Crimean–Congo hemorrhagic fever: a first case from Abbottabad, Pakistan

Saleem, Junaid; Usman, Muhammad; Ahmad, Naveed; Sethi, Shakeel Afzal; Salman, Muhammad

doi:10.1016/j.ijid.2008.07.023

Cited by 29 publications

(29 citation statements)

References 16 publications

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“…25 Human-to-human transmission occurs by infected blood or secretions but airborne transmission of the disease has not been documented. 8 All three of our nosocomial cases were involved in high-risk procedures such as inserting nasogastric and endotracheal tubes, with splashing of blood into their faces, percutaneous contact with patients' blood (intact skin), and cutaneous contact with non-sanguineous body fluids. These findings support the use of contact and droplet isolation as precautions for prevention of transmission.…”

Section: Discussionmentioning

confidence: 99%

“…9 Prophylaxis is suggested after high-risk contamination. 8 In our experience, ribavirin is potentially useful and should therefore be recommended for healthcare workers who are at risk of exposure, such as by percutaneous injuries. None of our cases received prophylaxis.…”

Section: T Able 1 Laboratory Findings Of Three Nosocomial Cases Of Crmentioning

confidence: 94%

“…8 We describe the manifestations and outcomes in three confirmed cases of CCHF in healthcare workers in Iran. The risk factors and routes of transmission in a hospital setting are discussed.…”

mentioning

confidence: 99%

“…[3][4][5][6][7] Human-to-human transmission occurs by infected blood or secretions, but airborne transmission of the disease has not been documented. 8 We describe the manifestations and outcomes in three confirmed cases of CCHF in healthcare workers in Iran. The risk factors and routes of transmission in a hospital setting are discussed.…”

mentioning

confidence: 99%

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Crimean-Congo Hemorrhagic Fever Virus as a Nosocomial Pathogen in Iran

Mardani¹,

Keshtkar-Jahromi²,

Ataie³

et al. 2009

The American Journal of Tropical Medicine and Hygiene

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Abstract. Crimean-Congo hemorrhagic fever (CCHF) is a viral disease with several different modes of transmission. We describe the manifestations, outcome, and likely modes of transmission for three nosocomial cases. All threee cases were healthcare workers (two men and one woman). They had fever, myalgia, and petechia. Disseminated intravascular coagulation resulted in the death occurred in the woman. Because this disease is manifested with non-specific influenzalike symptoms, diagnosis can be difficult. Data for these patients can be used to investigate airborne or sexual transmission of this virus, although neither route was substantiated for these patients. Use of universal precautions and early case detection are the most helpful strategy for preventing nosocomial transmission of CCHF.Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral disease that has been reported in more than 30 countries in Africa, Asia, southeastern Europe, and the Middle East.1 It was first described in the Crimea in 1944. Later, a virus isolated from the Congo was identified as the same virus, resulting in the name Crimean-Congo hemorrhagic fever virus (CCHFV).2 Infection with CCHFV is manifested as an acute viral disease (fever, myalgia, and arthralgia) and in severe cases, hemorrhagic manifestations may ensue. It is transmitted mainly through tick bite or animal contact but repeatedly has caused nosocomial outbreaks.3-7 Human-to-human transmission occurs by infected blood or secretions, but airborne transmission of the disease has not been documented. 8 We describe the manifestations and outcomes in three confirmed cases of CCHF in healthcare workers in Iran. The risk factors and routes of transmission in a hospital setting are discussed. INDEX CASE 1On August 2, 1999, a 55-year-old man (a shepherd) was referred to the emergency room of a hospital with hematemesis. He had a history of animal contact. Epistaxis developed after a nasogastric tube was inserted in an attempt to control gastrointestinal (GI) bleeding. Unfortunately, he died of intractable GI bleeding and disseminated intravascular coagulation (DIC) four days later. SECONDARY CASE 1On August 16, 1999, a 32 -year -old man (a physician) came to a clinic in Shahrekord in central Iran with severe headache, malaise, fever, vomiting, and diarrhea for one week. Petechiae, epistaxis and gum bleeding then developed, which resulted in his referral to the clinic. He was admitted to a hospital and treated with broad-spectrum antibiotics. There was no history of recent travel or contact with domestic animals. It was later discovered that he had been in contact with index case 1, who had died of severe GI bleeding two weeks before his first symptoms. The index case had coughed and splashed blood on the physician's face while he was trying to insert a nasogastric tube. Physical examination showed right cervical lymphadenopathy and a palpable spleen, but the patient was not febrile. Laboratory examinations showed leukopenia, thrombocytopenia, increased levels of aminotransferase...

