A 38 year-old male resident of the United Kingdom (UK), returned to Glasgow on Tuesday 2 October 2012 after having visited Afghanistan. He arrived in Glasgow from Kabul, Afghanistan via Dubai and was symptomatic from approximately 28 September with fever, diarrhoea, abdominal pain, haemoptysis and haematemesis. He attended the Emergency Department of a local hospital within three hours of his arrival from where he was transferred to a negative pressure room at Gartnavel General hospital, Glasgow.
The patient had alanine aminotransferase (ALT) levels of >1,000 IU/L (norm: 20-50 IU/L) and a platelet count of 6x109/L (norm: 150-400x109/L). No other indices were available.
On 3 October 2012, a serum sample was couriered to the Health Protection Agency’s (HPA) Microbiology Services Division (MSD), Porton Down which tested PCR-positive for Crimean – Congo haemorrhagic fever (CCHF) in an assay developed in-house following collaborative work between HPA and Central Asian colleagues.
The patient was given intravenous ribavirin and stabilised overnight before being transferred under high security precautions by air to the high-security infectious diseases unit at the Royal Free Hospital, London on 5 October in a specialist isolation facility with the support of the Scottish Ambulance Service and the Royal Air Force (RAF). The patient died on 6 October, despite intensive treatment.