The National Public Health Organization of Greece (EODY) has confirmed a domestic case of Crimean-Congo Hemorrhagic Fever (CCHF) in a village within the municipality of Elassona, in the regional unit of Larissa, Thessaly. The patient, a man over 70 years old, was hospitalized with a severe and deteriorating clinical condition and has since died.

What Is Crimean-Congo Hemorrhagic Fever?

Marko Zivcec, Florine E. M. Scholte, Christina F. Spiropoulou, Jessica R. Spengler, and Éric Bergeron, CC BY 4.0, via Wikimedia Commons

CCHF is a viral disease transmitted through the bite of infected ticks or direct contact with the blood, tissues, bodily fluids, or secretions of infected ticks, animals, or humans. Wild and domestic animals can carry the virus for a few days without showing symptoms, potentially infecting ticks that can then transmit the virus to other animals or humans.

Symptoms can range from none at all (in approximately 85% of cases) to mild flu-like illness or severe hemorrhagic fever. The incubation period ranges from 1 to 14 days. Common symptoms include sudden onset of fever, chills, headache, muscle and joint pain, fatigue, dizziness, sore throat, abdominal pain, diarrhea, nausea, and vomiting. Severe cases may involve mood or consciousness changes, internal bleeding, multi-organ failure, and circulatory shock. The disease has a high fatality rate (30–50% in hospitalized patients), and there is no specific antiviral treatment.

Global and Regional Context

CCHF is a viral hemorrhagic fever with a global footprint, transmitted mainly by ticks, with an estimated 10,000 to 15,000 infections annually. Outbreaks and sporadic cases have been reported in over 30 countries across Asia, the Middle East, Africa, and Europe. In Europe, cases have been documented in the Balkans (Bulgaria, Albania, Kosovo, North Macedonia), as well as in Spain, Portugal, Georgia, Russia, Ukraine, and Turkey. Greece last recorded a domestic case in 2008 in the region of Thrace.

Who Is at Risk?

High-risk groups include individuals exposed to rural, mountainous, or forested areas with tick populations, such as farmers, shepherds, hunters, foresters, gardeners, veterinarians, slaughterhouse workers, campers, hikers, and healthcare professionals caring for infected patients.

EODY Recommendations

In light of the recent case, EODY advises personal protective measures, especially for high-risk populations in the affected region. While the majority of ticks are not infected, precautions are essential as diseases transmitted by ticks can be serious.

Key Prevention Measures

  • Avoid areas with dense vegetation, tall grasses, leaf piles, and livestock.
  • Wear light-colored, protective clothing with long sleeves and trousers tucked into socks and boots.
  • Use insect repellent on skin and clothing.
  • Avoid sitting or lying on the ground outdoors.
  • Shower after outdoor activities and check body and clothing for ticks.
  • Remove ticks promptly and properly using tweezers. Do not use bare hands or apply substances like oil or alcohol to the tick.
  • Treat animals regularly for ticks and disinfect stables and barns as advised by veterinarians.
  • Wear gloves and protective gear when handling animals or animal products.
  • Only consume pasteurized milk and properly aged dairy products.

Preventing Human-to-Human Transmission:

  • Avoid close physical contact with suspected or confirmed cases.
  • Use protective gear when caring for patients.
  • Practice frequent hand hygiene.
  • Healthcare workers must strictly adhere to infection prevention and control protocols.
  • More information is available on the EODY website: https://eody.gov.gr/disease/tsimpoyria-krotones

Coordinated National Response Underway

Greek national and regional health and veterinary authorities are actively coordinating their response. A high-level working meeting was held on June 27, 2025, with participation from the Ministry of Health, EODY, the Ministry of Rural Development and Food, regional health and veterinary services, scientific experts, and institutions including Aristotle University of Thessaloniki and the Agricultural University of Athens.

Immediate Response Measures Include:

  • Tracing and monitoring of patient contacts in both community and healthcare settings.
  • Informing healthcare professionals nationwide to remain alert to potential cases.
  • Public information campaigns targeting high-risk groups in the affected area.
  • Tick and animal sampling in the region to detect viral presence.
  • Targeted disinfestation in the exposure area.
  • Seroepidemiological studies in the local population.
  • Targeted disease control measures for animals.

Greek authorities remain on high alert, emphasizing prevention and preparedness to minimize the risk of further cases.