Crimean-Congo hemorrhagic fever: Difference between revisions
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==Background== | ==Background== | ||
* | *Caused by tick-borne virus (Nairovirus) in the Bunyavirus family | ||
*First described in the Crimea and later in the Congo | *First described in the Crimea and later in the Congo | ||
*Affected regions: Eastern Europe, Mediterranean, NW China, central Asia, southern Europe, Africa, Middle East, Indian subcontinent | |||
*Ixodid ticks are reservoir and vector | |||
*Direct human-human transmission via body fluids | |||
==Clinical Features== | ==Clinical Features== | ||
| Line 24: | Line 25: | ||
{{Fever in Traveler DDX}} | {{Fever in Traveler DDX}} | ||
== | ==Evaluation== | ||
*Antigen-capture ELISA | *Antigen-capture ELISA | ||
*RT-PCR | *RT-PCR | ||
*Virus isolation | *Virus isolation | ||
*Antibody ELISA | *Antibody ELISA | ||
==Management== | ==Management== | ||
*Supportive | *Supportive care | ||
*IV/PO Ribavirin | *IV/PO Ribavirin | ||
==Disposition== | ==Disposition== | ||
*Admit | |||
==See Also== | ==See Also== | ||
[[Viral hemorrhagic fevers]] | *[[Viral hemorrhagic fevers]] | ||
== | ==External Links== | ||
[ | *[http://www.cdc.gov/vhf/crimean-congo/ CDC Crimean-Congo Hemorrhagic Fever] | ||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:ID]] | |||
[[Category:Tropical Medicine]] | |||
Latest revision as of 04:03, 28 July 2016
Background
- Caused by tick-borne virus (Nairovirus) in the Bunyavirus family
- First described in the Crimea and later in the Congo
- Affected regions: Eastern Europe, Mediterranean, NW China, central Asia, southern Europe, Africa, Middle East, Indian subcontinent
- Ixodid ticks are reservoir and vector
- Direct human-human transmission via body fluids
Clinical Features
History:
- Exposure risk factors: animal herders, livestock workers, slaughterhouse workers, and healthcare workers in endemic areas
- Incubation period usually lasts less than one week from exposure
- Sudden onset of: headache, high fever, back/joint/stomach pain, vomiting, photophobia
- Mood swing and confusion develop after initial symptoms, followed by sleepiness and depression.
- Abdominal pain migrates to RUQ
Physical Exam:
- Conjunctivitis, facial flushing, palatal erythema and petechiae, lymphadenopathy,
- Jaundice and changes in mood and sensory perception
- Signs of coagulopathy (starting around day 4)
- Palpable hepatomegaly
Clinical Course: Estimated 9-50% mortality
Differential Diagnosis
Fever in traveler
- Normal causes of acute fever!
- Malaria
- Dengue
- Leptospirosis
- Typhoid fever
- Typhus
- Viral hemorrhagic fevers
- Chikungunya
- Yellow fever
- Rift valley fever
- Q fever
- Amebiasis
- Zika virus
Evaluation
- Antigen-capture ELISA
- RT-PCR
- Virus isolation
- Antibody ELISA
Management
- Supportive care
- IV/PO Ribavirin
Disposition
- Admit