Bajpai Smrati, Nadkar Milind Y
Dept. of Medicine, Seth G S Medical College & KEM Hospital, Mumbai.
J Assoc Physicians India. 2011 Mar;59:164-7.
Crimean Congo hemorrhagic fever (CCHF) has been in the news with reports of its outbreak in India from Gujarat. CCHF is caused by a virus which is a member of the Nairovirus genus of the family Bunyaviridae. All of these viruses are transmitted by either ixodid or argasid ticks. Humans get this infection after a bite of an infected tick or from one infected human to another by contact with infectious blood or body fluids. Workers in livestock and agriculture industry, slaughterhouses, and veterinary practice are most prone to this infection. In severe cases after 3-6 days of the onset of symptoms hemorrhagic manifestations occur. IgG and IgM antibodies may be detected in serum by ELISA from about the sixth day of the illness. The mainstay of treatment in CCHF is supportive. Management of DIC, sepsis, shock and MODS should be undertaken. The antiviral drug Ribavirin has shown benefits. Benefits of treatment with ribavirin outweigh the fatal risks, and ribavirin may therefore be recommended. People at risk should use effective personal protective measures against tick bites. Acaricide treatment of livestock in CCHF virus endemic areas is effective in reducing the population of infected ticks.
克里米亚-刚果出血热（CCHF）因在印度古吉拉特邦爆发的报道而登上新闻。CCHF由一种病毒引起，该病毒属于布尼亚病毒科内罗病毒属。所有这些病毒均通过硬蜱或软蜱传播。人类在被感染的蜱叮咬后，或通过接触感染性血液或体液，从一名感染者传染给另一名感染者而感染此病。畜牧业、农业、屠宰场及兽医行业的工作人员最易感染此病。在症状出现3至6天后的严重病例中，会出现出血表现。从发病约第六天起，可通过ELISA在血清中检测到IgG和IgM抗体。CCHF的主要治疗方法是支持治疗。应进行弥散性血管内凝血、败血症、休克及多器官功能障碍综合征的管理。抗病毒药物利巴韦林已显示出疗效。利巴韦林治疗的益处超过致命风险，因此可推荐使用。高危人群应采取有效的个人防护措施以防蜱叮咬。在CCHF病毒流行地区，对牲畜进行杀螨剂处理可有效减少感染蜱的数量。
