and supportive treatment improve survival. There is also no approved vaccine in Spain. Prevention includes measures to reduce the population of ticks and their hosts and to avoid tick bites. In addition, the correct and early elimination or removal of ticks in the event of a bite is recommended.

Infection in humans is asymptomatic in a high percentage (up to 90%). Among symptomatic cases, most have mild symptoms: fever, myalgia, headache and dizziness (4-5 days). In a few cases, the disease progresses to a severe clinical picture with hemorrhagic manifestations in the skin and mucous membranes (2-3 days), which can progress to death, generally during the second week. The case fatality rate varies from 3% to 40% and increases with age (over 60 years) and according to other prognostic markers.

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