Epidemiological Profile of Crimean Congo Hemorrhagic Fever (CCHF) Cases at a Tertiary Care Hospital Quetta, Pakistan

Abstract

Introduction: Crimean Congo hemorrhagic fever (CCHF) is a severe hemorrhagic disease caused by a tick-borne virus transmitted to humans through the bite of infected ticks or by direct contact with viremic animals or humans. It is the second most widespread arbovirus of medical importance after Dengue. The objective of this study was to assess the epidemiological profile of CCHF cases at a tertiary care hospital in Quetta, Pakistan from the year 2015 to 2020.

Methods: A cross-section study was conducted among 187 positive cases at the CCHF isolation ward of a tertiary care public hospital at Quetta between the years 2015-20 using the convenient sampling technique after the ethical clearance. Hospital was visited regularly to do active surveillance, review patients’ records along with personal interviews with patients, doctors, nurses, and the medical superintendent of the hospital. Active contact tracing was undertaken among family, friends, and ward staff. Descriptive analysis of the data was done. The data collected through this study was compiled and analyzed in Epi Info® version 7.0.

Results: Out of a total of 480 suspected CCHF cases, Polymerase Chain Reaction (PCR) of 73% (n=349) cases resulted in 52% CCHF positive with a Case Fatality Rate(CFR) of 25%. Cases were mostly reported from various districts of Balochistan province, Pakistan (83%). The majority of the cases (84%) were males with a mean age of 33 years.

Conclusions: Animal contact was the most probable cause of the outbreak. Regulations of slaughterhouses and private slaughtering of animals by the municipality and district government through one health approach were recommended along with PCR laboratory services and other latest equipment at the Isolation ward urgently.