The Epinhood (TEH)

CRIMEAN-CONGO HEMORRHAGIC FEVER – EUROPE (04): NORTH MACEDONIA,
CONTACT HEALTHCARE WORKER INFECTED

A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Mon 7 Aug 2023
Source: Fokus – North Macedonia [in Macedonian, machine trans.,
edited] https://fokus.mk/vraboten-na-klinikata-za-infektiivni-bolesti-zarazen-so-kongo-krimska-hemoragichna-treska/

After doctors confirmed a case of Congo-Crimean hemorrhagic fever in a
27-year-old woman [from Shtip], an employee of the Clinic for
Infectious Diseases and Febrile Conditions (KIBFS) [in Skpoje], who
was identified as a medium-risk contact, showed symptoms on the 9th
day of surveillance and, according to the obtained results from the
EPI [Epidemiology of Infectious Diseases] Department of the Institute
of Public Health, a positive case of Congo-Crimean hemorrhagic fever
has been determined, the Ministry of Health announced.

The Ministry says that the patient is hospitalized at the clinic, and
the Department of Epidemiology of Infectious Diseases [EPI] at the
Institute of Public Health [DSZI] of Skopje immediately formed a field
inspection team that carried out the necessary activities, i.e.,
carried out a survey of the patient and placed under surveillance
health-risk contacts in order to prevent further spread of the
disease.

“After confirming a case of Congo-Crimean hemorrhagic fever (CCHF) in
a 27-year-old woman, the competent health institutions acted in
accordance with WHO recommendations. An expert team conducted field
research in the Shtip Clinical Hospital, Shtip Emergency Medical
Center, and in the family of a now-deceased woman. An expert team of
epidemiologists also conducted a field inspection of the KIBFS in
Skopje,” the Ministry of Health announced.

The Ministry of Health says that in all these locations,
epidemiologists have searched the contacts and classified them into
high-risk, medium-risk, low-risk, and no-risk individuals. All
identified contacts assessed with risk were issued decisions by the
State Sanitary and Health Inspectorate, DSZI, and placed under 14-day
health surveillance, conducted by a competent Center for Public
Health.

“One of the employees of KIBFS who was identified as a medium-risk
contact, on the 9th day of surveillance, showed symptoms, and,
according to the results obtained by the EPI Department of the Health
Ministry, a positive case of Congo-Crimean hemorrhagic fever was
determined. The patient is hospitalized at KIBFS,” the Ministry
announced.

The Ministry emphasizes that the health surveillance lasts 14 days
from the last contact with the patient. The contacts from the 1st
positive case are under surveillance until 10 Aug 2023.

The length of the period from infection to the appearance of symptoms
depends on the method of acquiring the virus, the announcement states.
After infection by a tick bite, the period is usually one to 3 days,
with a maximum of 9 days. The period after contact with infected blood
or tissues is usually 5 to 6 days, with a documented maximum of 14
days.

“The onset of the disease is sudden, with headache, high fever, back
pain, joint pain, stomach pain, and vomiting. Red eyes, flushed face,
red throat, and red spots on the palate are also present. Jaundice may
occur, and in more severe cases, mood changes. As the disease
progresses, large bruised areas appear on the sufferer’s body, as well
as nosebleeds. The recovery is slow,” the Ministry of Health informs.