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  Indian J Med Microbiol
 

Figure 2: Phases of Crimean-Congo hemorrhagic fever. Incubation phase: after infection with CCHFV, the incubation period starts and lasts up to 7 days. This process is symptom-free[39]. Pre-hemorrhagic phase: this phase usually occurs shortly after the incubation phase and is characterized by generalized symptoms. High fever is the most common feature in this process. In addition, the first five days of the pre-hemorrhagic phase are the safest time to isolate CCHFV. Furthermore, the RT-PCR test will diagnose this disease in early stage. Additionally, serological diagnostic approaches based on CCHFV-specific IgM and IgG (ELISA, IFA) are only applicable after the first five days of disease[1]. Hemorrhagic phase: If detection erupted, the disease would progress to the hemorrhagic process at an alarmingly fast rate. This CCHF phase is characterized by hemorrhagic manifestations such as decreased platelet and/leukocyte counts, elevated liver enzymes, and pro-inflammatory cytokines[30],[40],[41]. Generally, the patient can start feeling better 10-20 days after the symptoms has finished.

Figure 2: Phases of Crimean-Congo hemorrhagic fever. Incubation phase: after infection with CCHFV, the incubation period starts and lasts up to 7 days. This process is symptom-free<sup>[39]</sup>. Pre-hemorrhagic phase: this phase usually occurs shortly after the incubation phase and is characterized by generalized symptoms. High fever is the most common feature in this process. In addition, the first five days of the pre-hemorrhagic phase are the safest time to isolate CCHFV. Furthermore, the RT-PCR test will diagnose this disease in early stage. Additionally, serological diagnostic approaches based on CCHFV-specific IgM and IgG (ELISA, IFA) are only applicable after the first five days of disease<sup>[1]</sup>. Hemorrhagic phase: If detection erupted, the disease would progress to the hemorrhagic process at an alarmingly fast rate. This CCHF phase is characterized by hemorrhagic manifestations such as decreased platelet and/leukocyte counts, elevated liver enzymes, and pro-inflammatory cytokines<sup>[30],[40],[41]</sup>. Generally, the patient can start feeling better 10-20 days after the symptoms has finished.