Case Series of Crimean- Congo Disease: an Outbreak in South of Fars, Iran

Iran is one of the endemic regions of Crimean Congo hemorrhagic fever (CCHF). The most common route for transmission is contaminated pets in this region. This disease is associated with high mortality rate. This article is a report of an outbreak of this disease in Jahrom (a city in the south of Fars in Iran).CASES: The first and second patients were two young brothers aged 23 and 26, with a history of butchering from Banarouyeh (a village in the south of Fars-Iran). These patients were referred to Peymanieh hospital in Jahrom after the death of a woman who was in their neighborhood. The cause of her death was coagulation disorders. They had history of contact with infected animals in the days before the onset of symptoms. Symptoms in these patients were fever, weakness, lethargy, drowsiness, melena, bloody vomiting, and productive cough. The third patient was a young person who was the nephew of the mentioned patients. He had a history of contact with these patients and eating contaminated meat. He came with flu-like symptoms, without any symptoms of bleeding. The fourth patient was a health care worker, who had contact with these patients. She also came with flu-like symptoms and then developed hemorrhagic disorders and alveolar hemorrhagic pneumonia. Serology and RT-PCR for CCHF was positive in all of these patients. They responded to Ribavirin and supportive therapy.

Iran is an endemic region of CCHF. So outbreak of the disease may happen every time. High mortality rate of this disease shows the importance of the knowledge about this disease. It also is necessary to emphasize for being more careful in contact with patients with CCHF in community and hospitals. In addition we should try to improve public information about this disease to prevent it better.