Nosocomial outbreak of Crimean-Congo haemorrhagic fever

Naderi, HamidReza; Sarvghad, MohammadReza; Bojdy, Amin; Hadizadeh, Mohammad; Sadeghi, Reza; Sheybani, Fereshte

doi:10.1017/s0950268810002001

Cited by 42 publications

(44 citation statements)

References 8 publications

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“…One of the secondary cases in that report recalled a probable skin contact with the patient's blood while wearing a pair of perforated gloves. 11 Harxhi and others, 12 in an outbreak in Albania, concluded that the CCHF agent can be transmitted through apparently intact skin exposed to infected blood but, in the absence of skin defects or percutaneous injury with a contaminated device, exposure of mucous membranes through droplets or contaminated hands could have played a more important role.…”

Section: Discussionmentioning

confidence: 99%

Fatal Nosocomial Spread of Crimean-Congo Hemorrhagic Fever with Very Short Incubation Period

Naderi

Sheybani²,

Bojdi³

et al. 2013

The American Society of Tropical Medicine and Hygiene

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Abstract. Crimean-Congo hemorrhagic fever is a tick-borne viral zoonosis with the potential of human-to-human transmission with case fatality rates from 3% to 50%. The incubation period depends on host, route of infection, and viral dose. Herein, we report a nosocomial spread of the disease in a hospital at Mashhad, northeastern Iran, with a very short incubation period for one of the secondary cases. The patient was a medical student who had a negligible contact with a Crimean-Congo hemorrhagic fever patient during his admission to the hospital. The time interval between the contact and the onset of symptoms was merely 20 hours. Unfortunately, he died within 1 week of exposure.

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Section: Discussionmentioning

confidence: 99%

Fatal Nosocomial Spread of Crimean-Congo Hemorrhagic Fever with Very Short Incubation Period

Naderi

Sheybani²,

Bojdi³

et al. 2013

The American Society of Tropical Medicine and Hygiene

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“…[6][7][8][9] CCHF nosocomial transmission have been reported from various countries, including Pakistan, Dubai, North Africa, Iran and Turkey. 4,5,7,10,11 In general terms, during post-exposure prophylaxis, health care workers take ribavirin if they are exposed to the CCHF virus. 3,12 According to our knowledge this is the first nosocomial outbreak report due to CCHF virus in Turkey.…”

Section: Introductionmentioning

confidence: 99%

“…The use of N95 or FFP2 masks is imperative during procedures resulting in aerosol formation. 3,7 It should not be forgotten that the airborne path is one potential route of transmission.…”

mentioning

confidence: 99%

“…Ribavirin might help healing of clinical symptoms and enhances prognosis. 7,11 Early identification of such cases and adherence with universal precautions to prevent transmission of CCHF in hospitals is the most useful strategy. Medical workers should take all protective measures (including barrier nursing, isolation, and use of face shields or surgical masks, eye protection, and gloves) when handling infected patients, their blood, and other bodily fluids, or even when simply working in proximity to CCHF patients.…”

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confidence: 99%

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A nosocomial outbreak of Crimean-Congo hemorrhagic fever

Parlak¹,

Ertürk²,

Koşan³

et al. 2015

Journal of Microbiology and Infectious Diseases

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ABSCRACTObjectives: An outbreak of nosocomial Crimean-Congo Hemorrhagic Fever (CCHF) occurred in a university hospital in May 2014. The index case was hospitalized with a preliminary diagnosis of intoxication, liver failure and disseminated intravascular coagulopathy (DIC). The index case, a farmer, died a few hours later with signs of bleeding.Outbreak Investigation: Crimean-Congo Hemorrhagic Fever Polymerase Chain Reaction (PCR) was positive in the index case serum. RT-PCR and/or IgM serology were reported as positive for CCHF virus in all cases.Six health care workers and two relatives in direct or indirect contact with the index case were infected. The main symptoms were myalgia, fatigue, headache, anorexia, sore throat and eruption. Maculopapular rash was observed in five cases. Three patients had exudative tonsillitis. Emergency workers and internal medicine intensive care, radiology and infectious disease personnel had a history of contact with index and/or secondary cases. Ribavirin was given to all patients. One health care worker died because of CCHF. İndeks vaka ile doğrudan ve dolaylı teması olan altı sağlık çalışanı ve iki akrabasına hastalık bulaştı. Başlıca yakınmalar iştahsızlık, halsizlik, kas ağrısı, başağrısı, boğaz ağrısı ve döküntü idi. Makulopapüler döküntü beş vakada mevcut idi. Hastaların üçünde eksüdatif tonsilit vardı. Acil servis, dâhiliye yoğun bakım, radyoloji ünitesi, infeksiyon hastalıkları ve laboratuvar çalışanlarının indeks vaka ve/veya sekonder vakalarla teması oldu. Hastaların tamamına ribavirin tedavisi verildi. ConclusionSonuç: Bir hastane çalışanı KKKA nedeni ile kaybedildi. Bu sunum üniversal korunma önlemlerinin önemini vurgulamaktadır.Anahtar kelimeler: Kırım kongo kanamalı ateşi, nozokomiyal, salgın, korunma

