Clinical and Epidemiologic Features of Crimean-Congo Hemorrhagic Fever Among Children and Adolescents From Southeastern Iran

Sharifi-Mood, Batool; Mardani, Masoud; Keshtkar-Jahromi, Maryam; Rahnavardi, Mohammad; Hatami, Hossein; Metanat, Maliheh

doi:10.1097/inf.0b013e3181673c28

Cited by 46 publications

(77 citation statements)

References 16 publications

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“…It is endemic in Africa, Asia, the Middle East, and in Eastern Europe, with a mortality rate of 40% to 70% (1,4). This disease is generally asymptomatic in infected animals and about 75% asymptomatic in humans, but it can be highly fatal in humans (3,4,6).…”

Section: Discussionmentioning

confidence: 99%

“…Today, CCHF is endemic in Africa, the Middle East, Eastern European countries, and Asian countries such as Iran, Turkey, Pakistan, and Afghanistan. Following infection by a tick bite, the incubation period is usually 1 to 3 days, with a maximum of 9 days, which it is longer than the patient has a contact with infected animal tissues (1,3,4). The onset of symptoms is uaually sudden, with fever, myalgia, neck and back pain, headache, sore throat, or nausea, vomiting, diarrhea, and abdominal pain.…”

Section: Introductionmentioning

confidence: 99%

“…CCHF can also transmit from the infected person to another person through contact with infectious body fluids, such as infected blood (1,(4)(5)(6)(7)(8). Transmission of CCHFV has been reported in hospitals because of improper sterilization of medical equipment, through needle sticks, and air among patients who have been hospitalized in the same wards.…”

Section: Introductionmentioning

confidence: 99%

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Report of a Family with Crimean-Congo Hemorrhagic Fever Following Contact with Frozen Meat: A Case Seires Study

Metanat¹,

Sharifi-Mood²,

Fathollahzadeh³

et al. 2017

Arch Clin Infect Dis

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Introduction: Crimean-Congo hemorrhagic fever (CCHF) is caused by a tick-borne virus in the family of Bunyaviridae. A hard tick, in the genus of Hyalomma, is a reservoir and also a vector for CCHF virus. Infection in humans usually occurs by infected tick bite or through contact with infected animal tissues and blood. CCHF can also transmit from one infected person to another through contact with infectious blood or body fluids. Human-to human transmission is also reported as a nosocomial infection. Case Presentation: Here, we presented 5 patients from a family with Crimean-Congo hemorrhagic fever, who got the illness at the same time when they cut the frozen meat together. Fortunately, all patients referred to hospital soon and received treatment during 24 to 72 hours after the first sign or symptom was presented. Conclusions: Frozen meat can transmit CCHFV to humans, which can be due to high viral load or a virus with high virulence in the infected animal tissues.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Report of a Family with Crimean-Congo Hemorrhagic Fever Following Contact with Frozen Meat: A Case Seires Study

Metanat¹,

Sharifi-Mood²,

Fathollahzadeh³

et al. 2017

Arch Clin Infect Dis

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“…Therefore, physicians need to reduce the complications, morbidity, and mortality using another effective treatment regimens. However, interferon has shown significant antiviral activity against hemorrhagic viruses, and the use of interferon and intravenous immunoglobulin in critically ill patients is recommended, but few studies have been done in this regard, and the results are still under consideration (9).…”

Section: Introductionmentioning

confidence: 99%

“…The virus causes severe disease in humans with a mortality rate near 80% and cases of nosocomial outbreaks have also been reported (8,9). The severe forms of the disease are associated with higher mortality and morbidity, and they are as follow: bleeding presentations, a sharp drop in platelets, decreased level of consciousness, low fibrinogen levels, and prolonged partial thromboplastin time (PTT), and those patients whose total of all mentioned parameters (Severity Scoring Index) equal to 10 or more (10).…”

Section: Introductionmentioning

confidence: 99%

Effects of Dexamethasone on Clinical Outcome in Patients with Severe Crimean-Congo Hemorrhagic Fever

