This is a zoonosis transmitted through ticks of the Hyalomma species. The larvae and nymphs feed on small mammals, like rabbits, and ground frequenting birds like hen, crane etc. while the adult ones prefer larger animals. This would mean humans are bitten by the immature ticks, but by the adult ones. Even the adult ticks are not so fond of humans. This is why the cases are rare.
Then how do the humans get infected? It is either occasionally by the tick bite or from contact of infected blood/tissue through broken skin either from other infected humans or animals. Farm dwellers and stockmen are more prone to get infected, humans working in the slaughter house or abattoir are other susceptible people.
Typically it has an incubation period of 1-3 days. Flu like symptoms appears which resolves in a week, in few cases however hemorrhagic signs appear between 3-5 days. There is mood instability, agitation, mental confusion, throat petechiae, nose bleed, bloody urine, vomiting, and black stools. The liver wells and becomes painful. As the disease progresses kidney failure, shock and sometimes acute respiratory distress syndrome follows.
Recovery begins 9 to 10 days after the onset of symptoms though 30% tends to get fatal
Treatment is symptomatic and supportive in vitro Ribavirin is effective but there is no trial evidence found.
Prevention focuses on agricultural regulations like de-ticking the farm animals before slaughter. Use of adequate clothing and footwear, use of insect repellent would be personal avoidance measures.
Infected patients should isolated particularly when evidence of bleeding is seen.