unusual case of crimean congo hemorrhagic fever: prolonged bleeding with successful recovery

Crimean Congo Hemorrhagic Fever [CCHF] is a tick-borne viral disease with a major reservoir in both domestic and wild animals. In Pakistan, it is endemic largely in rural areas and most cases occur in spring and autumn. Recently, cases are being reported throughout the year, including winter months, with some even from urban areas. Death from CCHF is most likely to occur during the hemorrhagic phase. We report a case presenting from an urban locality in December. Clinical presentation was characterized by a prolonged hemorrhagic phase and a delayed normalization of platelet counts

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

Crimean-Congo hemorrhagic fever: case series from a medical center in Golestan province, Northeast of Iran (2004).

Crimean-Congo hemorrhagic fever (CCHF) is a widely distributed lethal disease, worldwide. Humans are usually infected with CCHF virus through a tick bite or close contact with viral contaminated tissues or with blood of domestic animals or of infected patients. The present study reports six cases of CCHF, who were in contact with both infected tissues and blood from sheep. In some regions like Golestan province (North of Iran), clinician suspicion may have an important role in early diagnosis and treatment of the disease. Conservative therapy (intensive monitoring) and prescription of antiviral medication (Ribavirin) accompanied with corticosteroids, was useful at the early stage of CCHF.

Ribavirin: an effective treatment of Crimean-Congo haemorrhagic fever

To determine the efficacy of Ribavirin, an anti-viral drug, in patients diagnosed to have CCHF. Design: A hospital-based prospective study. Place and Duration: The Department of pathology in collaboration with the Department of Medicine, Sandeman Provincial Teaching Hospital, Quetta, Balochistan, conducted this study from March 1st, 1998 to December 31st, 1999. Patients and A total of 94 cases were included in the study on high index of suspicion of CCHF. The major criteria of admission were a short history of high-grade fever associated with bleeding from more than one site, i.e., haematemesis, epistaxis etc. the mean age was 34.71+12.81 years. All the suspected cases were kept in isolation unit of the hospital and barrier nursing was advised. All the 94 cases were sent to CDC, Atlanta, USA for confirmation and 39 [41.4%] were confirmed to have CCHF. Symptomatic treatment like platelet concentrate transfusions, fresh-blood transfusions and antipyretics were given to all cases. Oral Ribavirin was given only to the confirmed cases. It was started in a dose of 2 gm initially, followed by 1 gm 6 hourly for 4 days and then 500 mg 8 hourly for 6 days. After a mean period of 2.30+0.69 days of treatment with Ribarivin, the clinical as well as the laboratory parameters started improving and returned to normal levels after 10 -day course of treatment. Mild anaemia and thrombocytosis were seen as adverse effects in some of the patients. Conclusions: For treatment of this fatal disease, we recommend use of oral Ribavirin in all patients diagnosed to have CCHF in the above-mentioned doses, on the basis of our study results