Alert issued over outbreak of serious infection in Spain and Greece this summer

An alert has been issued after Spain and Greece were hit by rising cases of a serious illness which kills around a third of people infected - with one area described as a hotspot. Since the beginning of 2025, and as of 23 July 2025, two countries in Europe have reported cases of Crimean Congo haemorrhagic fever (CCHF)

Cases have been found in Spain and Greece - with the latter outbreak being described as ‘unexpected’. Officials from the European Centre for Disease Prevention and Control (ECDC) said the Greece cases have been detected in the Thessaly region. Earlier this year sources speaking to Parliament’s Science, Innovation and Technology Committee revealed that it was “highly likely” the UK would soon see cases.

The UK Health Security Agency has reported that an estimated 10,000 to 15,000 human infections occur globally each year, including approximately 500 fatalities. However, this figure is likely underestimated due to unreported cases.

The surge has been highlighted by the UK Travel Health Pro website which is backed by the Foreign Office. The ECDC said: “The cases in Greece that occurred in the Thessaly region are unexpected, as this region and neighbouring regions have not reported CCHF cases or CCHF virus circulation in animals previously.

"The primary case was probably infected through a tick bite, while the secondary case was a healthcare professional who provided care to the primary case, although the exact transmission route is still under scrutiny.

“These are the first cases since 2008, when the only other locally acquired case reported by Greece to date was found in the Thrace region (bordering Bulgaria).”

With the ones which have been detected in Spain, the ECDC latest report released this week said cases - in Salamanca - have previously been reported. It said: “From 2016 to 2024, a total of 16 autochthonous CCHF cases have been reported in Spain, with dates of disease onset between April and August.

“The province of Salamanca is a hotspot for CCHF, with 50% of the cases being exposed to ticks. Two cases have been detected in previous years in the same locality as the current case. In this area, the presence of Hyalomma marginatum, the main vector of this disease, is well known, and studies conducted in wild and domestic animals have shown seroprevalence higher than 70% for CCHF virus.

“Although the risk of contracting CCHF for the general population in the areas where the virus is known to be present in Spain is low, this risk drastically increases for people performing activities that expose them to tick bites

(e.g. hunting, forestry work, hiking, animal surveillance).”

The disease is caused by Nairovirus, which is spread by ticks and has a fatality rate of between 10 and 40 percent according to the World Health Organization (WHO).

Typically found in Africa, the Balkans, the Middle East and Asia, the disease could be expanding beyond its usual territories and moving towards countries like Britain and France due to climate change.

The World Health Organisation has identified CCHF amongst its nine “priority diseases”, a classification that highlights the most significant public health threats. The condition was initially documented in Crimea during 1944, affecting military personnel and farm workers, and by 1969 scientists had established that the pathogen responsible was the same virus that had been isolated from a Congolese child in 1956.

The ECDC said: “As a general precaution against CCHF, but also against other tick-borne diseases, people who may potentially be exposed to ticks should apply personal protective measures against tick bites. “

The virus presents with various symptoms, including severe headaches, elevated temperature, spinal and joint discomfort, abdominal pain, and nausea. Bloodshot eyes, facial flushing, throat redness, and petechiae (small red marks) across the roof of the mouth are frequently observed.

In serious instances, the WHO cautions, patients may experience yellowing of the skin, emotional instability and altered sensory awareness. As the condition advances, extensive severe bruising, heavy nosebleeds, and uncontrollable haemorrhaging at injection points may develop, typically commencing around the fourth day of the illness and persisting for approximately a fortnight.

During recorded CCHF outbreaks, mortality rates amongst hospitalised individuals have varied from nine per cent to as much as 50 per cent.