Nosocomial Outbreak of CCHF, Sudan | CDC EID

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Volume 16, Number 5–May 2010
Dispatch
Nosocomial Outbreak of Crimean-Congo Hemorrhagic Fever, Sudan
Imadeldin E. Aradaib, Bobbie R. Erickson, Mubarak E. Mustafa, Marina L. Khristova, Nageeb S. Saeed, Rehab M. Elageb, and Stuart T. Nichol
Author affiliations: The National Ribat University, Khartoum, Sudan (I.E. Aradaib); University of Khartoum, Khartoum (I.E. Aradaib); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (B.R. Erickson, M.L. Khristova, S.T. Nichol); Central Public Health Laboratory, Khartoum (M.E. Mustafa); Juba University, Khartoum (M.E. Mustafa); Federal Ministry of Health, Khartoum (N.S. Saeed); and National Medical Laboratory, Khartoum (N.S. Saeed, R.M. Elageb)

Suggested citation for this article

Abstract
To confirm the presence of Crimean-Congo hemorrhagic fever in Sudan, we tested serum of 8 patients with hemorrhagic fever in a rural hospital in 2008. Reverse transcription–PCR identified Crimean-Congo hemorrhagic fever virus. Its identification as group III lineage indicated links to virus strains from South Africa, Mauritania, and Nigeria.
Crimean-Congo hemorrhagic fever virus (CCHFV; family Bunyaviridae, genus Nairovirus) is a tick-borne virus. Its tripartite RNA genome consists of small (S), medium, and large segments. The virus is distributed throughout much of Africa, Asia, and southern Europe (1–5). In some regions, the virus is responsible for annual outbreaks of hemorrhagic fever with high case-fatality rates; in others, it causes sporadic cases only. Because of its association with rapid-onset hemorrhagic fever and an ≈30% case-fatality rate, CCHFV is on the US Select Agent list of agents considered to have bioterrorism potential (2–5).

Distribution of CCHF largely mirrors that of its Ixodid tick hosts, particularly those of the genus Hyalomma (1). Persons become infected when bitten by virus-infected ticks or after contact with blood or tissue from viremic livestock or other persons. Outbreaks often involve persons in rural communities, such as shepherds, slaughterhouse workers, or medical staff of resource-poor hospitals. Despite presence of Hyalomma tick vectors in Sudan, no CCHF cases have been confirmed there. However, in the past 2 years, suspected CCHF outbreaks and sporadic cases in the Kordufan region of Sudan have been reported.

From a public health perspective, confirming CCHF in Sudan and determining which virus lineages may be present in this region will provide a more detailed understanding of the movement of virus strains and identification of areas at risk for CCHFV. We therefore analyzed an outbreak of hemorrhagic fever, including a nosocomial chain of transmission in a rural hospital in Sudan in 2008.

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Suggested Citation for this Article
Aradaib IE, Erickson BR, Mustafa ME, Khristova ML, Saeed NS, Elageb RM, et al. Nosocomial outbreak of Crimean-Congo hemorrhagic fever, Sudan. Emerg Infect Dis [serial on the Internet]. 2010 May [date cited].
http://www.cdc.gov/EID/content/16/5/837.htm

DOI: 10.3201/eid1605.091815