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“…[9][10][11][12][13][14] Moreover, transmission may occur by respiratory contact. 1 We conducted a prospective contact tracing study to investigate the possibility of CCHFV transmission through respiratory contact, including droplet and airborne, and ungloved physical contact with the patient or objects around the patient.…”

mentioning

confidence: 99%

Investigation of Crimean-Congo Hemorrhagic Fever Virus Transmission from Patients to Relatives: A Prospective Contact Tracing Study

Gözel¹,

Bakır²,

Öztop³

et al. 2014

The American Society of Tropical Medicine and Hygiene

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Abstract. We investigated the possibility of transmission of Crimean-Congo hemorrhagic fever (CCHF) virus through respiratory and physical contact. In this prospective study, we traced 116 close relatives of confirmed CCHF cases who were in close contact with the patients during the acute phase of the infection and evaluated the type of contact between patients and their relatives. These relatives were followed for clinical signs or symptoms indicative of CCHF disease, blood samples of those with and without clinical signs were analyzed for CCHF virus immunoglobulin M and G (IgM and IgG, respectively) by enzyme-linked immunosorbent assay. No close relatives developed any signs or symptoms of CCHF and were negative for CCHF virus IgM and IgG. The results suggest that CCHF virus is not easily transmitted from person to person through respiratory or physical contact.Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease caused by CCHF virus (CCHFV), which belongs to the Bunyaviridae family, and Nairovirus genus.1,2 Human infections begin with nonspecific febrile symptoms but progress to a serious hemorrhagic disease. In severe cases, circulatory shock and disseminated intravascular coagulation may occur and result in death. [3][4][5][6] The fatality rate attributed to this infection is between 3% and 30%. 4,5,7,8 The CCHFV is generally transmitted to humans through the bite of Ixodid ticks or by contact with blood or tissue of infected livestock.3,5 Human-to-human transmission has been reported only by direct contact with viremic patients during the acute phase of infection. Needle stick injuries, gastrointestinal hemorrhage interventions, emergency surgical procedures, and unsafe handling of patients or their infected materials have been reported to be high-risk activities for CCHFV transmission; however, transmission through droplet, viral droplet, or physical contact has not been definitely tested.9-14 Moreover, transmission may occur by respiratory contact. 1 We conducted a prospective contact tracing study to investigate the possibility of CCHFV transmission through respiratory contact, including droplet and airborne, and ungloved physical contact with the patient or objects around the patient.This study was conducted at the Cumhuriyet University Hospital in Turkey, between June and September 2011. The CCHF patients were generally referred to our hospital 2-5 days after the initial onset of disease symptoms. This delay was primarily because of non-specific symptoms on the first several days of the infection. After confirmation of CCHF infection, the first degree relatives from the same household were identified and types of repeated contact between patients and their relatives were recorded. Some of these relatives were allowed to remain in the same hospital room as caregivers, because many patients and their relatives came from outside the city, had strong emotional ties and fear of death, and the relatives desired to be near the patients during what might be their last days; however, the use of prote...

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Nosocomial outbreak of Crimean-Congo haemorrhagic fever

Cited by 42 publications

References 8 publications

Fatal Nosocomial Spread of Crimean-Congo Hemorrhagic Fever with Very Short Incubation Period

Fatal Nosocomial Spread of Crimean-Congo Hemorrhagic Fever with Very Short Incubation Period

A nosocomial outbreak of Crimean-Congo hemorrhagic fever

Investigation of Crimean-Congo Hemorrhagic Fever Virus Transmission from Patients to Relatives: A Prospective Contact Tracing Study

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