A comparison of clinaical diagnosis and serological diagnosis in an epidemic of Crimean-Congo Haemorrhagic fever. | [Pakistan Journal of Medical Sciences • 2003]

Author(s):

1. Mansoor Nadeem: Department of Medicin, P.N.S Shifa Hospital, Defence Housing Authority, Karachi, Pakistan

2. Nadir Ali: Department of Medicin, P.N.S Shifa Hospital, Defence Housing Authority, Karachi, Pakistan

3. Masood Anwar: Department of Medicin, P.N.S Shifa Hospital, Defence Housing Authority, Karachi, Pakistan

4. Ikhlaq Hussain: Department of Medicin, P.N.S Shifa Hospital, Defence Housing Authority, Karachi, Pakistan

5. Taj Mohammad: Department of Medicin, P.N.S Shifa Hospital, Defence Housing Authority, Karachi, Pakistan

6. Abdul-Hayee: Department of Medicin, P.N.S Shifa Hospital, Defence Housing Authority, Karachi, Pakistan

Abstract:

Crimean Congo Haemorrhagic Fever (CCHF) is life threatening disease caused by Nairovirus of genus Bunyavirus caused by tick bite of Hayalomma species or by direct contact of the blood/sera of the patient and animals suffering from this disease. Epidemics have been occurring in Balochistan province of Pakistan and neighbouring Afghanistan and Iran from time to time with high mortality. In the absence of facilities for detection of serological markers of CCHF (igm & IgG) antibodies and PCR for viral RNA), a study was designed to diagnose and treat cases of CCHF reporting to a specialist unit hospital situated at Quetta, Pakistan. The aim was to compare the clinical features, complications and outcome of both groups of patients; one detecting the disease clinically only and the other depending upon serological tests for the diagnosis. Thirty four patients having fever of less than two weeks of duration with features of bleeding from the skin and various orifices were included in this study from June 2001 to September 2001 after hospitalization. Index case and some of the consecutive cases were subject to detection of serological markers. Rest of the case were diagnosed on clinical grounds and baseline laboratory investigations only. Difference in both the groups was noted carefully. All the patients were given Ribavirin and blood products as and when required. Statistically there was no obvious difference in clinical manifestations (fever, body aches, purpuric spots, ecchymosis, epistaxis, gum bleed etc.) and laboratory findings (blood picture, serum ALT, serum urea and electrolytes, PT, APIT, etc). there was also no difference in mortality of the two groups studied. In an on ongoing outbreak of CCHF, history, clinical findings and supportive baseline laboratory investigations may be sufficient for early detection and treatment of CCHF cases. However for documentation of start of epidemic, serological markers should be done. Therefore facilities for detection of viral markers of CCHF should be available at centers like Quetta.

Page(s): 247-251

DOI: DOI not available

Published: Journal: Pakistan Journal of Medical Sciences, Volume: 19, Issue: 4, Year: 2003

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