{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:31:54Z","timestamp":1792801914924,"version":"4.5.0"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2020,4,14]],"date-time":"2020-04-14T00:00:00Z","timestamp":1586822400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Crimean Congo haemorrhagic fever (CCHF) is an emerging zoonotic infection with high mortality. Nosocomial spread is described secondary to body fluid contact.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients meeting the case definition for viral haemorrhagic fever (VHF) from August to November 2019 were tested for CCHF after ruling out dengue, malaria, scrub typhus and leptospirosis in a tertiary teaching hospital in western Rajasthan, India. Diagnosis was confirmed using both quantitative reverse transcription polymerase chain reaction and immunoglobulin M\/immunoglobulin G enzyme-linked immunosorbent assay for all patients. All hospital contacts were line listed and tested and symptomatic high-risk contacts received ribavirin post-exposure prophylaxis. Cohorting, personal protective equipment use and hand washing were employed to prevent nosocomial spread.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four patients tested positive for CCHF. We encountered uncommon initial presentations involving motor weakness and supraventricular tachycardia. Elevated serum lactate dehydrogenase and creatinine kinase were useful in clinical diagnosis. Only one patient survived despite ribavirin therapy. There was zero nosocomial transmission. A partial segment of nucleocapsid of amplified CCHF virus was 99.62% identical to the Afghanistan and Oman strains.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The distribution of CCHF appears to be expanding, with CCHF emerging as endemic in Rajasthan, India. In this setting of high mortality, hand washing and PPE use prevented nosocomial transmission.<\/jats:p><\/jats:sec>","DOI":"10.1093\/trstmh\/traa014","type":"journal-article","created":{"date-parts":[[2020,2,8]],"date-time":"2020-02-08T20:09:07Z","timestamp":1581192547000},"page":"650-656","source":"Crossref","is-referenced-by-count":10,"title":["Clinical profile and outcome of patients with Crimean Congo haemorrhagic fever: a hospital based observational study from Rajasthan, India"],"prefix":"10.1093","volume":"114","author":[{"given":"Swapnil","family":"Tripathi","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, All India Institute of Medical Sciences, Jodhpur, Basni Industrial estate, Jodhpur, 342005, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajendra","family":"Bhati","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, All India Institute of Medical Sciences, Jodhpur, Basni Industrial estate, Jodhpur, 342005, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maya","family":"Gopalakrishnan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, All India Institute of Medical Sciences, Jodhpur, Basni Industrial estate, Jodhpur, 342005, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gopal Krishna","family":"Bohra","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, All India Institute of Medical Sciences, Jodhpur, Basni Industrial estate, Jodhpur, 342005, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarika","family":"Tiwari","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Basni Industrial estate, Jodhpur, 342005, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samhita","family":"Panda","sequence":"additional","affiliation":[{"name":"Department of Neurology, All India Institute of Medical Sciences, Jodhpur, Basni Industrial estate, Jodhpur, 342005, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rima R","family":"Sahay","sequence":"additional","affiliation":[{"name":"Indian Council of Medical Research, National Institute of Virology, 20\/ A, Dr. Ambedkar Road, Pune, 411001, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pragya D","family":"Yadav","sequence":"additional","affiliation":[{"name":"Indian Council of Medical Research, National Institute of Virology, 20\/ A, Dr. Ambedkar Road, Pune, 411001, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijaya Lakshmi","family":"Nag","sequence":"additional","affiliation":[{"name":"Department of Microbiology, All India Institute of Medical Sciences, Jodhpur, Basni Industrial estate, Jodhpur, 342005, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahendra Kumar","family":"Garg","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, All India Institute of Medical Sciences, Jodhpur, Basni Industrial estate, Jodhpur, 342005, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,4,14]]},"reference":[{"issue":"8","key":"2020083020421245900_ref1","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1093\/trstmh\/trv050","article-title":"The global distribution of Crimean-Congo hemorrhagic fever","volume":"109","author":"Messina","year":"2015","journal-title":"Trans R Soc Trop Med Hyg."},{"issue":"(5)","key":"2020083020421245900_ref2","doi-asserted-by":"crossref","first-page":"e1653","DOI":"10.1371\/journal.pntd.0001653","article-title":"Detection, isolation and confirmation of Crimean-Congo hemorrhagic fever virus in human, ticks and animals in Ahmadabad, India, 2010\u20132011","volume":"6","author":"Mourya","year":"2012","journal-title":"PLoS Negl 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