Crimean-Congo Hemorrhagic Fever (CCHF) is a deadly viral illness that causes symptoms like high fever, haemorrhage, and, in severe instances, death. This disease is caused by Nairovirus, a member of the Bunyaviridae family, and is transmitted mostly by tick bites or direct contact with infected blood or body fluids.¹ CCHF affects both children and adults. There may be variances in how it affects people, with immunity, symptoms, and results frequently exhibiting diverse patterns.

What Is Crimean-Congo Hemorrhagic Fever (CCHF)?

CCHF is a viral disease spread primarily by ticks, particularly the Hyalomma tick.² People can also catch the virus by coming into contact with the blood or body fluids of infected animals or humans. Those at the highest risk include people who work with animals, healthcare workers, and those in close contact with CCHF patients. The initial symptoms include a sudden rise in body temperature followed by muscle aches, abdominal discomfort, nausea, headache, and vomiting, and since it affects the body's ability to clot, it causes severe bleeding and bruising. Severe cases lead to organ failure and ultimately to death. This is prevalent in the regions of Africa, and the Middle East, usually in rural areas.

How does CCHF affect adults?

In adults, the symptoms rapidly accelerate but usually start like the flu. The progression leads to internal and external bleeding and multiple organ damage. Some people may develop shock, which can be very life-threatening. The overall fatality rate of CCHF among adults is between 10% to 40%, but this varies depending on the underlying health conditions of the individual and the quality of medical care provided to treat the patient.³ Adults are particularly at higher risk before they work in agriculture or healthcare, and have an increased risk of exposure to infected ticks or tissues. The duration of the infection in adults can vary, but it usually lasts for several weeks. Recovery can be slow because of the progression of the virus, especially in cases riddled with complications. If the patient overcomes the serious complications, they may still have long-term health problems that affect their life.

How does CCHF affect children?

The infection often begins in children, like in adults, with fever, headache, and body aches. However, studies suggest that children may experience milder symptoms than adults and that they are less likely to develop severe bleeding or organ failure, although serious cases can still occur depending on the circumstances, like the child's health condition and the availability of health care.⁴ Children may experience symptoms like vomiting, diarrhoea, and mild bruising, but they are generally more resilient to the severe progression of the disease. Since children have weaker immune systems than adults, they can be more vulnerable to certain infections. However, children’s immune systems may respond differently to CCHF, which might help explain why they experience fewer severe symptoms. Younger children are generally at lower risk because they have less exposure to ticks and infected animals compared to adults. The duration of the infection in children can be shorter compared to adults. Recovery in mild cases often happens within a couple of weeks, though children who develop severe symptoms may take longer to recover. For children, it is crucial to get timely treatment and monitoring to prevent the disease from becoming severe.

What are the key differences of CCHF in both adults and children?

Symptoms

While both adults and children with CCHF have similar symptoms, children often have milder symptoms and are less likely to experience life-threatening complications. Studies suggest that children are less prone to severe bleeding and organ failure, though cases of severe illness and death can still occur in young patients.

Mortality rates

Adults with CCHF have a mortality rate ranging from 10% to 40%, depending on medical care quality and treatment access. Although data is scarce, children often have lower death rates than adults. According to studies, youngsters tend to recover faster and with fewer difficulties and have milder symptoms.⁵ Younger children with underlying health difficulties, as well as those who get delayed treatment, may face substantial dangers. The death rate in children is lower than the mortality rate among adults. This pattern indicates that youngsters may have a greater chance of surviving CCHF than adults.

Transmission risks

Adults who work in agriculture or healthcare, are at a higher risk of CCHF exposure due to their working conditions. Children are less likely to be exposed to ticks and diseased animals since they do not work in agriculture or with animals. They can still get the infection if they reside in a tick-infested environment or have close contact with affected family members.

Immunity and health complications

Adults have better-developed immune systems than children, but they may have pre-existing health conditions that make them more susceptible to severe CCHF consequences. Chronic illnesses, such as diabetes or liver disease, might make it difficult for the patients to fight off the infection. On the other hand, children with weakened or less mature immune systems, such as those under the age of five, may have more severe symptoms or complications.

Duration and recovery 

Adults who have severe symptoms typically have a more prolonged and more difficult recovery process and it could weeks and sometimes months to fully recover. Children, particularly those without difficulties, tend to heal faster. However, early medical care is vital to ensure less severity and increase the survival chances.

Summary

Crimean-Congo Hemorrhagic fever affects both adults and children, but there are noticeable differences in how it impacts each group. Adults generally experience more severe symptoms, higher mortality rates, and longer recovery times, partly due to increased exposure and existing health issues. Children, while not immune, tend to have milder symptoms and a quicker recovery period, though they still need immediate treatment to avoid complications. Understanding these differences can help improve prevention strategies, healthcare responses, and overall outcomes for both children and adults. By using protective measures and educating high-risk groups, we can reduce the spread and impact of CCHF in vulnerable communities.