Frequency and Level of Exposure of Health Care Workers to Hospitalized Crimean-Congo Hemorrhagic Fever Cases and Their Management: A Descriptive Study from a Tertiary Care Hospital

Abstract

Background: Crimean-Congo hemorrhagic fever (CCHF) is a life threatening zoonotic infection. The virus is transmitted either by tick bite or through contact with infected blood or body fluid. Nosocomial transmission and outbreaks in health care is widely reported. Health care workers (HCWs) are at a higher risk of exposure to CCHF.
Methods: It is a descriptive study conducted from January 2015-September 2017 at Aga Khan University Hospital. The study aims to estimate the frequency of exposure of HCWs to confirm cases of CCHF and the efficacy of Ribavirin for prophylaxis use. Demographics, level of exposure, efficacy of Ribavirin prophylaxis and clinical outcome were studied.
Results: During January 2015 till September 2017, 9 cases of CCHF were admitted at our hospital. A total of 65 HCWs were exposed to CCHF cases amongst which there were 18 doctors, 33 nurses and 14 other supportive staff. Nine HCWs had a high-risk of exposure and were given Ribavirin prophylaxis. All of these exposures remained clinically asymptomatic for CCHF.
Conclusion: Hospitalized cases of CCHF virus pose a significant risk of exposure to HCWs which can be prevented by strict adherence to infection control practices. Although efficacy of Ribavirin for prophylaxis is not definitive and very little data exists on
its prophylactic use, but since none of our high-risk exposures developed symptomatic infection after Ribavirin prophylaxis,
our study supports its role in prevention.
Key words: CCHF; HCWs; Exposure; Ribavirin prophylaxis