et al. 2017

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Background: Crimean-Congo hemorrhagic fever (CCHF) is an acute viral hemorrhagic disease, and it is currently endemic in Southeastern Iran. The present study aimed at comparing the effect of ribavirin alone and in combination with dexamethasone on clinical outcome of patients with severe form of Crimean-Congo hemorrhagic fever. Methods: In this clinical trial study, we studied 30 patients with severe form of Crimean-Congo hemorrhagic fever (2 groups with 14 controls and 16 cases), who were admitted to Boo Ali hospital in Zahedan (Southeast of Iran) from July 2015 to April 2016. Patients were selected randomly for each group. The intervention group received dexamethasone and ribavirin, and the control group was treated only with ribavirin. Then, the rate of recovery, mortality rate, blood products used, and duration of hospitalization in both groups were recorded and compared. The distribution of samples and comparison of quantitative variables were evaluated by Kolmogorov Smirnov test, t test, and Man-Whitney test. The comparison of qualitative variables was performed by Chi-square and McNamara's test. Results: Of 30 patients, 24 (80%) and 6 (20%) were male and female, respectively. A few patients required transfusion of blood products in the intervention group compared to controls, but there was no statistically significant difference between the 2 groups (P < 0.05). The mean duration of hospitalization was 10.87 and 12 days in the intervention and control groups, respectively. No significant difference was obtained between the 2 groups in the duration of recovery (P < 0.05). No patients died in the intervention and control groups. Conclusions: It seems that high-dose dexamethasone is effective in the treatment of patients with severe form of CCHF. Blood products requirement for severe CCHF patients was reduced after receiving high-dose dexamethasone. Further investigations are necessary to determine the efficacy of corticosteroid and its effect on outcome.

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Ribavirin for treating Crimean Congo haemorrhagic fever

Johnson

Maayan

Mills

et al. 2018

Cochrane Database of Systematic Reviews

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BackgroundCrimean Congo haemorrhagic fever (CCHF) is a tick-borne disease that occurs in parts of Asia, Europe and Africa. Since 2000 the infection has caused epidemics in Turkey, Iran, Russia, Uganda and Pakistan. Good-quality general supportive medical care helps reduce mortality. There is uncertainty and controversy about treating CCHF with the antiviral drug ribavirin.ObjectivesTo assess the effects of ribavirin for treating people with Crimean Congo haemorrhagic fever.Search methodsWe searched the Cochrane Infectious Diseases Group Specialized Register; the Central Register of Controlled Trials (CENTRAL); MEDLINE (PubMed); Embase (OVID); Science Citation Index-Expanded, Social Sciences Citation index, conference proceedings (Web of Science); and CINAHL (EBSCOHost). We also searched the WHO International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov for trials in progress. We conducted all searches up to 16 October 2017. We also contacted experts in the field and obtained further studies from these sources.Selection criteriaWe evaluated studies assessing the use of ribavirin in people with suspected or confirmed Crimean Congo haemorrhagic fever. We included randomised control trials (RCTs); non-randomised studies (NRSs) that included more than 10 participants designed as cohort studies with comparators; and case-control studies.Data collection and analysisTwo review authors assessed eligibility, risk of bias, and extracted data. For non-randomized studies we used the ROBINS-I tool to assess risk of bias. The main effects analysis included all studies where we judged the risk of bias to be low, moderate or high. We summarized dichotomous outcomes using risk ratios (RRs) and continuous outcomes using mean differences (MDs), and used meta-analyses where appropriate. We carried out a subsidiary appraisal and analysis of studies with critical risk of bias for the primary outcome, as these are often cited to support using ribavirin.Main resultsFor the main effects analysis, five studies met our inclusion criteria: one RCT with 136 participants and four non-randomized studies with 612 participants. We excluded 18 non-randomized studies with critical risk of bias, where none had attempted to control for confounding.We do not know if ribavirin reduces mortality (1 RCT; RR 1.13, 95% confidence interval (CI) 0.29 to 4.32; 136 participants; very low-certainty evidence; 3 non-randomized studies; RR 0.72, 95% CI 0.41 to 1.28; 549 participants; very low-certainty evidence). We do not know if ribavirin reduces the length of stay in hospital (1 RCT: mean difference (MD) 0.70 days, 95% CI -0.39 to 1.79; 136 participants; and 1 non-randomized study: MD -0.80, 95% CI -2.70 to 1.10; 50 participants; very low-certainty evidence). We do not know if it reduces the risk of patients needing platelet transfusions (1 RCT: RR 1.23, 95% CI 0.77 to 1.96; 136 participants; very low-certainty evidence). For adverse effects (including haemolytic anaemia and a need to discontinue treatment), we do not know whether there is a...

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Clinical and Epidemiologic Features of Crimean-Congo Hemorrhagic Fever Among Children and Adolescents From Southeastern Iran

Cited by 46 publications

References 16 publications

Report of a Family with Crimean-Congo Hemorrhagic Fever Following Contact with Frozen Meat: A Case Seires Study

Report of a Family with Crimean-Congo Hemorrhagic Fever Following Contact with Frozen Meat: A Case Seires Study

Effects of Dexamethasone on Clinical Outcome in Patients with Severe Crimean-Congo Hemorrhagic Fever

Ribavirin for treating Crimean Congo haemorrhagic fever

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