Tow cases of Crimean- Congo hemorrhagic fever and a suspected case in South Khorasan Province, 2011

Crimean–Congo hemorrhagic fever (CCHF) is a zoonotic viral hemorrhagic disease, which can be seen in Asia, Africa, East Europe and the Middle East. Mortality rate of this disease is about 30% which can be reduced with timely diagnosis and treatment with Ribavirin and supportive care. In this paper, two confirmed and one suspected cases of CCHF are introduced. Three days after the death of a woman with Disseminated Intravascular Coagulation (DIC) in the infectious diseases ward, a nurse working there and a housewife living in the city of Birjand, had been referred with vaginal bleeding. With suspicious to CCHF, both of them underwent oral treatment with Ribavirin and broad-spectrum antibiotics. The first case had expired in ICU before performing CCHF diagnostic tests; but in the latter two cases the disease was confirmed through molecular tests. The nurse refused to hospitalize and used self-medication at home. However, five days after the symptoms started, she referred to the hospital with a bad general health status, vaginal bleeding and low consciousness and eventually died of this disease. But the second patient recovered after receiving a dose of drug and supportive measures and discharged with a good general health status.