Health Care Response to CCHF in US Soldier and Nosocomial Transmission to Health Care Providers, Germany, 2009

被引：64

作者：

Conger, Nicholas G. ^{[1
]}

Paolino, Kristopher M. ^{[2
]}

Osborn, Erik C. ^{[1
]}

Rusnak, Janice M. ^{[3
]}

Guenther, Stephan ^{[4
]}

Pool, Jane ^{[1
]}

Rollin, Pierre E. ^{[5
]}

Allan, Patrick F. ^{[1
]}

Schmidt-Chanasit, Jonas ^{[4
]}

Rieger, Toni ^{[4
]}

Kortepeter, Mark G. ^{[6
]}

机构：

[1] Landstuhl Reg Med Ctr, Landstuhl, Germany

[2] Walter Reed Army Inst Res, Silver Spring, MD USA

[3] Force Hlth Protect, Ft Detrick, MD USA

[4] Bernhard Nocht Inst Trop Med, D-20359 Hamburg, Germany

[5] Ctr Dis Control & Prevent, Atlanta, GA USA

[6] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA

来源：

EMERGING INFECTIOUS DISEASES | 2015年 / 21卷 / 01期

关键词：

CONGO HEMORRHAGIC-FEVER; SERUM-LEVELS; VIRAL LOAD; VIRUS; ACTIVATION; PATHOGENESIS; INTERFERON; PROGNOSIS; RIBAVIRIN; OUTBREAK;

D O I：

10.3201/eid2101.141413

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

In 2009, a lethal case of Crimean Congo hemorrhagic fever (CCHF), acquired by a US soldier in Afghanistan, was treated at a medical center in Germany and resulted in nosocomial transmission to 2 health care providers (HCPs). After his arrival at the medical center (day 6 of illness) by aeromedical evacuation, the patient required repetitive bronchoscopies to control severe pulmonary hemorrhage and renal and hepatic dialysis for hepatorenal failure. After showing clinical improvement, the patient died suddenly on day 11 of illness from cerebellar tonsil herniation caused by cerebral/cerebellar edema. The 2 infected HCPs were among 16 HCPs who received ribavirin postexposure prophylaxis. The infected HCPs had mild or no CCHF symptoms. Transmission may have occurred during bag-valve-mask ventilation, breaches in personal protective equipment during resuscitations, or bronchoscopies generating infectious aerosols. This case highlights the critical care and infection control challenges presented by severe CCHF cases, including the need for experience with ribavirin treatment and postexposure prophylaxis.

引用

页码：23 / 31

页数：9

共 40 条

[1] Imported Lassa Fever, Pennsylvania, USA, 2010 [J].