Page 110 - Journal of Special Operations Medicine - Winter 2015

have been reported to be as high as 40% to 50%, even Vaccination
for those treated in a medical facility.
No vaccine currently exists for this disease for people or
animals, although studies are in progress.
Diagnosis
Diagnosis of CCHF can be made by a variety of tests, Importance in a Deployed Setting
but only in a specialized laboratory where the blood or Because a vaccine is lacking, as well as an effective anti-
tissue can be handled safely. Antigen-capture enzyme- viral treatment, prevention is key. Wearing permethrin-
linked immunosorbent assay (ELISA), real-time PCR, treated uniforms, using DEET-containing repellent, and
detection of immunoglobulin IgM and IgG antibody by avoiding contact with raw meat or blood in areas where
ELISA, and virus isolation have all been used in the past. CCHF is endemic is important. If a patient is suspected
Suspicion of the diagnosis must be discussed with the of having been infected with the CCHF virus, Special
reference laboratory in advance, as the virus that causes Operations Forces medical personnel should remember
CCHF is a Category IV biosafety hazard.
to wear gloves and protective equipment, if available,
while involved in care.
Treatment
The treatment for CCHF is supportive. Ribavirin has Disclaimer
been shown to be an effective treatment in vitro but is The views expressed in this publication are those of the
still administered as an IND. Extreme caution must be author and do not reflect the official policy or position
undertaken by those involved in the care of patients sus- of the Department of the Army, Department of Defense,
pected or known to have CCHF, to avoid the spread of or the US Government.
infection through blood or body fluids during patient
care and transport to higher levels of treatment.
Disclosure
The author has nothing to disclose.

Association of Police Officer Bibliography
Paramedics of the United States Bente DA, Forrester NL, Watts DM, et al. Crimean-Congo hem-
orrhagic fever: history, epidemiology, pathogenesis, clinical
syndrome and genetic diversity. Antiviral Res. 2013;100:
159–189.
Conger NG, Paolino KM, Osborn EC, et al. Health care re-
sponse to CCHF in US soldier and nosocomial transmission
to health care providers, Germany 2009. Emerg Infect Dis.
2015;21:23–31
Mustafa ML, Ayazi E, Mohareb E, et al. Crimean-Congo hemor-
rhagic fever, Afghanistan, 2009. Emerg Infect Dis. 2011;17:
1940–1941.

Recommended Internet Link
http://www.who.int/mediacentre/factsheets/fs208/en/
The mission of the APOPUS is to advocate for cross- http://www.cdc.gov/vhf/crimean-congo/
trained police officer EMT/paramedics across the
United States. Our advocacy exists in two broad
areas. The first is in securing discounted training and
education, travel, equipment and supplies, exhibitions, COL Burnett is currently Chief of Pediatric Subspecialties
competitions and certifications. The second is to foster and Pediatric Infectious Diseases at Tripler Army Medical
professional discourse and communication between Center in Hawaii. He is Board-certified in Pediatrics and Pe-
our members by recommending pertinent professional diatric Infectious Diseases. He has served overseas in Korea,
journals and articles as well as high-quality initial and
sustainment training centers. In doing so, the APOPUS Germany, Kosovo, Iraq, Afghanistan, Kuwait, and as the
seeks ultimately to advance both the recognition and JSOTF-P Surgeon in the Philippines. He is a graduate of the
career opportunities of our members in the United University of Wisconsin-Madison and the Medical College of
States and abroad. Wisconsin.
www.apopus.com

98 Journal of Special Operations Medicine Volume 15, Edition 4/Winter 2015