A nosocomial outbreak of Crimean-Congo hemorrhagic fever

Emine Parlak, Ayşe Ertürk, Zahide Koşan, Mehmet Parlak, Zülal Özkurt
1.639 618

Abstract


Objectives: 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. Conclusion: A healthcare worker died due to nosocomial CCHF. This presentation emphasized importance of universal precautions.

Keywords


Crimean-Congo hemorrhagic fever, nosocomial, outbreak, prevention

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DOI: http://dx.doi.org/10.5799/ahinjs.02.2015.01.0166

References


Fisher-Hoch SP. Lessons from nosocomial viral hemorrhagic fever outbreaks. Br Med Bull 2005;74:123-137.

Ftika L, Maltezou HC. Viral haemorrhagic fevers in healthcare settings. J Hosp Infect 2013;83:185-192.

Ergonul O. Crimean-Congo hemorrhagic fever virus: new out- breaks, new discoveries. Curr Opin Virol 2012;2:215-220.

Gürbüz Y, Sencan İ, Öztürk B, Tütüncü E. A case of nosoco- mial transmission of Crimean-Congo hemorrhagic fever from patient to patient. Int J Infect Dis. 2009;13:e105-e107.

Mardani M, Namazee N. Close contact precautions could pre- vent an outbreak of Crimean-Congo Hemorrhagic Fever: A case series report from southern part of Tehran. Int J Prev Med. Jun 2013;4:715-719.

Elata AT, Karsany MS, Elageb RM, et al. A nosocomial trans- mission of Crimean-Congo hemorrhagic fever to an attend- ing physician in North Kordufan, Sudan. Virol J 2011;8:303.

Naderi HR, Sarvghad MR, Bojdy A, et al. Nosocomial outbreak of Crimean-Congo haemorrhagic fever. Epidemiol Infect 2011;139:862-866.

Aradaib IE, Erickson BR, Mustafa ME, et al. Nosocomial out- break of Crimean-Congo hemorrhagic fever, Sudan. Emerg Infect Dis. 2010;16:837-839.

Mardani M, Rahnavardi M, Rajaeinejad M, et al. Crimean- Congo hemorrhagic fever among health care workers in Iran: a seroprevalence study in two endemic regions. Am J Trop Med Hyg 2007;76:443-445.

Harxhi A, Pilaca A, Delia Z, et al. Crimean-Congo Hemor- rhagic Fever: A case of nosocomial transmission. Infection 2005;33:295-296.

Celikbas AK, Dokuzoğuz B, Baykam N, et al. Crimean-Con- go Hemorrhagic Fever among health care workers, Turkey. Emerg Infec Dis 2014;20:477-479.

World Health Organization. Crimean-Congo haemorrhagic fever. Fact sheet 208. Geneva: World Health Organization; 2001. Available at: http://www.who.int/mediacentre/fact- sheets/fs208/

Burney MI, Ghafoor A, Saleen M, et al. Nosocomial outbreak of viral hemorrhagic fever caused by Crimean hemorrhagic fever-Congo virus in Pakistan, January 1976. Am J Trop Med Hyg 1980;29:941-947.

Hasan Z, Mahmood F, Jamil B, et al. Crimean-Congo Hemor- rhagic Fever nosocomial ınfection in a ımmunosuppressed patient, Pakistan: case report and virological ınvestigation. J Med Virol 2013;85:501-504.

Ascioglu S, Leblebicioglu H, Vahaboglu H, Chan KA. Riba- virin for patients with Crimean-Congo haemorrhagic fever: a systematic review and meta-analysis. J Antimicrob Che- mother 2011;66:1215-1222.

Tarantola A, Ergonul O, Tattevin P. Estimates and prevention of Crimean Congo hemorrhagic fever risks for health care workers. In: Ergonul O, Whitehouse CA. Dordrecht, eds. Crimean-Congo Hemorrhagic Fever: A Global Perspective. NL: Springer; 2007:281-294.