2000-2023 年伊朗医护人员中的克里米亚-刚果出血热，国家参考实验室报告。

Crimean-Congo haemorrhagic fever among healthcare workers in Iran 2000-2023, a report of National Reference Laboratory.

机构信息

Department of Arboviruses and Viral Hemorrhagic Fevers (National Reference Laboratory), Pasteur Institute of Iran, Tehran, 1316943551, Iran.

Infectious & Tropical Diseases, Depts. Immunology & Infection/Pathogen Microbiology, London School of Hygiene & Tropical Medicine, London, UK.

出版信息

BMC Infect Dis. 2024 Nov 18;24(1):1312. doi: 10.1186/s12879-024-10199-1.

DOI:10.1186/s12879-024-10199-1

PMID:39558265

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11571530/

Abstract

BACKGROUND

Crimean-Congo haemorrhagic fever (CCHF) is a lethal acute viral zoonosis with a case fatality rate of 5-50%. Due to the potential of human-to human transmission of the disease, healthcare workers (HCWs) are at risk of occupational exposure to CCHF virus. Little is known about CCHF virus route of transmission and risks in Iranian HCWs. Therefore this study was designed to identify the routes of exposure to the CCHF virus among Iranian HCWs.

METHODS

From Oct 2000 to Feb 2023, 96 CCHF suspected healthcare workers referred to national reference laboratory were tested for CCHF virus infection by the use of RT-PCR and IgM Capture Enzyme-Linked Immunosorbent Assay (MAC-ELISA) and exposure history of cases were investigated to determine the CCHF virus routes of transmission in nosocomial settings.

RESULTS

Twelve CCHF confirmed cases were identified including seven nurses and five physicians, with the median age of 32.5 years (range 23-53 years) and the median incubation period of 6.8 days (range from 1 to 22 days). None of the cases reported a history of tick bite or close contact with tissues or animal blood. The cases were from Razavi Khorasan (seven cases), Sistan and Baluchistan (two cases), Isfahan (one case), South Khorasan (one case) and Fars (one case). Percutaneous exposure (needle stick) (three cases), mucosal exposure (blood splash in to face) (three cases) and skin contact with blood (three cases) constituted the most prevalent routes of transmission. Since 2013, no CCHF cases have been identified among Iranian HCWs.

CONCLUSIONS

In healthcare settings, physicians and nurses are at risk of nosocomial CCHF virus infection. The routes of transmission mainly include direct exposures via needle-stick, mucosal or direct contact with the skin to infected blood. Continuous education and implementation of infection prevention and control measures are key factors to minimize the incidence of healthcare related CCHF.

摘要

背景

克里米亚-刚果出血热（CCHF）是一种致命的急性病毒性人畜共患病，病死率为 5-50%。由于该疾病具有人际传播的潜力，医护人员（HCWs）面临职业暴露于 CCHF 病毒的风险。目前对于伊朗 HCWs 感染 CCHF 病毒的传播途径和风险知之甚少。因此，本研究旨在确定伊朗 HCWs 感染 CCHF 病毒的途径。

方法

从 2000 年 10 月至 2023 年 2 月，96 例疑似 CCHF 的医护人员因与医院环境相关的感染，被送往国家参考实验室进行 CCHF 病毒感染检测，使用 RT-PCR 和 IgM 捕获酶联免疫吸附试验（MAC-ELISA）。对病例的暴露史进行调查，以确定医院环境中 CCHF 病毒的传播途径。

结果

共确定了 12 例 CCHF 确诊病例，包括 7 名护士和 5 名医生，中位年龄为 32.5 岁（范围 23-53 岁），潜伏期中位数为 6.8 天（范围 1-22 天）。这些病例均无蜱虫叮咬史或与组织或动物血液密切接触史。这些病例来自拉扎维霍拉桑省（7 例）、锡斯坦和俾路支省（2 例）、伊斯法罕省（1 例）、南霍拉桑省（1 例）和法尔斯省（1 例）。最常见的传播途径包括经皮暴露（针刺伤）（3 例）、黏膜暴露（血液溅到面部）（3 例）和皮肤接触血液（3 例）。自 2013 年以来，伊朗 HCWs 中未发现 CCHF 病例。