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Section: Discussionmentioning

confidence: 99%

Section: T Able 1 Laboratory Findings Of Three Nosocomial Cases Of Crmentioning

confidence: 94%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Crimean-Congo Hemorrhagic Fever Virus as a Nosocomial Pathogen in Iran

Mardani¹,

Keshtkar-Jahromi²,

Ataie³

et al. 2009

The American Journal of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

show abstract

“…CCHF is a zoonosis (by wild and domestic animals) and widespread tick-borne(genus Hyalommafamily: Ixodidae). Due to vertical or transovarian transmission of hereditary has been preserve in the life cycle ticks, which helps keep to the viral reservoir in arthropod [2]. CCHF can cause severe infection in humans with a fatality rate of up to 25%-30%.…”

Section: Introductionmentioning

confidence: 99%

Crimean-Congo Hemorrhagic Fever: Report of Three Cases from Iran

Jamshidi¹,

Daneshi²,

Parad³

2017

J Infect Dis Ther

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Introduction: Crimean-Congo Haemorrhagic Fever (CCHF) is a viral haemorrhagic fever caused by RNA virus (Nairovirus -family: Bunyaviridae). CCHF can cause severe infection in humans with a fatality rate of up to 25%-30%. Typically sings are headache, agitation, high fever, mood instability, muscular pain, thrombocytopenia, leukopenia, leukocytosis, nosebleeds and black stools with 1-7 days' incubation period.

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Crimean–Congo hemorrhagic fever nosocomial infection in a immunosuppressed patient, Pakistan: Case report and virological investigation

Hasan

Mahmood

Jamil

et al. 2012

Journal of Medical Virology

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Crimean-Congo hemorrhagic fever (CCHF) is endemic in the Baluchistan province, Pakistan. Sporadic outbreaks of CCHF occur throughout the year especially in individuals in contact with infected livestock. Nosocomial transmission remains a risk due to difficulties in the diagnosis of CCHF and limited availability of facilities for the isolation of suspected patients. Rapid diagnosis of CCHF virus infection is required for early management of the disease and to prevent transmission. This study describes the case of a 43-year-old surgeon who contracted CCHF during a surgical procedure in Quetta, Baluchistan and who was transferred to a tertiary care facility at the Aga Khan University Hospital, Karachi within 1 week of contracting the infection. Diagnosis of CCHF was made using a rapid real-time reverse transcription polymerase chain reaction (RT-PCR) assay for CCHF viral RNA. The patient had chronic hepatitis B and hepatitis D infection for which he had previously received a liver transplant. He proceeded to develop classic hemorrhagic manifestations and succumbed to the infection 14 days post-onset of disease. There was no further nosocomial transmission of the CCHF during the hospital treatment of the surgeon. Early diagnosis of CCHF enables rapid engagement of appropriate isolation, barrier nursing and infection control measures thus preventing nosocomial transmission of the virus.

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Crimean–Congo hemorrhagic fever: a first case from Abbottabad, Pakistan

Cited by 29 publications

References 16 publications

Crimean-Congo Hemorrhagic Fever Virus as a Nosocomial Pathogen in Iran

Crimean-Congo Hemorrhagic Fever Virus as a Nosocomial Pathogen in Iran

Crimean-Congo Hemorrhagic Fever: Report of Three Cases from Iran

Crimean–Congo hemorrhagic fever nosocomial infection in a immunosuppressed patient, Pakistan: Case report and virological investigation

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