Man dies after contracting Ebola-like tick-borne disease in Spain

By Jack Guy, CNN

(CNN) — A man has died from an Ebola-like disease named Crimean-Congo hemorrhagic fever (CCHF) after being bitten by a tick in Spain.

The 74-year-old died of organ failure on Saturday in an isolation unit at the La Paz-Carlos III Hospital in the Spanish capital, Madrid, a spokesperson for the hospital told CNN on Monday.

CCHF causes severe viral hemorrhagic fever outbreaks, similar to Ebola. Initial symptoms commonly include sudden fever, chills, vomiting and diarrhea, followed by mood swings and confusion.

It is also associated with bleeding, including nose bleeds, broken capillaries in the eyes, a rash caused by bleeding into the skin and signs of internal bleeding such as blood in urine or stools.

It is difficult to prevent and treat, there is no vaccine available and the mortality rate is up to 40%, according to the World Health Organization (WHO).

It is most often transmitted by ticks and contact with the infected blood or tissue of livestock animals, but human-to-human transmission can occur, according to WHO.

The man visited a hospital in the town of Móstoles on July 19, reporting a fever and a general malaise after being bitten by a tick in Buenasbodas, in the Toledo province of central Spain, several days earlier.

On July 21, health authorities confirmed that the man was infected with CCHF, and he was transferred to the isolation unit at the La Paz-Carlos III Hospital that day, according to a statement from the hospital, published July 22.

The statement reported that he was in stable condition, but he died a week after it was published.

Death normally occurs in the second week of illness, according to WHO, which said that those who recover normally start to see an improvement in symptoms nine or 10 days after they first become ill.

The disease is endemic in Africa, the Balkans, the Middle East and Asian countries south of the 50th parallel, according to WHO.

Jacob Lorenzo-Morales, director of the Canary Islands Institute of Tropical Disease and Public Health at the University of La Laguna, told CNN that the first case of CCHF in Spain was detected in 2016, and since then there have been one to three confirmed cases each year in the center and west of the country.

As the virus is transmitted by ticks, cases in Spain tend to be detected between April and August each year, Lorenzo-Morales said, adding that climate change has meant ticks can reproduce more quickly and more times per year.

Spain has developed a national plan to deal with tick-borne diseases, including CCHF, but people should take action to avoid tick bites, Lorenzo-Morales said.

Recommendations include wearing trousers and long sleeves in light colors; wearing boots or closed shoes with trousers tucked into socks; and using tick repellent.

“CCHF is an emerging disease which is present in all of Western Europe,” he said.

Consuelo Giménez Pardo, a lecturer in medical parasitology at the University of Alcalá in Madrid, told CNN that “there will undoubtedly be more cases” of CCHF in Spain.

The country offers favorable conditions for the virus due to its climate, which is hospitable to ticks, and the fact that migratory birds bring ticks with them on their journeys between Europe and Africa, which is in close proximity to Spain, she said Monday.

Although Giménez said CCHF is “a virus with wide distribution and high potential for human-to-human transmission,” through infected blood and bodily fluids, she also underlined that it is asymptomatic in humans in up to 90% of cases, and most people will suffer only light symptoms.

Nonetheless, “one case is considered an outbreak,” she added.

Professor Emma Thomson of the London School of Hygiene & Tropical Medicine called the case “concerning” and highlighted the detection of CCHF in ticks in both Spain and France.

“I expect that we will see more cases in the coming years,” Thomson told CNN on Monday. “There is a risk also of spread to other European countries including the UK.”

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