Health care response to CCHF in US soldier and nosocomial transmission to health care providers, Germany, 2009

Nicholas G. Conger, Kristopher M. Paolino, Erik C. Osborn, Janice M. Rusnak, Stephan Günther, Jane Pool, Pierre E. Rollin, Patrick F. Allan, Jonas Schmidt-Chanasit, Toni Rieger, Mark G. Kortepeter

Research output: Contribution to journalArticle

46 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)23-31
Number of pages9
JournalEmerging infectious diseases
Volume21
Issue number1
DOIs
StatePublished - 2015

ASJC Scopus subject areas

  • Epidemiology
  • Microbiology (medical)
  • Infectious Diseases

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    Conger, N. G., Paolino, K. M., Osborn, E. C., Rusnak, J. M., Günther, S., Pool, J., Rollin, P. E., Allan, P. F., Schmidt-Chanasit, J., Rieger, T., & Kortepeter, M. G. (2015). Health care response to CCHF in US soldier and nosocomial transmission to health care providers, Germany, 2009. Emerging infectious diseases, 21(1), 23-31. https://doi.org/10.3201/eid2101.141413