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Woman diagnosed with Crimean-Congo haemorrhagic fever by Cambridge University Hospitals NHS Foundation Trust



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A woman has been diagnosed with Crimean-Congo haemorrhagic fever by doctors at Cambridge University Hospitals NHS Foundation Trust.

It is only the third known case of the viral disease in the UK, which is typically transmitted by ticks and livestock animals in countries where the disease is endemic.

The woman contracted the disease following travel to central Asia, according to the UK Health Security Agency (UKHSA).

A Hyalomma tick - the main carrier of Crimean-Congo haemorrhagic fever
A Hyalomma tick - the main carrier of Crimean-Congo haemorrhagic fever

Following diagnosis at CUH, which runs Addenbrooke’s Hospital in Cambridge, she is now receiving specialist care at the Royal Free Hospital in London.

Dr Susan Hopkins, chief medical advisor at UKHSA, said: “It’s important to be aware that CCHF is usually spread by tick bites in countries where the disease is endemic. It does not spread easily between people and the overall risk to the public is very low.

“We are working with NHS EI to contact the individuals who have had close contact with the case prior to confirmation of their infection, to assess them as necessary and provide advice.

“UKHSA and the NHS have well established and robust infection control procedures for dealing with cases of imported infectious disease and these will be strictly followed.”

The two prior cases recorded in the UK were in 2012 and 2014, and neither spread.

About 30 per cent of patients with the virus die, usually in the second week of infection, according to the World Health Organisation

The patients who recover generally see improvement in their condition on the ninth or tenth day following the onset of the illness.

Symptoms of Crimean-Congo haemorrhagic fever come on suddenly and include fever, muscle ache, dizziness, neck pain and stiffness, backache, headache, sore eyes and sensitivity to light.

Patients also suffer from nausea, vomiting, diarrhoea, abdominal pain and sore throat early on, followed by sharp mood swings and confusion. It can cause a rash in the mouth and throat, fast heart rate and enlarged lymph nodes.

Asked if there was any cause for concern for any staff or patients at Cambidge University Hospitals, and whether anyone would need to isolate, a UKHSA spokesperson told the Cambridge Independent: “UKHSA is working with the NHS to contact the individuals who have had close contact with the case prior to confirmation of their infection, to assess them as necessary and provide advice. This includes healthcare workers that may have come into contact with the case.

“There is no evidence of onward transmission. Human to human transmission requires unprotected contact with infectious blood and body fluids. CCHF does not spread easily between people and all appropriate public health actions are being taken.

“If contacts have had close direct unprotected contact with the patient or their body fluids they will be asked to isolate for 14 days to ensure that any illness can be identified quickly and to ensure there is a smaller chance of passing the infection on to someone else.

“Other contacts who are assessed to be at lower risk have been provided with information about what to do if they feel unwell so that any illness can be identified quickly.”

Addenbrooke's Hospital. Picture: Keith Heppell
Addenbrooke's Hospital. Picture: Keith Heppell

Dr Sir Michael Jacobs, consultant in infectious diseases at the Royal Free London, said: “The Royal Free Hospital is a specialist centre for treating patients with viral infections such as Crimean-Congo haemorrhagic fever.

“Our high-level isolation unit is run by an expert team of doctors, nurses, therapists and laboratory staff and is designed to ensure we can safely treat patients with these kind of infections.”

The Hyalomma tick is the main carrier of Crimean-Congo haemorrhagic fever. This type of tick is not established in the UK and the virus has never been detected in the UK in a tick.

However, anyone visiting areas where the ticks are found should take protection, the UKHSA said.

This includes avoiding areas where ticks are abundant at times when they are active, using tick repellents. Travellers should also check their clothing and skin carefully for ticks.

The affected ticks are found in North Africa and Asia and are also present in southern and eastern Europe, having been recorded in Albania, Bosnia and Herzegovina, Bulgaria, Croatia, Cyprus, France, Greece, Italy, Kosovo, the former Yugoslav Republic of Macedonia, Moldova, Montenegro, Portugal, Romania, Russia, Serbia, Spain and Ukraine, according to the European Centre for Disease Prevention and Control.

The diagnosis at Cambridge University Hospitals comes just weeks after a case of Lassa fever was diagnosed at Addenbrooke’s. Staff who had contact with the patient on February 11 had to undertake a precautionary isolation period of 14 days, and not have patient contact for 21 days. It led to shortages in critical care capacity at a time when the hospital continues to see significant numbers of Covid-19 patients.

Staff at CUH were praised for their response to the Lassa fever incident. The patient was transferred to a London hospital for treatment.

Crimean-Congo haemorrhagic fever can be diagnosed using RT-PCR testing for nucleic acid detection, through virus isolation or through antibody detection methods.

The UKHSA also has specialised laboratory facilities that can provide a definitive diagnosis at PHE Porton. Samples are sent to Public Health England’s Rare and Imported Pathogens Laboratory (RIPL).


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