Emerging/re-emerging viral diseases & new viruses on the Indian horizon

Infectious diseases remain as the major causes of human and animal morbidity and mortality leading to significant healthcare expenditure in India. The country has experienced the outbreaks and epidemics of many infectious diseases. However, enormous successes have been obtained against the control of major epidemic diseases, such as malaria, plague, leprosy and cholera, in the past. The country's vast terrains of extreme geo-climatic differences and uneven population distribution present unique patterns of distribution of viral diseases. Dynamic interplays of biological, socio-cultural and ecological factors, together with novel aspects of human-animal interphase, pose additional challenges with respect to the emergence of infectious diseases. The important challenges faced in the control and prevention of emerging and re-emerging infectious diseases range from understanding the impact of factors that are necessary for the emergence, to development of strengthened surveillance systems that can mitigate human suffering and death. In this article, the major emerging and re-emerging viral infections of public health importance have been reviewed that have already been included in the Integrated Disease Surveillance Programme.

An overview of Crimean-Congo hemorrhagic fever in Pakistan

Crimean-Congo Hemorrhagic Fever (CCHF) is a disease affecting domestic livestock and wild animals which can spread to humans. It is caused by infection with a tick- borne virus (Nairovirus) in the family Bunyaviridae or by contacting with infected tissues or from animal blood. CCHF cases were recorded from published data from 2013 to 2018 in different geographic regions of Pakistan. The intensity and risk factors were also determined from all four provinces of Pakistan. A total of 391 cases of CCHF have been reported from all over Pakistan during period of 2013-2018. Majority of them were recorded at the time of Eid-ul-Adha. CCHF cases were identified predominantly in Baluchistan (n=12), Karachi (n=5), Bahawalpur (n=2), and Khyber Pakhtunkhwa (n=1). The prevalence of disease were different in different areas of Pakistan (Fata 1%, Islamabad 5%, Punjab 21%, Sindh 8%, KPK 14% and Baluchistan 39%). The political disturbances faced by the Pakistan have increased Pakistan's susceptibility because large number of refugees have migrated to Pakistan from Afghanistan which is an endemic country. Most of the immigrants and their cattles from Afghanistan settled in Khyber, Pakhtunkhwa and Baluchistan provinces which ultimately cause higher prevalence of CCHF in these arears. Currently there is no complete cure or commercially available vaccine of CCHF available in Pakistan. Mostly Ribavirin antiviral drug is used to treat CCHF. The disease can be controlled by implementing preventive measures like avoiding contact with blood of the suspected animal and tick bites.

Crimean-Congo haemorrhagic fever: an overview.

Crimean-Congo Hemorrhagic Fever (CCHF) is an acute, highly-contagious and life-threatening vector borne disease. The CCHF virus causes severe viral hemorrhagic fever outbreaks, with a case fatality rate of 10-40%. CCHF virus isolation and/or disease has been reported from more than 30 countries in Africa, Asia, South eastern Europe and Middle east. Jan 2011 marks first ever reports of outbreak of CCHF in India, total 5 cases were detected of CCHF from Gujarat. CCHF has recently in news again, 6 human cases and 32 animal samples test positive for CCHF from Kariyana village of Amreli district (Gujarat state) July 2013. Crimean-Congo hemorrhagic fever virus (CCHFV), member of genus Nairovirus in the family Bunyaviridae. Numerous genera of ixodid ticks serve both as vector and reservoir for CCHFV. Human infections occurred through tick bites, direct contact with blood or tissue of infected livestock, or nosocomial infections. Human infections begin with nonspecific febrile symptoms, but progress to a serious hemorrhagic syndrome with a high case fatality ratio. The most definitive way of diagnosis is the demonstration of virus or viral genome in sera samples. Hospitalization in special care unit with constant effort to prevent haemorrhagic complication along with laboratory monitoring is cornerstone for treatment of CCHF. Till date there is no FDA approved drug or definitive treatment for CCHF, ribavirin is tried by many physician need to be evaluated further. Current article is an effort to update existing knowledge about CCHF by due focus on various aspects especially prevention of this zoonotic disease. Much of the real life queries about this disease are elaborated after extensive literature research.

Molecular epidemiology of crimean-congo hemorrhagic fever virus genome isolated of ticks from Hamadan province of Iran.

Background & objectives: Crimean-Congo hemorrhagic fever (CCHF) virus is a tick-borne member of the genus Nairovirus, family Bunyaviridae. CCHFV has been isolated from at least 31 different tick species. The virus is transmitted through the bite of an infected tick, or by direct contact with CCHFV-infected patients or the products of infected livestock. This study was undertaken to study the genetic relationship and distribution of CCHFV in the tick population of Hamadan province of Iran. Method: In this study, RT-PCR has been used for detection of the CCHFV genome. Results: This genome was detected in 19.2% of the ticks collected from livestock of different regions of the Hamadan province in western Iran. The infected species belonged to Hyalomma detritum, H. anatolicum, Rhipicephalus sanguineus and Argas reflexus. With one exception, genetic analysis of the virus genome isolates showed high sequence identity to each other. Even though they clustered in the same group with the strain circulating in Iran, they had a closer relationship to the Matin strain. Interpretation & conclusion: Vector control programs should be applied for reducing population density of potential tick vectors in this province. Further surveys are indicated in this region to provide a better view of the distribution and epidemiology of the virus.