Crimean Congo Hemorrhagic Fever ( CCHF ) : An Investigation Report , India , 2015

Background: In India, first confirmed outbreak of Crimean Congo Hemorrhagic Fever (CCHF) was reported in 2011. Since then till now clusters of outbreaks were reported from various parts of Rajasthan. A team from National Centre for Disease Control, New Delhi, investigated the CCHF outbreak in Jodhpur, Rajasthan, and reporting here their result. Methodology: A team conducted a CCHF outbreak investigation January 2015, with review of hospital records, discussion with hospital staffs and community members along with contact tracing. Environmental examination, collection of human and animal serum sample, collection of tick sample and entomological survey was also carried out. Results: Four laboratories confirmed CCHF cases reported among male nurses working in the ICU of a private Hospital. Two expired and other two cases took treatment from private hospitals and have now recovered and are healthy. As per records, one case admitted in ICU was suspected as with possible symptoms of CCHF. Seventy-five percent of confirmed cases did not follow proper biosafety precautions. The blood and ticks’ samples of domestic animals were found to be negative for CCHF. Overall CFR in this outbreak was 50%. Conclusion: CCHF outbreak was propagated nosocomially due to poor infection control practice and low index of suspicion for CCHF amongst treating physicians.