A nosocomial transmission of crimean-congo hemorrhagic fever to an attending physician in north kordufan, Sudan

Abstract

BackgroundCrimean-Congo hemorrhagic fever (CCHF), a tick-borne disease caused by Crimean-Congo hemorrhagic fever virus (CCHFV), is a member of the genus Nairovirus in the family Bunyaviridae. Recently, CCHFV has been reported as an important emerging infectious viral pathogen in Sudan. Sporadic cases and multiple CCHF outbreaks, associated with nosocomial chain of transmission, have been reported in the Kordufan region of Sudan.AimsTo confirm CCHF in an index patient and attending physician in North Kordufan region, Sudan, and to provide some information on virus genetic lineages.MethodsAntibody captured ELISA, reverse transcription PCR, partial S segment sequences of the virus and subsequent phylogenetic analysis were used to confirm the CCHFV infection and to determine the virus genetic lineages.ResultsCCHF was confirmed by monitoring specific IgM antibody and by detection of the viral genome using RT-PCR. Treatment with oral ribavirin, replacement with fluid therapy, blood transfusion and administration of platelets concentrate resulted in rapid improvement of the health condition of the female physician. Phylogenetic analysis of the partial S segment sequences of the 2 CCHFV indicates that both strains are identical and belong to Group III virus lineage, which includes viruses from Africa including, Sudan, Mauritania, South Africa and Nigeria.ConclusionFurther epidemiologic studies including, CCHFV complete genome analysis and implementation of improved surveillance are urgently needed to better predict and respond to CCHF outbreaks in the Kordufan region, Sudan.

Crimean-Congo hemorrhagic fever: History, epidemiology, pathogenesis, clinical syndrome and genetic diversity

“…In cells that lack SKI-1, PreG N and PreG C accumulate in the Golgi apparatus, and infected cells secrete virus particles lacking surface glycoproteins (Bergeron et al, 2007). (Papa et al (2002c(Papa et al ( ) 1948(Papa et al ( -2000 Khazakhstan 108 35 Hoogstraal (1979) and Yashina et al (2003Yashina et al ( ) 1943Yashina et al ( -2010 Tajikistan 237 16 Asia-2 IV; M2 Hoogstraal (1979), Seregin et al (2004) and Ergonul (2010Ergonul ( ) 1976Ergonul ( -2000 Pakistan 23 39 Asia-1 IV; M1; M2; Asia-IV Burney et al (1980) and Smego et al (2004Smego et al ( ) 2011 India 6 83 Asia-2 IV; M2; Asia-IV Yadav et al (2013) Suleiman et al (1980), Schwarz et al (1997) and Watts et al (1989Watts et al ( ) 1990 Saudi Arabia 7 0 El-Azazy and Scrimgeour (1997Scrimgeour ( ) 1995Scrimgeour ( -1997 Oman 4 Asia-1 IV; M1; Asia-IV Saluzzo et al (1985Saluzzo et al ( ) 1979Saluzzo et al ( -1980 Iraq 55 Saluzzo et al (1985) and Nabeth et al (2004aNabeth et al ( , 2004bNabeth et al ( ) 1983 Burkina Faso 1 0 Watts et al (1989Watts et al ( ) 1981Watts et al ( -1986 South Africa 32 31 S Africa/W Africa-III; M1; M2 Watts et al (1989) Elata et al (2011) N-linked glycosylation of G N is also essential for the final processing of both glycoproteins (Erickson et al, 2007). G N performs a chaperone-like function for G C , and must be present for correct folding to occur (Shi et al, 2012).…”

Exposure of Health Care Workers to Crimean-Congo Hemorrhagic Fever in Senegal: An Investigation of Two Imported Cases

“…Previous studies have described the use of ribavarin for the prevention and treatment of CCHF [11,12]. Ribavarin was not provided to any of the contacts in our study as the drug was not available in Senegal during our study period.…”

Biosafety standards for working with Crimean-Congo hemorrhagic fever virus

“…A more recent detailed literature review of nosocomial CCHF transmission to HCWs listed 44 infections in 494 HCW contacts in 12 countries (Tarantola et al, 2007). Nosocomial infections were reported from South Africa Shepherd et al, 1985;Vandewal et al, 1985;Vaneeden et al, 1985a, b), Mauretania (Nabeth et al, 2004), Sudan (Elata et al, 2011), Albania (Harxhi et al, 2005;Papa et al, 2001), Kosovo (Papa et al, 2002), Bulgaria (Kunchev & Kojouharova, 2008;Papa et al, 2004), Turkey (Celikbas et al, 2014;Gürbüz et al, 2009), Iran (Chinikar et al, 2013;Mardani et al, 2009;Naderi et al, 2013), Dubai (Suleiman et al, 1980), Pakistan (Burney et al, 1980;Hasan et al, 2013), India , Tajikistan (ProMED-mail, 2009b), Kazakhstan (ProMED-mail, 2009a) and Germany (Conger et al, 2015).…”