Emine PARLAK, Ayşe ERTÜRK, Zahide KOŞAN, Mehmet PARLAK, Zülal ÖZKURT

A nosocomial outbreak of Crimean-Congo hemorrhagic fever

Amaç: 2014 yılı Mayıs ayında hastanemizde nozokomiyal Kırım Kongo Kanamalı Ateşi (KKKA) salgını meydana geldi. İndeks vaka toksikasyon, karaciğer yetmezliği, dissemine intravasküler koagulasyon (DİK) ön tanıları ile yatırıldı. Çiftçilikle uğraşan hasta kanama belirtileri ile birkaç saat sonra öldü. Salgın Araştırması: İndeks vakanın serumundan çalışılan KKKA PCR’ı pozitif sonuçlandı. Tüm olgularda KKKA virüsü için RT-PCR ve / veya IgM serolojisi pozitif olarak rapor edildi. İndeks vaka ile doğrudan ve dolaylı teması olan altı sağlık çalışanı ve iki akrabasına hastalık bulaştı. Başlıca yakınmalar iştahsızlık, halsizlik, kas ağrısı, başağrısı, boğaz ağrısı ve döküntü idi. Makulopapüler döküntü beş vakada mevcut idi. Hastaların üçünde eksüdatif tonsilit vardı. Acil servis, dâhiliye yoğun bakım, radyoloji ünitesi, infeksiyon hastalıkları ve laboratuvar çalışanlarının indeks vaka ve/veya sekonder vakalarla teması oldu. Hastaların tamamına ribavirin tedavisi verildi. Sonuç: Bir hastane çalışanı KKKA nedeni ile kaybedildi. Bu sunum üniversal korunma önlemlerinin önemini vurgulamaktadır

Anahtar Kelimeler:

Kırım kongo kanamalı ateşi, nozokomiyal, salgın, korunma

A nosocomial outbreak of Crimean-Congo hemorrhagic fever

Objectives: An outbreak of nosocomial Crimean-Congo Hemorrhagic Fever (CCHF) occurred in a university hospital in May 2014. The index case was hospitalized with a preliminary diagnosis of intoxication, liver failure and disseminated intravascular coagulopathy (DIC). The index case, a farmer, died a few hours later with signs of bleeding. Outbreak Investigation: Crimean-Congo Hemorrhagic Fever Polymerase Chain Reaction (PCR) was positive in the index case serum. RT-PCR and/or IgM serology were reported as positive for CCHF virus in all cases. Six health care workers and two relatives in direct or indirect contact with the index case were infected. The main symptoms were myalgia, fatigue, headache, anorexia, sore throat and eruption. Maculopapular rash was observed in five cases. Three patients had exudative tonsillitis. Emergency workers and internal medicine intensive care, radiology and infectious disease personnel had a history of contact with index and/or secondary cases. Ribavirin was given to all patients. One health care worker died because of CCHF. Conclusion: A healthcare worker died due to nosocomial CCHF. This presentation emphasized importance of universal precautions.

Keywords:

Crimean-Congo hemorrhagic fever, nosocomial, outbreak, prevention,

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