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Volume 21, Number 1—January 2015
Synopsis

Health Care Response to CCHF in US Soldier and Nosocomial Transmission to Health Care Providers, Germany, 2009

Nicholas G. CongerComments to Author , Kristopher M. Paolino, Erik C. Osborn, Janice M. Rusnak, Stephan Günther, Jane Pool, Pierre E. Rollin, Patrick F. Allan, Jonas Schmidt-Chanasit, Toni Rieger, and Mark G. Kortepeter1
Author affiliations: Landstuhl Regional Medical Center, Landstuhl, Germany (N.G. Conger, E.C. Osborn, J. Pool, P.F. Allan); Walter Reed Army Institute of Research, Silver Spring, Maryland, USA (K.M. Paolino); Force Health Protection, Fort Detrick, Maryland, USA (J.M. Rusnak); Bernard Nocht Institute, Hamburg, Germany (S. Günther, J. Schmidt-Chanasit, T. Rieger); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P. Rollin); Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA (M.G. Kortepeter)

Main Article

Table 3

Surveillance criteria and PEP, by exposure risk, for contacts of US soldier with fatal Crimean–Congo hemorrhagic fever, Germany, 2009*

Group no. No persons Risk PEP and monitoring
1
 18
 Contact of skin or mucous membranes with contaminated blood or body fluids; present during bronchoscopy or during use of bag-valve-mask ventilation device (risk of aerosolization of infectious blood/body fluids likely) and without proper PPE†
 Oral ribavirin PEP offered; baseline and at least weekly chemistries and CBC; CCHF acute/convalescentphase titers‡; monitoring for fever (twice daily) and for CCHF symptoms and medication side effects (for 15 d in clinic)
2
 31
 Present during bronchoscopy or during use of bag-valve-mask ventilation device (even with proper PPE)†; known contact with contaminated blood or body fluids but wore proper PPE and without PPE breaches† (no known mucosal or skin contact with infectious blood/body fluids); laboratory workers who performed tests on specimens (removed specimens from container) and wore proper PPE†
 Monitoring for fever twice daily for 15 d (in clinic); self-observation and reporting of signs or symptoms e.g., fever) for 15 d
3 41 Persons in patient’s room who wore proper PPE and without PPE breaches and no contact with infectious blood/body fluids†; laboratory workers who handled laboratory specimens (but did not remove specimens from container) and wore proper PPE† No active monitoring; self-observation and reporting of signs or symptoms (e.g., fever) for 15 d

*CBC, complete blood count; CCHF, Crimean–Congo hemorrhagic fever; PEP, postexposure prophylaxis; PPE, personal protective equipment.
†Proper PPE for aerosol exposure included gown, gloves, N95 respirator, and protective eyewear; powered air-purifying respirators and full biohazard suits were required during bronchoscopies and chest tube placements by physician performing the procedure.
‡ELISA for CCHF-specific IgM and IgG performed at the Centers for Disease Control and Prevention, Atlanta, Georgia, USA (11).

Main Article

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1Preliminary results from this study were presented at the Annual Meeting of the Armed Forces Infectious Disease Society; May 23, 2010, San Antonio, Texas, USA; NATO Biomedical Advisory; May 27, 2010, Munich, Germany; and Asian Pacific Military Medicine Conference, May 3, 2011, Sydney, New South Wales, Australia.

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