Unusual nosocomial transmission of Crimean-Congo haemorrhagic fever; two cases report from Turkey
Abstract number: R2342
Tulek N., Bulut C., Ergin F., Tuncer Ertem G., Ataman Hatipoglu C., Oral B.
Objectives: Crimean Congo Hemorrhagic Fever (CCHF) is a severe hemorrhagic fever caused by a Nairovirus, belonging to the family Bunyaviridae. In the spread of this zoonosis to humans, the main role is that of ticks; however, transmission is also possible via blood, tissue and bodily fluids of infected people or animals. Nosocomial transmission is also possible and, health care workers are one of the major risk groups for CCHF virus acquisition especially when caring for patients with hemorrhages from different body sites. In this paper we are reporting CCHF in two health care workers whose did not have any contact to blood or body fluids of a patient.
Case 1: 30 years old and pregnant nurse (ten weeks) admitted to our clinic with sudden onset high fever, myalgia, arthralgia and fatigue. She was caring the patients with CCHF in our clinic. Four days ago, in her shift, one patient died because of CCHF, the patient had respiratory symptoms and renal insufficiency. Although we don't have negative-pressure room, all the patients had to be isolated in a private room, and all healthcare workers are using barrier-nursing techniques that include disposable gloves, masks and goggles and hand-washing or use of alcohol based desenfectans are the main way of protection. We isolated the nurse and sent serum samples to the national reference laboratory for CCHF tests. Next day she was diagnosed as CCHF with positive PCR and with her informed consent, ribavirin treatment was given. On the following days, fever was continued and alanine aminotransferase, lactat dehydrogenase, creatine phosphokinase levels were increased. After five days, clinical and laboratory findings improved and she discharged with a medical abortus decision.
Case 2: 26 years old, male resident admitted to our clinic with the same complaint after two days of nurse's admission. He had cared the same patient on same day with the nurse. He was diagnosed CCHF with laboratory RT-PCR test. He had been taking the oral ribavirin with a decision of himself and we continued the therapy. His symptoms began to resolve in third day and he discharged from hospital.
The only history of their contacts to inside the patient's room without mask once or twice.
Conclusion: Although the main way of transmission of CCHF to health care workers is close contact to blood and other body fluids, transmission with aerosol or air droplets may be possible.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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