CRIMEAN CONGO HEMORRHAGIC FEVER IN HAZARA DIVISION
Abstract
Background: Crimean-Congo Hemorrhagic fever (CCHF) is endemic in certain areas of Pakistanwith 14 outbreaks in addition to many sporadic cases so far. It is highly fatal zoonotic disease causedby bite of infected tick. The objective of our study is to describe clinical features, treatment andoutcome of CCHF positive cases during its outbreak in Hazara division, with the intention to bringfocus to this fatal emerging disease. Methods: This study was conducted in Medical A Unit of AyubTeaching Hospital, Abbottabad for a period of three months. All patients presenting with fever andplatelet count less than 50,000/mm3 were included in the study. Apart from baseline investigationstheir blood samples were sent for the detection of CCHF virus. All patients were given supportivetreatment including fresh frozen plasma and were started on oral Ribavirin. All patients were isolatedand barrier personal precautions were observed by health care givers Results: Eighty-eight patientswith fever and thrombocytopenia were included. Among these, 8 were found to be positive forCCHF. Supportive treatment with oral Ribavirin was given to all patients. One patient with CCHFdied. One left against advice and six patients recovered completely. Conclusions: All patientspresenting with acute fever and thrombocytopenia should be suspected and evaluated for CCHF.Oral Ribavirin is safe and effective in the treatment of CCHF.Keywords: Crimean Congo Hemorrhagic fever, Pakistan, RibavirinReferences
Drosten C, Gottig S, Schilling S, Asper M, Panning M,
Schmitz H, et al. Rapid detection and quantification of RNA
of Ebola and Marburg Viruses, Lassa Virus, Crimean-Congo
Hemorrhagic fever virus, Rift Valley fever Virus, Dengue
virus and Yellow fever virus by Real- Time Reverse
Transcription-PCR. J Clin Microbiol 2002;40:2323–30.
Al-Tikriti SK, Al-Ani F, Jurji FJ, Tantawi H, Al-Moslih M,
Al-Janabi N, et al. Congo-Crimean haemorrhagic fever in
Iraq. Bull World Health Organ 1981;59(1):85–90.
Ergonul O, Celikbas A, Baykam N, Eren S, Dokuzoguz B.
Analysis of risk-factors among patients with Crimean-Congo
haemorrhagic fever virus infection: severity criteria revisited.
AMI clinical microbiology and infection. Clin Microbiol
Infect 2006;12:551–4.
Athar MN, Baqai HZ, Ahmad M, Khalid MA, Bashir N,
Ahmad AM, et al. Short report: Crimean-Congo
haemorrhagic fever outbreak in Rawalpindi, Pakistan,
February 2002. Am J Trop Med Hyg 2003;69:284–7.
Jamil B, Hasan RS, Sarwari AR, Burton J, Hewson R, Clegg
C. Crimean-Congo hemorrhagic fever: experience at a
tertiary care hospital in Karachi, Pakistan. Trans R Soc Trop
Med Hygi 2005;99:577–84.
Durrani AB, Shaikh M, Khan Z. Congo Crimean
hemorrhagic fever in Baluchistan. J Coll Physicians Surg Pak
;17:543–5.
Bosan AH, Asghar H, Dill AS, Kakar F, Toor Z, Altaf A, et
al. Crimean Congo hemorrhagic fever (CCHF) outbreak in
Karachi. Pak J Med Res 2002;41(1):36–8.
Waqar S, Tariq WZ. Crimean Congo Hemorrhagic fever
(CCHF) in Pakistan. Pak J Pathol 2006;17(2):74–84.
Ali N, Chotani RA, Anwar M, Nadeem M, Karamat KA,
Tariq WUZ. A Crimean- Congo Hemorrhagic fever outbreak
in Northern Baluchistan. J Coll Physicians Surg Pak
;17:477–81.
Sheikh NS, Sheikh AS, Sheikh AA. Knowledge, attitude and
practices regarding Crimean-Congo Hemorrhagic fever
among healthcare workers in Baluchistan. J Ayub Med Coll
Abbottabad 2004;16(3):39–42.
Ali A, Siddiqui S. Viral hemorrhagic fevers. A ICU
perspective. J Coll Physicians Surg Pak 2006;16:493–4.
Athar MN, Baqai HZ, Ahmad M, Khalid MA, Bashir N,
Ahmad AM, et al. Crimean-Congo Hemorrhagic fever
outbreak in Rawalpindi, Pakistan, February 2002: contact
tracing and risk assessment. Am J Trop Med Hyg
;72:471–3.
Nadeem M, Ali N, Anwar M, Hussain I, Mohammad T,
Hayee A. A comparison of clinical diagnosis and serological
diagnosis in an epidemic of Crimean Congo Hemorrhagic
fever. Pak J Med Sci 2003;19(4):247–52.
Sheikh SS, Sheikh AA, Sheikh NS, Tariq M. Ribavirin: an
effective treatment of Crimean Congo Hemorrhagic fever.
Pak J Med Sci 2004;20(3):201–6.
Published
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
