Crimean-Congo haemorrhagic fever (CCHF) is an acute febrile illness, often accompanied by haemorrhagic manifestations, with a high case fatality rate (CFR). The causative agent is CCHF virus (CCHFV), and is transmitted to humans mainly through tick bites or exposure to blood or tissues of viraemic patients or livestock. Human-to-human transmission usually occurs in hospital settings, and healthcare workers (HCWs) are mainly affected. A review on nosocomial CCHFV infections was performed to elucidate the routes and circumstances of CCHFV transmission in hospital settings. From 1953 to 2016, 158 published cases of CCHFV nosocomial infection in 20 countries in Africa, Asia and Europe were found. Almost all cases were symptomatic (92.4%), with an overall CFR of 32.4%. The majority of cases occurred in hospital clinics (92.0%) and 10 cases (8.0%) occurred in laboratories. Most cases occurred among HCWs (86.1%), followed by visitors (12.7%) and hospitalized patients (1.3%). Nursing staff (44.9%) and doctors (32.3%) were the most affected HCWs, followed by laboratory staff (6.3%). The primary transmission route was percutaneous contact (34.3%). Cutaneous contact accounted for 22.2% of cases, followed by exposure to aerosols (proximity) (18.2%), indirect contact (17.2%) and exposure to patient environment (8.1%). CCHFV can cause nosocomial infections with a high CFR. During the care and treatment of patients with CCHF, standard contact precautions, barrier precautions and airborne preventive measures should be applied. In order to improve patient safety and reduce healthcare-associated CCHFV exposure, there is a need for guidelines and education for HCWs to ensure that CCHF is appropriately included in differential diagnoses; this will enable early diagnosis and implementation of infection prevention measures.

中文翻译：

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克里米亚-刚果出血热病毒引起的医院感染。

克里米亚-刚果出血热（CCHF）是一种急性发热性疾病，通常伴有出血表现，病死率高（CFR）。病原体是CCHF病毒（CCHFV），主要通过tick叮咬或接触病毒性患者或牲畜的血液或组织传播给人类。人与人之间的传播通常发生在医院环境中，而医护人员（HCW）受其影响最大。进行了院内CCHFV感染的审查，以阐明医院环境中CCHFV传播的途径和情况。从1953年到2016年，在非洲，亚洲和欧洲的20个国家/地区发现了158例CCHFV医院内感染病例。几乎所有病例都是有症状的（92.4％），总CFR为32.4％。多数病例发生在医院诊所（92.0％）和10例（8。0％）发生在实验室。大多数病例发生在医护人员中（86.1％），其次是访客（12.7％）和住院患者（1.3％）。受影响最严重的医护人员是护理人员（44.9％）和医生（32.3％），其次是实验室人员（6.3％）。主要的传播途径是经皮接触（34.3％）。皮肤接触占病例的22.2％，其次是接触气溶胶（接近）（18.2％），间接接触（17.2％）和患者环境（8.1％）。CCHFV可以导致高CFR的医院感染。在CCHF患者的护理和治疗期间，应采用标准的接触预防措施，屏障预防措施和机载预防措施。为了提高患者安全性并减少与医疗保健相关的CCHFV暴露，需要对医护人员进行指导和教育，以确保将CCHF适当地包括在鉴别诊断中；这将有助于及早诊断和实施感染预防措施。