Crimean Congo hemorrhagic fever and diffuse alveolar haemorrhage

Doğancı, Levent; Ceyhan, Meltem; Tasdeler, Nuriye Fisgin; Sarikayalar, Hanife; Tülek, Necla

doi:10.1258/td.2008.070406

Cited by 18 publications

(15 citation statements)

References 8 publications

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“…About 40-60% of patients in this phase die. In most cases, multiorgan failure, DIC, and death as a result of shock occur 30,31 . Of 68 patients with CCHF (data were obtained for 46), 6 in our region died; data for 2 of these 6 patients were obtained.…”

Section: Resultsmentioning

confidence: 99%

Evaluation of patients with Crimean-Congo hemorrhagic fever in Bolu, Turkey

Duran¹,

Küçükbayrak²,

Ocak³

et al. 2013

Afr H. Sci.

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Background: Crimean-Congo hemorrhagic fever (CCHF), which is associated with a high mortality rate in the Black Sea region of Turkey, has received increasing attention. Objective: In this study, the epidemiological features, clinical and laboratory findings, treatments, and outcomes of patients diagnosed with CCHF between 2006 and 2012 based on data obtained from the Bolu Provincial Directorate of Health (BPDH) were evaluated. Methods: BPDH data were reviewed for the period between 1 January 2006 and 31 July 2012. The locations where the tick had attached to the patient, the site of the tick bite on the patient's body, the dates of tick bite and removal, and the demographic characteristics of each patient were recorded. BPDH data on the total number of tick bites, patients with confirmed CCHF, and deaths due to CCHF in Bolu Province during the study period were also evaluated. Results: A total of 46 patients with CCHF and 38 patients without CCHF but who had been bitten by ticks were admitted to the BPDH. Of the patients with CCHF, 54.3% were female. The mean age of the patients was 46.88 ± 2.05 years (range, 1-79 years). The mortality rate was 8.82%. Patients were predominantly observed in June and July. When the patients were distributed according to their occupations, the majority was houswife (48.6%), followed by animal husbandry worker (27.0%), farmer (10.8%), health worker (5.4%), and other (8.1%). The symptoms of the patients with CCHF included fatigue (60.9%), fever (60.9%), and myalgia (60.9%). Of those patients with CCHF, 41.3% were determined to have a high fever. Conclusions: The probability of developing CCHF decreased as the duration of tick attachment increased. Moreover, although the clinical presentation is important, it is not diagnostic. Physical examination and laboratory findings become more specific in later stages.

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Section: Resultsmentioning

confidence: 99%

Evaluation of patients with Crimean-Congo hemorrhagic fever in Bolu, Turkey

Duran¹,

Küçükbayrak²,

Ocak³

et al. 2013

Afr H. Sci.

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“…3,4,7,14 Acute respiratory distress syndrome (ARDS) and diffuse alveolar hemorrhage, accompanied by systemic inflammatory reaction, have been reported during hemorrhagic manifestations. 15,16 Pulmonary alveolar hemorrhage was observed in index case 2, which led to ARDS and death. Intubation of this patient in such a critical condition led to splashing of blood into a physician's face, which was the probable route for virus transmission.…”

Section: Discussionmentioning

confidence: 99%

“…Although alveolar hemorrhage would be a fatal manifestation of disease, rapid clinical recovery and radiologic clearance were obtained within a few days after starting oral ribavirin treatment in a study from Turkey. 16 Nosocomial transmission has been described in reports from Pakistan, Iraq, Dubai, South Africa, and Iran. 4,14,17 Transmission of CCHFV among healthcare workers has been reported in parallel with outbreaks in the general population.…”

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confidence: 99%

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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“…Ribavirin therapy was initiated with successful clinical and radiological results. Emphasis was placed on the contagious nature of the virus and the high-risk probability for nosocomial spread in bronchoscopes contaminated with patient blood [23].…”

Section: Evidencesmentioning

confidence: 99%

Crimean-Congo Hemorrhagic Fever: What Do We Know about Pulmonary Injury? A Compilation of Evidence

Leon-Roman¹

2017

Int J Respir Pulm Med

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Crimean Congo hemorrhagic fever and diffuse alveolar haemorrhage

Cited by 18 publications

References 8 publications

Evaluation of patients with Crimean-Congo hemorrhagic fever in Bolu, Turkey

Evaluation of patients with Crimean-Congo hemorrhagic fever in Bolu, Turkey

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

Crimean-Congo Hemorrhagic Fever: What Do We Know about Pulmonary Injury? A Compilation of Evidence

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