Outbreak of Crimean-Congo haemorrhagic fever in Quetta, Pakistan: contact tracing and risk assessment

In December 1994 in a private hospital in Quetta, Pakistan, 3 health-worker s contracted Crimean-Congo haemorrhagic fever (CCHF) after surgery on a ble eding patient who later died. We conducted a retrospective study to determi ne transmission risks among contacts. Fifty contacts gave blood for antibod y tests and answered questions about exposure. Two of four people exposed p ercutaneously and one of five with cutaneous exposure contracted CCHF The p erson with cutaneous exposure was a surgeon who tore his glove during surge ry and noted blood on his hand but no cut. There were no anti-CCHF antibodi es or CCHF cases among persons whose skin came into contact with body fluid s other than blood (0/4), who had skin-to-skin contact (0/16) with patients or were physically close to them (0/21). Three index case relatives report ed that although 10 family members had cutaneous exposure, none developed C CHF. The family refused blood tests. CCHF transmission in resource-constrai ned settings can be limited by focusing on avoiding health worker contact w ith blood.