• Saqib Malik
  • Inayat Ullah Diju
  • Farhat Naz


Background: Crimean-Congo Hemorrhagic fever (CCHF) is endemic in certain areas of Pakistanwith 14 outbreaks in addition to many sporadic cases so far. It is highly fatal zoonotic disease causedby bite of infected tick. The objective of our study is to describe clinical features, treatment andoutcome of CCHF positive cases during its outbreak in Hazara division, with the intention to bringfocus to this fatal emerging disease. Methods: This study was conducted in Medical A Unit of AyubTeaching Hospital, Abbottabad for a period of three months. All patients presenting with fever andplatelet count less than 50,000/mm3 were included in the study. Apart from baseline investigationstheir blood samples were sent for the detection of CCHF virus. All patients were given supportivetreatment including fresh frozen plasma and were started on oral Ribavirin. All patients were isolatedand barrier personal precautions were observed by health care givers Results: Eighty-eight patientswith fever and thrombocytopenia were included. Among these, 8 were found to be positive forCCHF. Supportive treatment with oral Ribavirin was given to all patients. One patient with CCHFdied. One left against advice and six patients recovered completely. Conclusions: All patientspresenting with acute fever and thrombocytopenia should be suspected and evaluated for CCHF.Oral Ribavirin is safe and effective in the treatment of CCHF.Keywords: Crimean Congo Hemorrhagic fever, Pakistan, Ribavirin


Drosten C, Gottig S, Schilling S, Asper M, Panning M,

Schmitz H, et al. Rapid detection and quantification of RNA

of Ebola and Marburg Viruses, Lassa Virus, Crimean-Congo

Hemorrhagic fever virus, Rift Valley fever Virus, Dengue

virus and Yellow fever virus by Real- Time Reverse

Transcription-PCR. J Clin Microbiol 2002;40:2323–30.

Al-Tikriti SK, Al-Ani F, Jurji FJ, Tantawi H, Al-Moslih M,

Al-Janabi N, et al. Congo-Crimean haemorrhagic fever in

Iraq. Bull World Health Organ 1981;59(1):85–90.

Ergonul O, Celikbas A, Baykam N, Eren S, Dokuzoguz B.

Analysis of risk-factors among patients with Crimean-Congo

haemorrhagic fever virus infection: severity criteria revisited.

AMI clinical microbiology and infection. Clin Microbiol

Infect 2006;12:551–4.

Athar MN, Baqai HZ, Ahmad M, Khalid MA, Bashir N,

Ahmad AM, et al. Short report: Crimean-Congo

haemorrhagic fever outbreak in Rawalpindi, Pakistan,

February 2002. Am J Trop Med Hyg 2003;69:284–7.

Jamil B, Hasan RS, Sarwari AR, Burton J, Hewson R, Clegg

C. Crimean-Congo hemorrhagic fever: experience at a

tertiary care hospital in Karachi, Pakistan. Trans R Soc Trop

Med Hygi 2005;99:577–84.

Durrani AB, Shaikh M, Khan Z. Congo Crimean

hemorrhagic fever in Baluchistan. J Coll Physicians Surg Pak


Bosan AH, Asghar H, Dill AS, Kakar F, Toor Z, Altaf A, et

al. Crimean Congo hemorrhagic fever (CCHF) outbreak in

Karachi. Pak J Med Res 2002;41(1):36–8.

Waqar S, Tariq WZ. Crimean Congo Hemorrhagic fever

(CCHF) in Pakistan. Pak J Pathol 2006;17(2):74–84.

Ali N, Chotani RA, Anwar M, Nadeem M, Karamat KA,

Tariq WUZ. A Crimean- Congo Hemorrhagic fever outbreak

in Northern Baluchistan. J Coll Physicians Surg Pak


Sheikh NS, Sheikh AS, Sheikh AA. Knowledge, attitude and

practices regarding Crimean-Congo Hemorrhagic fever

among healthcare workers in Baluchistan. J Ayub Med Coll

Abbottabad 2004;16(3):39–42.

Ali A, Siddiqui S. Viral hemorrhagic fevers. A ICU

perspective. J Coll Physicians Surg Pak 2006;16:493–4.

Athar MN, Baqai HZ, Ahmad M, Khalid MA, Bashir N,

Ahmad AM, et al. Crimean-Congo Hemorrhagic fever

outbreak in Rawalpindi, Pakistan, February 2002: contact

tracing and risk assessment. Am J Trop Med Hyg


Nadeem M, Ali N, Anwar M, Hussain I, Mohammad T,

Hayee A. A comparison of clinical diagnosis and serological

diagnosis in an epidemic of Crimean Congo Hemorrhagic

fever. Pak J Med Sci 2003;19(4):247–52.

Sheikh SS, Sheikh AA, Sheikh NS, Tariq M. Ribavirin: an

effective treatment of Crimean Congo Hemorrhagic fever.

Pak J Med Sci 2004;20(3):201–6.



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