Close contact precautions could prevent an outbreak of Crimean-Congo hemorrhagic fever: a case series report from southern part of Tehran

Between the end of June and the middle of July 2011, an outbreak of CCHF occurred in southern part of Tehran, Iran. This study reports clinical, laboratory findings and outcome of six cases, who were all consanguine. Index case who was livestock-worker died with hemorrhagic manifestations; thereafter his pregnant wife, three brothers, mother-in-law and his pregnant sister-in-law were admitted and except for the latter, ribavirin was administered. The brother with close contact with body fluids and blood of index case, died with hemorrhage. Low platelet, high aminotransferases and elevated PT, PTT were detected in this case. Skin manifestations were present in five cases. Only in one case RT-PCR and IgM serology were reported as positive for CCHF virus by reference laboratory. In endemic areas, high index of suspicion should be kept in mind in successfully finding and treating cases in early phase of the disease

Crimean-Congo haemorrhagic fever outbreak investigation in the Western Region of Afghanistan in 2008

Crimean-Congo haemorrhagic fever [CCHF] is a life-threatening viral haemorrhagic fever. This paper reports on the first multifocal outbreak recorded in the Afghanistan. The outbreak was detected in 2008 in the Western Region of the country and 30 cases [17 males and 13 females] were detected between 10 July and 22 October 2008. Standard case definitions based on World Health Organization sources were used. Most of the cases [27] occurred in Herat province; 25 were aged between 18-55,1 was > 55 years and 4 were12-18 years [median age was 27 years]. The case fatality rate was 33%; 41% among males and 23% among females [P - 0.29]. Significantly more patients infected by contact with meat and body fluids died that those whose contact was through animal husbandry or ticks [P = 0.0048]. Of the 30 cases, 33 close contacts were traced; 3 were positive for CCHF IgM with no symptomatic evidence of the disease

A Q fever case mimicking crimean-congo haemorrhagic fever.

Coxiella burnetii is the bacterium that causes Q fever. Human infection is mainly transmitted from cattle, goats and sheep. The disease is usually self-limited. Pneumonia and hepatitis are the most common clinical manifestations. In this study, we present a case of Q fever from the western part of Turkey mimicking Crimean-Congo haemorrhagic fever (CCHF) in terms of clinical and laboratory findings.

CCHF in Iraq

The Ministry of Health in Iraq has reported a total of 18 suspected cases of Crimean-Congo hemorrhagic fever [CCHF] since 1 May 2010 from Mosul of Ninawa Governorate. Nine [9] of the cases were laboratory confirmed, and there were 3 related deaths. The cases were confirmed at the Central Public Health Laboratory in Baghdad. The last confirmed case was reported on 5 July 2010. The MOH with support from WHO Country Office has taken appropriate public health measures that included strengthening of surveillance, case investigations, case management and health education to contain and prevent further spread of the outbreak

outcome of patients with crimean-congo hemorrhagic fever in Zahedan, southeast of Iran: a comparative study

Crimean-Congo hemorrhagic fever was rarely reported from Iran before 1999. In a recent outbreak, the disease has been reported from different provinces of Iran, especially from Sistan and Baluchestan. Ribavirin has been recommended by World Health Organization as a potential therapeutic modality for Crimean-Congo hemorrhagic fever. This study was conducted to determine the clinical outcome and the effect of ribavirin in two groups of patients with Crimean-Congo hemorrhagic fever who were treated at different times. In this cross-sectional study, we evaluated patients with Crimean-Congo hemorrhagic fever who were admitted to Boo-Ali Hospital in Zahedan, a subtropical area in southeastern Iran, at the first three years after beginning of the last outbreak [1999 - 2003] and those who were admitted during 2005 - 2007. First, we found all patients with confirmed Crimean-Congo hemorrhagic fever infection who were treated with oral ribavirin. Then, they were evaluated for recovery and mortality rate. We evaluated 123 patients with confirmed Crimean-Congo hemorrhagic fever infection [91 patients treated between 1999 and 2003, and 32 patients between 2005 and 2007]. Among the 91 patients, 73 [80%] survived, and 18 [20%] died of the disease. During 2005 - 2007, among the 32 patients who were treated within three days of onset of the disease, only one [3%] died of the disease. The recovery rate was higher among patients who were admitted during 2005 - 2007 than those hospitalized between 1999 and 2003 [97% vs. 80%]. There was a significant [P=0.001] difference in the mortality rate between the two groups. Prompt treatment with oral ribavirin can increase the recovery rate in patients with Crimean-Congo hemorrhagic fever

CCHF in Afghanistan

On 11 August 2008, a suspected case of haemorrhagic fever was admitted at the regional hospital of Herat province in Afghanistan. The case, a married woman of 33 years, was admitted with high fever, headache, vomiting and epistaxis. The patient was, later, laboratory confirmed as suffering from Crimean Congo haemorrhagic fever [CCHF]. The family of the patient has cows, goats and sheep in their house, and the patient had a history of slaughtering sheep and coming in contact with blood and meat of the slaughtered sheep. The patient has recovered and no more cases were reported from the area

Seroepidemiology of Crimean-Congo hemorrhagic fever in the local and imported sheep in Isfahan province, Iran, 2002

Crimean-Congo hemorrhagic fever [CCHF] is an arboviral zoonotic infection with several reported cases in Iran. The present study was conducted with the aim of establishing effective ways to reduce exposure to the infectious agent and to organize appropriate policies for importing animals. Materials and methods: For this cross sectional study, 372 local and 372 imported sheep were randomly selected and the presence of CCHF-related 1gG antibody and tick on their body were investigated. Totally, 286 [76.9%] of local and 223 [57.8%] of imported sheep were seropositive, however, their difference did not reach a statistical significant level. Ticks were found on the body surface of 115 [31%] local sheep, but imported sheep lacked any tick on their body. Our results revealed the endemic spreading of CCHF in sheep in Isfahan province. Further studies in other parts of Iran may pave the way for better understanding of the CCHF epidemiology in Iran. Keywords: Crimean-Congo hemorrhagic fever, sheep, Iran

Sero-epidemiological study of crimean-congo hemorrhagic fever [CCHF] during 36 months.

Laboratory diagnosis of CCHF by complement fixation test [CFT] was used in 441 human blood samples from 18 provinces of Iraq during the period of 36 months. 102 samples were taken from patients provisionally diagnosed as CCHF while the other number of samples were taken from the contact persons. 54 samples were positive[55%]and 365 animals blood samples were examined from different province the number of positive samples cases was 39 samples. [10.6%] Antamologic study revealed that hyalemma anatollucum, antolicum was the vector. The age incidence range from 15-40 year, no significant difference between male and female, the peak seasonal incidence was in June up to September, no pediatric cases were detected. No positive sample among the contacts [close contact to the patient]. This study disclosed the laboratory diagnosis using serological test, CFT may help in reaching the clinical diagnosis of CCHF of can be used as a good epidemiological tool and as screening test to detect the prevalence of antibodies among the clinical cases and the contact