Volume 76, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


Crimean-Congo hemorrhagic fever (CCHF) has repeatedly caused nosocomial outbreaks among hospital staff. In the summer of 2003, we studied the seroprevalence of anti-CCHF IgG among health care workers who had come in contact with Crimean-Congo hemorrhagic fever patients from three referral hospitals in endemic regions of Iran. A total of 223 eligible staff were examined. Whereas 5 of 129 (3.87%) exposed health care workers tested positive, none of the 94 in the unexposed group did ( = 0.075). Seropositivity was more frequent among those whose intact skin had come in contact with nonsanguineous body fluids (9.52%) and those who had had percutaneous contacts (7.14%). Health care workers exposed to Crimean-Congo hemorrhagic fever patients, those who live in Systan-Baluchestan province, and older health care workers were more prone to seropositivity. Where introduction of high-risk modes of contact cannot be confined, we propose that health care workers take all the protective measures when handling Crimean-Congo hemorrhagic fever patients, particularly their blood and other body fluids.


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  1. Hoogstraal H, 1979. The epidemiology of tick borne Crimean-Congo haemorrhagic fever in Asia, Europe and Africa. J Med Entomol 15 : 307–417. [Google Scholar]
  2. Ergonul O, 2006. Crimean-Congo haemorrhagic fever. Lancet Infect Dis 6 : 203–214. [Google Scholar]
  3. Burney MI, Ghafoor A, Saleen M, Webb PA, Casals J, 1980. Nosocomial outbreak of viral hemorrhagic fever caused by Crimean Hemorrhagic fever-Congo virus in Pakistan, January 1976. Am J Trop Med Hyg 29 : 941–947. [Google Scholar]
  4. van Eeden PJ, Joubert JR, van de Wal BW, King JB, de Kock A, Groenewald JH, 1985. A nosocomial outbreak of Crimean-Congo haemorrhagic fever at Tygerberg Hospital. Part I. Clinical features. S Afr Med J 68 : 711–717. [Google Scholar]
  5. Fisher-Hoch SP, McCormick JB, Swanepoel R, Van Middlekoop A, Harvey S, Kustner HG, 1992. Risk of human infections with Crimean-Congo hemorrhagic fever virus in a South African rural community. Am J Trop Med Hyg 47 : 337–345. [Google Scholar]
  6. Altaf A, Luby S, Ahmed AJ, Zaidi N, Khan AJ, Mirza S, Mc-Cormick J, Fisher-Hoch S, 1998. Outbreak of Crimean-Congo haemorrhagic fever in Quetta, Pakistan: contact tracing and risk assessment. Trop Med Int Health 3 : 878–882. [Google Scholar]
  7. Athar MN, Khalid MA, Ahmad AM, Bashir N, Baqai HZ, Ahmad M, Balouch AH, Bashir K, 2005. Crimean-Congo hemorrhagic fever outbreak in Rawalpindi, Pakistan, February 2002: contact tracing and risk assessment. Am J Trop Med Hyg 72 : 471–473. [Google Scholar]
  8. Smego RA Jr, Sarwari AR, Siddiqui AR, 2004. Crimean-Congo hemorrhagic fever: prevention and control limitations in a resource-poor country. Clin Infect Dis 38 : 1731–1735. [Google Scholar]
  9. Khan AS, Maupin GO, Rollin PE, Noor AM, Shurie HH, Shalabi AG, Wasef S, Haddad YM, Sadek R, Ijaz K, Peters CJ, Ksiazek TG, 1997. An outbreak of Crimean-Congo hemorrhagic fever in the United Arab Emirates, 1994–1995. Am J Trop Med Hyg 57 : 519–525. [Google Scholar]
  10. Ergonul O, Zeller H, Celikbas A, Dokuzoguz B, 2007. The lack of Crimean-Congo hemorrhagic fever virus antibodies in health-care workers in an endemic region. Int J Infect Dis 11: 48–51. [Google Scholar]
  11. Chinikar S, Fayaz A, Mirahmadi R, Mazaheri V, Mathiot CC, 2002. The specific serological investigation of suspected human and domestic animals to have Crimean-Congo haemorrhagic fever in various parts of Iran using ELISA techniques. Hakim Journal 4 : 294–300. [Google Scholar]
  12. Bryan JP, Iqbal M, Ksiazek TG, Ahmed A, Duncan JF, Awan B, Krieg E, Riaz M, Leduc JW, Nabi S, Qureshi MS, Malik IA, Legters LJ, 1996. Prevalence of sand fly fever, West Nile, Crimean-Congo hemorrhagic fever, and leptospirosis antibodies in Pakistani military personnel. Mil Med 161 : 149–153. [Google Scholar]
  13. Norusis MJ, 1999. Logistic regression analysis examples. In: SPSS Regression Models 10.0. Chicago: SPSS Inc, 35–64.
  14. Izadi S, Naieni KH, Madjdzadeh SR, Nadim A, 2004. Crimean-Congo hemorrhagic fever in Sistan and Baluchestan Province of Iran, a case-control study on epidemiological characteristics. Int J Infect Dis 8 : 299–306. [Google Scholar]
  15. Chapman LE, Wilson ML, Hall DB, LeGuenno B, Dykstra EA, Ba K, Fisher-Hoch SP, 1991. Risk factors for Crimean–Congo hemorrhagic fever in rural northern Senegal. J Infect Dis 164 : 686–692. [Google Scholar]
  16. Watts DM, el-Tigani A, Botros BA, Salib AW, Olson JG, Mc-Carthy M, Ksiazek TG, 1994. Arthropod–borne viral infections associated with a fever outbreak in the northern province of Sudan. J Trop Med Hyg 97 : 228–230. [Google Scholar]
  17. Baron RC, McCormick JB, Zubeir OA, 1983. Ebola virus disease in southern Sudan: hospital dissemination and intrafamilial spread. Bull World Health Organ 61 : 997–1003. [Google Scholar]
  18. Centers for Disease Control (CDC), 1988. Management of patients with suspected Viral Hemorrhagic Fever. MMWR Morb Mortal Wkly Rep 37 : 1–16. [Google Scholar]
  19. Dalgard DW, Hardy RJ, Pearson SL, Pucak GJ, Quander RV, Zack PM, Peters CJ, Jahrling PB, 1992. Combined simian hemorrhagic fever and Ebola virus infection in cynomolgus monkeys. Lab Anim Sci 42 : 152–157. [Google Scholar]
  20. Centers for Disease Control (CDC), 1995. Update: management of patients with suspected viral hemorrhagic fever–United States. MMWR Morb Motal Wkly Rep 44 : 475–479. [Google Scholar]
  21. van de Wal BW, Joubert JR, van Eeden PJ, King JB, 1985. A nosocomial outbreak of Crimean-Congo haemorrhagic fever at Tygerberg Hospital. Part IV. Preventive and prophylactic measures. S Afr Med J 68 : 729–732. [Google Scholar]

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  • Received : 25 Jul 2006
  • Accepted : 07 Dec 2006

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