High number of CCHF cases in Afghanistan: an assessment conducted

Afghanistan has experienced an unusual increase in cases and deaths from Crimean- Congo Hemorrhagic Fever [CCHF] during 2017 with Herat province being the most affected. Up to date, a total of 242 cases including 42 deaths [CFR: 17.35%] have been reported in 27 out of 34 provinces. WHO organized a technical mission in February 2018 to support activities for improving prevention and control efforts

Disease outbreaks in Eastern Mediterranean Region [EMR], January to June 2018

Since beginning of the year 2018, the WHO Eastern Mediterranean Region [EMR] has experienced ongoing and new outbreaks of emerging and re-emerging infectious disease in many countries. A number of these outbreaks are continuing from the previous year

CCHF in Afghanistan

Afghanistan has reported unusual increase in cases of Crimean Congo hemorrhagic fever [CCHF]. The increase is mainly in Herat province in the western part of the country. As of week 33, 154 cases including 35 deaths [CFR=22.7%] have been reported countrywide

Crimean-Congo hemorrhagic fever in Afghanistan

The Ministry of Public Health in Afghanistan recently reported an increase in the number of Crimean-Congo haemorrhagic fever [CCHF] cases in the country. In 2017, a total of 237 cases of CCHF in-cluding 41 deaths [CFR: 17.2%] have been reported throughout 27 provinces. Majority of these cases-71 cases including 13 associated deaths [CFR: 18.3%], were reported from the capital city, Kabul

CCHF in the EMR: current knowledge gaps

Crimean-Congo hemorrhagic fever [CCHF] is the most wide-spreading tickborne viral disease in humans. The disease is also endemic in many countries of the Eastern Mediterranean Region [EMR] of WHO. The incidence of the disease has increased in recent time. Despite the rapidly growing incidence, its control efforts are hindered by lack of data on the maintenance and transmission of the virus and the pathogenesis of the human disease remain poorly understood in the Region

CCHF in Pakistan: cases rise

Crimean-Congo haemorrhagic fever [CCHF] cases recorded a dramatic rise in Pakistan this year. From 01 January to 19 October 2016, a total of 431 suspected cases including 60 deaths [CFR: 14%] were reported from four provinces across the country

unusual case of crimean congo hemorrhagic fever: prolonged bleeding with successful recovery

Crimean Congo Hemorrhagic Fever [CCHF] is a tick-borne viral disease with a major reservoir in both domestic and wild animals. In Pakistan, it is endemic largely in rural areas and most cases occur in spring and autumn. Recently, cases are being reported throughout the year, including winter months, with some even from urban areas. Death from CCHF is most likely to occur during the hemorrhagic phase. We report a case presenting from an urban locality in December. Clinical presentation was characterized by a prolonged hemorrhagic phase and a delayed normalization of platelet counts

case of brucellosis mimicking Crimean-Congo hemorrhagic fever

Brucellosis is a zoonotic disease caused by Brucella spp. that is transmitted to humans by the ingestion of unpasteurized milk and other dairy products from infected animals or through close contact with secretions. Crimean-Congo hemorrhagic fever [CCHF] is a tick-borne disease caused by a virus that is transmitted to humans by ixoid tick bites, contact with blood and tissue of infected animals or contact with infected humans. The symptoms of brucellosis are non-specific; it can mimic other diseases. In this paper, we present a case of brucellosis that was initially evaluated as CCHF. We emphasize that brucellosis should be considered in the differential diagnosis of CCHF, especially in endemic countries

Dengue fever in Pakistan

The Disease Early Warning System [DEWS] in Pakistan has recently reported high number of dengue fever cases across the provinces of Punjab, Sindh, Balochistan and Khyber Pakthunkhwa [KPK]. A total of 4,388 suspected cases were reported so far from 01 January to 11 September 2013. The province of KPK reported the highest number of cases so far [3,177 cases] followed by the province of Sindh [1098 cases]

Close contact precautions could prevent an outbreak of Crimean-Congo hemorrhagic fever: a case series report from southern part of Tehran

Between the end of June and the middle of July 2011, an outbreak of CCHF occurred in southern part of Tehran, Iran. This study reports clinical, laboratory findings and outcome of six cases, who were all consanguine. Index case who was livestock-worker died with hemorrhagic manifestations; thereafter his pregnant wife, three brothers, mother-in-law and his pregnant sister-in-law were admitted and except for the latter, ribavirin was administered. The brother with close contact with body fluids and blood of index case, died with hemorrhage. Low platelet, high aminotransferases and elevated PT, PTT were detected in this case. Skin manifestations were present in five cases. Only in one case RT-PCR and IgM serology were reported as positive for CCHF virus by reference laboratory. In endemic areas, high index of suspicion should be kept in mind in successfully finding and treating cases in early phase of the disease

Crimean-Congo haemorrhagic fever outbreak investigation in the Western Region of Afghanistan in 2008

