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CRIMEAN-CONGO HEMORRHAGIC FEVER OUTBREAK IN RAWALPINDI, PAKISTAN, FEBRUARY 2002: CONTACT TRACING AND RISK ASSESSMENT

MUHAMMAD NAUMAN ATHARDepartment of Internal Medicine, Mercy Catholic Medical Center, Darby, Pennsylvania; Department of Medicine, and Department of Pathology, Holy Family Hospital, Rawalpindi Medical College, Rawalpindi, Pakistan; Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan

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MOHAMMAD ALI KHALIDDepartment of Internal Medicine, Mercy Catholic Medical Center, Darby, Pennsylvania; Department of Medicine, and Department of Pathology, Holy Family Hospital, Rawalpindi Medical College, Rawalpindi, Pakistan; Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan

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AHSAN MAQBOOL AHMADDepartment of Internal Medicine, Mercy Catholic Medical Center, Darby, Pennsylvania; Department of Medicine, and Department of Pathology, Holy Family Hospital, Rawalpindi Medical College, Rawalpindi, Pakistan; Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan

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NAGHMAN BASHIRDepartment of Internal Medicine, Mercy Catholic Medical Center, Darby, Pennsylvania; Department of Medicine, and Department of Pathology, Holy Family Hospital, Rawalpindi Medical College, Rawalpindi, Pakistan; Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan

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HAIDER ZAIGHAM BAQAIDepartment of Internal Medicine, Mercy Catholic Medical Center, Darby, Pennsylvania; Department of Medicine, and Department of Pathology, Holy Family Hospital, Rawalpindi Medical College, Rawalpindi, Pakistan; Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan

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MASOOD AHMADDepartment of Internal Medicine, Mercy Catholic Medical Center, Darby, Pennsylvania; Department of Medicine, and Department of Pathology, Holy Family Hospital, Rawalpindi Medical College, Rawalpindi, Pakistan; Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan

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ABBAS HAYAT BALOUCHDepartment of Internal Medicine, Mercy Catholic Medical Center, Darby, Pennsylvania; Department of Medicine, and Department of Pathology, Holy Family Hospital, Rawalpindi Medical College, Rawalpindi, Pakistan; Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan

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KAUKAB BASHIRDepartment of Internal Medicine, Mercy Catholic Medical Center, Darby, Pennsylvania; Department of Medicine, and Department of Pathology, Holy Family Hospital, Rawalpindi Medical College, Rawalpindi, Pakistan; Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan

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A 25-year-old woman, later identified as index case of Crimean-Congo hemorrhagic fever (CCHF), presented to Holy Family Hospital in Rawalpindi, Pakistan with fever and generalized coagulopathy. A retrospective contact tracing was conducted to explore the modes of exposure possibly associated with transmission of CCHF infection among contacts. We traced 32 contacts of the index case and 158 contacts of secondary cases and tested them for IgG and IgM antibodies against CCHF virus by an enzyme-linked immunosorbent assay technique. According to the type of exposure, contacts were divided into five subsets: percutaneous contact with blood, blood contact to unbroken skin, cutaneous contact to non-sanguineous body fluids, physical contact with patients without body fluids contact, and close proximity without touching. Two out of four contacts who reported percutaneous exposure tested positive for antibodies to CCHF virus. We conclude that simple barrier methods and care in provision of CCHF cases may prevent transmission of this infection.

Author Notes

Reprint requests: Muhammad Nauman Athar, 151 South Bishop Avenue, Apartment #K-12, Secane, PA 19018, Telephone/Fax: 610-394-6331, E-mail: drnaumanathar@yahoo.com.
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