ID4U Episode 28 Crimean-Congo Hemorrhagic Fever

Dr. Jessica Pelletier, Dr. Lawrence Mendy, Dr. Elicana Nduhuura, and Malan Alfred Opoka discuss the epidemiology, pathophysiology, clinical presentation, diagnostic workup, management, and prevention of Crimean-Congo Hemorrhagic Fever (CCHF). Take-Home Points: - CCHF is a severe tick-borne viral illness caused by CCHFV, occurring in Africa, the Middle East, Asia, and parts of Europe. - Transmission is primarily via Hyalomma tick bites, but also through contact with infected animal tissues or the blood/body fluids of infected patients. - High-risk groups include farmers, livestock handlers, abattoir workers, veterinarians, hunters, military personnel, healthcare workers, and travelers to endemic areas. - CCHF progresses through four phases: incubation, prehemorrhagic, hemorrhagic, and convalescent. Early symptoms are nonspecific (fever, headache, myalgia, back pain, nausea, vomiting, abdominal pain, weakness). Hemorrhagic signs (e.g., petechiae, epistaxis, hematemesis) indicate severe disease. - Labs often show thrombocytopenia, leukopenia, elevated liver enzymes, and DIC. - Diagnosis is by RT-PCR in the acute phase; serology (IgM/IgG) is useful later. - Management is supportive: isolation, fluids, blood products, and avoidance of NSAIDs. Ribavirin is commonly used, though mortality benefit is uncertain. - Mortality ranges from 10–40%, depending on severity and complications (e.g., shock, DIC, multiorgan failure). - Prevention includes tick avoidance, protective equipment, animal handling precautions, and infection control in healthcare settings. You can view the full show notes and references here: https://docs.google.com/document/d/1jDZcgifY0BKCgB3fzPxzePjcu\_eOfJYSFEqhAAhg-IA/edit?usp=sharing Image attribution: generated with Adobe Firefly using this image as a reference: By Adam Cuerden - Own work, Public Domain, https://commons.wikimedia.org/w/index.php?curid=3148918 Episode sound attributions: - More jazz guitar: more Jazz guitar.wav by Sub-d: https://freesound.org/s/49658/ -- License: Creative Commons 0 - Ragtime Logo Standard Version: https://pixabay.com/sound-effects/ragtime-logo-standard-version-116100/ - Counting to 20: Creative Commons 0: http://creativecommons.org/publicdomain/zero/1.0/ - Sheep on Shearing Day 4 by Ali\_6868 -- https://freesound.org/s/679001/ -- License: Creative Commons 0 - harpsicord\_dream-leave3.flac by zerolagtime -- https://freesound.org/s/29628/ -- License: Attribution 4.0 - Ambulance\_Traffic\_Mic on top of car.WAV by deleted\_user\_6718832 -- https://freesound.org/s/365254/ -- License: Creative Commons 0 Credit goes to Nakamatte Swaburah for assisting Dr. Pelletier with the writing of the podcast transcript.