Crimean-Congo haemorrhagic fever [CCHF] is a life-threatening viral haemorrhagic fever. This paper reports on the first multifocal outbreak recorded in the Afghanistan. The outbreak was detected in 2008 in the Western Region of the country and 30 cases [17 males and 13 females] were detected between 10 July and 22 October 2008. Standard case definitions based on World Health Organization sources were used. Most of the cases [27] occurred in Herat province; 25 were aged between 18-55,1 was > 55 years and 4 were12-18 years [median age was 27 years]. The case fatality rate was 33%; 41% among males and 23% among females [P - 0.29]. Significantly more patients infected by contact with meat and body fluids died that those whose contact was through animal husbandry or ticks [P = 0.0048]. Of the 30 cases, 33 close contacts were traced; 3 were positive for CCHF IgM with no symptomatic evidence of the disease

[Crimean -Congo Hemorrhagic Fever]

Crimean-Congo Hemorrhagic Fever [CCHF] is an acute viral hemorrhagic disease which is transmitted to humans by the bite of the Hyalomma tick or by direct contact with blood of an infected animal or human. CCHF was first recognized in the Crimean peninsula in the mid-1940s, and the same virus was isolated from a patient in Democratic Republic of Congo, in 1956. Person-to-person transmission of CCHF virus occurs through direct exposure to blood or other secretions; in addition, nosocomial transmission is well-documented with case fatality rates ranging from 30 70%. Tick bite is one of the most important risk factors for CCHF acquisition and Hyalomma tick is its main reservoir in the nature, but many domestic animals including cattle, sheep, goats, hare, buffalo, and even ostrich can be infected by this virus. Disease in animals is subclinical and they are infected only for one week. During the viremia phase, direct exposure to blood or other secretions can infect human. Hyalomma ticks favor dry climates and arid-type vegetation, and are abundant in European countries bordering the Mediterranean Sea; numerous animals may act as CCHF virus hosts. In recent years, a number of cases have been reported from Africa, Eastern Europe and Asia. Healthcare workers are also at risk of infection through unprotected contact with infected blood and other body fluids. Incubation phase is about 3 to 4 days after tick bite and 3-14 days when the patient is exposed to infected blood and other body fluids. Typical CCHF progresses rapidly with high fever, malaise, severe headache, myalgia, and gastrointestinal symptoms like abdominal pain and nausea. CCHF is confirmed either by detection of specific immunoglobulin M antibodies or a four-fold increase of immunoglobulin G titers using enzyme-linked immunoassays, indirect immunofluorescent assays, or through RT-PCR. Supportive therapy is an essential part of the case management. Intensive monitoring of fluid volume and blood component replacement is recommended. Oral ribavirin is the therapy of choice in the clinical practice. If the patient meets the criteria for probable CCHF, treatment with ribavirin protocol needs to be started immediately. Interferon and Immunoglobulin have significant antiviral activity in vitro against CCHF. Recently, we face many cases of CCHF in several provinces of Iran. The aim of this article is to review clinical manifestations, treatment and prevention of this disease

CCHF In Pakistan

The Crimien-Congo haemorrhagic fever [CCHF] has been reported from Pakistan in recent time. A total of 8 cases of CCHF including 3 deaths were reported which have the date of onset between 5 to 28 April 2012. While all these 8 cases were identified in all 4 provinces of Pakistan, they were all linked to Balochistan, a known endemic focus of CCHF

A Q fever case mimicking crimean-congo haemorrhagic fever.

Coxiella burnetii is the bacterium that causes Q fever. Human infection is mainly transmitted from cattle, goats and sheep. The disease is usually self-limited. Pneumonia and hepatitis are the most common clinical manifestations. In this study, we present a case of Q fever from the western part of Turkey mimicking Crimean-Congo haemorrhagic fever (CCHF) in terms of clinical and laboratory findings.

Crimean--Congo hemorrhagic fever: a molecular survey on hard ticks (Ixodidae) in Yazd province, Iran

OBJECTIVE@#To determine the rate of Crimean--Congo hemorrhagic fever virus (CCHFV) infection in hard ticks (Ixodidae) in Yazd province of Iran.@*METHODS@#A molecular survey on hard ticks (Ixodidae) was conducted in Yazd province during 2008-2009. A total of 140 hard ticks (three genera and 7 species) were collected from randomly selected villages and were exanimate for presence of CCHFV reverse transcription--polymerase chain reaction (RT-PCR) method.@*RESULTS@#CCHFV genome was found in 5.71% of hard ticks. All positive ticks were from Hyalomma genus. Positive ticks including: Hyalomma dromedarii, Hyalomma marginatum, Hyalomma anatolicum, Hyalomma detritum, Hyalomma asiaticum. We were not able to find virus in in Rhipicephalus sanguineus and Dermacentor marginatus. Results exhibited that Hyalomma is the main vector in the study area.@*CONCLUSIONS@#Due to the presence of virus in 24 provinces' out of 31, we recommend the use of acaricides and repellent to prevent disease transmission among humans. Greta care should be taken by the people who are working in slaughter houses.

VHFs remain a persistent public health threat: review of 2010

In the year 2010, the occurrence and spread of Viral Haemorrhagic Fevers [VHFs] in the EMR continued to represent a major and persistent threat to public health. Most of these emerging infectious disease events have involved zoonotic infectious agents. A number of countries in the Region [Please see the map] have reported VHFs in 2010 signifying an increasing risk for geographic expansion of these emerging viral threats in the Region