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Crimean-Congo haemorrhagic fever in travellers: A systematic review

Leblebicioglu, Hakan, Ozaras, Resat, Fletcher, Tom and Beeching, Nicholas ORCID: https://orcid.org/0000-0002-7019-8791 (2016) 'Crimean-Congo haemorrhagic fever in travellers: A systematic review'. Travel Medicine and Infectious Disease, Vol 14, Issue 2, pp. 73-80.

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Abstract

Background
The recent Ebola epidemic has increased public awareness of the risk of travel associated viral haemorrhagic fever (VHF). International preparedness to manage imported cases Ebola virus infection was inadequate, highlighted by cases of nosocomial transmission. Crimean-Congo haemorrhagic fever (CCHF) is a re-emerging tick-borne VHF centred in the Eurasian region, affecting a large geographical area and with human-to-human transmission reported, especially in the healthcare setting.

Objectives
To systematically review the characteristics of travel associated Crimean-Congo haemorrhagic fever.

Methods
A systematic review of travel-associated cases of CCHF was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement protocol. PubMed, SCOPUS, Science Citation Index (SCI) and ProMED databases were searched for reports published between January 1960 and January 2016. Three independent reviewers selected and reviewed studies and extracted data.

Results
21 cases of travel associated CCHF were identified, of which 12 died (3 outcome unknown) and 4 secondary (nosocomial) infections were reported. Risk occupations or activities for CCHF infection were reported in 8/12 cases when data were available. Travel from Asia to Asia occurred in 9 cases, Africa to Africa occurred in 5 cases, Africa to Europe in 3 cases, Asia to Europe in 2 cases and Europe to Europe in 2 cases.

Conclusion
CCHF related to travel is rare, is generally associated with at risk activities/occupation and is frequently fatal. Key to early diagnosis and prevention of nosocomial transmission is an understanding of CCHF risk factors and the geographical distribution of CCHF. International travel to CCHF endemic areas is increasing and clinicians and laboratory personnel managing returning travellers should maintain a high index of suspicion.

Item Type: Article
Corporate Authors: ESCMID Study Group for Infections in Travellers and Migrants (ESGITM)
Subjects: WA Public Health > Preventive Medicine > WA 108 Preventive health services. Preventive medicine. Travel Medicine.
WA Public Health > Preventive Medicine > WA 110 Prevention and control of communicable diseases. Transmission of infectious diseases
WC Communicable Diseases > Virus Diseases > General RNA Virus Infections > WC 501 RNA virus infections (General or not elsewhere classified)
WC Communicable Diseases > Virus Diseases > Viral Hemorrhagic Fevers. Other Virus Diseases > WC 534 Viral hemorrhagic fevers
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1016/j.tmaid.2016.03.002
Depositing User: Jessica Jones
Date Deposited: 30 Mar 2016 09:46
Last Modified: 21 Nov 2019 12:09
URI: https://archive.lstmed.ac.uk/id/eprint/5819

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