Tahir Shahzad  ( Memon Medical Institute Hospital (MMIH) )

Madam, I find it necessary and vital to share with you a case of Crimean-Congo haemorrhagic fever (CCHF)proven on PCR who came from Aga Khan University Hospital after leaving against medical advice to the Memon Medical Institute Hospital’s Emergency Room on 5th June 2018. CCHF is a life threatening haemorrhagic tick-borne viral disease with a mortality rate of up to 40% ¹. CCHF is a highly contagious disease and can spread from person to person through contact with bodily fluids, blood and fomites and may also cause nosocomial outbreaks if recommended precautions are not followed. One of our doctor from the team examined the patient without acquiring recommended contact precautions including gloves, gown, face mask, face shield and eye protection which are all part of personal protective equipment (PPE)², also the attendants were unaware about the contact precaution measures that must be taken to avoid spread from human to human. There are several cases reported regarding spread of CCHF within close contacts of the index patient resulting in fatal outcomes³. To avoid nosocomial spread patient must be kept in isolation and recommended precaution techniques must be followed. I found several loop holes in the above-mentioned scenario including lack of proper counselling of the attendants regarding severity and fatality of the disease in case of spread within close contacts and recommended contact precautions. Also, every health care worker must use Personal Protective Equipment as recommended by the U.S Centers for Disease control (CDC) while dealing with such types of highly contagious and fatal diseases. Since we are a part of area in which CCHF is endemic according to WHO¹, our hospitals must have a proper isolation ward and quarantine.

Disclaimer: None.
Conflict of Interest: None.
Funding Sources: None.

References

1. World Health Organization. Crimean-Congo haemorrhagic fever. [Online] 2018 [Cited 2018 June 6]. Available from: URL:
http://www.who.int/news-room/fact-sheets/detail/crimeancongo-haemorrhagic-fever
2. Gozel GM, Dokmetas I, Oztop AY, Engin A, Elaldi N, Bakir M. Recommended precaution procedures protect healthcare workers from Crimean-Congo hemorrhagic fever virus. Int J Infect Dis 2013; 17: e1046-50
3. Mardani M, Namazee N. Close contact precautions could prevent an outbreak of crimean-congo hemorrhagic Fever: a case series report from southern part of tehran. Int J Prev Med 2013; 4: 715-9.