Crimean-Congo hemorrhagic fever: Experience at a tertiary care hospital in Karachi, Pakistan

Bushra Jamil, Rumina S. Hasan, Arif R. Sarwari, Jane Burton, Roger Hewson, Christopher Clegg

    Research output: Contribution to journalArticlepeer-review

    59 Citations (Scopus)

    Abstract

    Crimean-Congo hemorrhagic fever (CCHF) is endemic in certain rural areas of Pakistan. Since the discovery of CCHF virus (CCHFV) in the country in the 1960s, there have been 13 outbreaks in addition to sporadic cases. An outbreak during 2000 coincided with the movement of sacrificial animals from rural to urban areas for the festival of Eid-ul-Azha. Diagnosis was suspected in patients with fever and thrombocytopenia, and confirmed retrospectively using immunoassays and reverse transcriptase-PCR. Patients were given platelet, plasma and red cell infusions. Management varied due to unfamiliarity with the condition and its treatment, lack of availability of diagnostic laboratory tests and limited supply of ribavirin. Inadequate antiviral treatment and late presentation probably contributed to the death of six of the eight patients. Renal failure, disseminated intravascular coagulation and persistent high-grade fever were associated with mortality. The nucleotide sequence of the small genomic RNA segment of the CCHFV isolated in this outbreak was found to be very closely related to the CCHFV strains previously isolated in Pakistan.

    Original languageEnglish
    Pages (from-to)577-584
    Number of pages8
    JournalTransactions of the Royal Society of Tropical Medicine and Hygiene
    Volume99
    Issue number8
    DOIs
    Publication statusPublished - Aug 2005

    Keywords

    • Crimean-Congo hemorrhagic fever
    • Nucleotide sequence
    • Pakistan
    • Prognostic markers
    • Reverse transcriptase-PCR

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