CRIMEAN-CONGO HEMORRHAGIC FEVER - PAKISTAN (05): ex AFGHANISTAN
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Date: Mon 7 Oct 2013
Source: The Express Tribune [edited]
http://tribune.com.pk/story/614554/anot ... n-doctors/
Four butchers died after being infected with Crimean-Congo hemorrhagic fever virus [CCHF] virus in September 2013.
Amid the paralysing spread of polio in Fata and Khyber-Pakhtunkhwa (K-P), the CCHF virus may be the next epidemic to hit the country. The virus may be a serious threat to human lives if timely precautionary measures are not taken, warned Dr Muhammad Najeeb Khan Durrani, the senior Surveillance Coordinator Communicable Diseases, Islamabad.
People in areas of Punjab, K-P and Balochistan have been exposed to the deadly virus, Dr Durrani, who is also member of the Global Outbreak Alert Response Network, told The Express Tribune. People think that because of its name, CCHF virus cannot be found in Pakistan, which is an ignorant assumption, he said. "CCHF virus is a reality in the country."
The virus causes Crimean-Congo hemorrhagic fever, a widespread tickborne viral disease in domestic and wild animals that affects humans. Domestic animals brought from Afghanistan to Pakistan through the border at Chaman carry the infectious ticks. The disease spreads among the animals through the ticks. In humans, it is spread by close contact with the blood, secretions, organs, or other bodily fluids of infected animals or persons.
The virus was initially found in Loralai in 2006, where some butchers and livestock buyers died because of the disease, revealed Dr Durrani. Authorities took immediate precautionary measures then, and it was made mandatory for Afghan sheep to cross a pond filled with virus-killing medicine [sheep dip?]. This precautionary practice continued for some time, which helped in CCHF prevention. However, the practice has not continued for a few years due to negligence.
The recent outbreak of virus was reported on Sat 7 Sep 2013 in Haripur when 4 butchers lost their lives after they slaughtered and touched the meat of a sheep. Sohrab Ahmed, president of the Butchers' Association of Haripur, while reporting on the deaths of the 4 butchers, told The Express Tribune that the sheep were bought from the animals' market in Hazro, Attock. Ahmed said it is a known fact that the animals sold at the Hazro market are being brought over from Afghanistan.
The district administration of Haripur immediately imposed a ban on the slaughtering of animals for 7 days and arranged for a vaccine [disinfectant?] spray in the meat shops and houses of butchers. The butchers have also been provided with safety kits that include masks, hand gloves, and aprons that they still use. Generally, sheep, cows, and other animals are exported to Afghanistan from Pakistan via the Torkham border, but a large number of lambs are also brought for grazing in the mountainous areas of Balochistan from the eastern neighboring country. After the Afghan lambs are 2-3 years old, they are sold to local businessmen and cattle traders in Pakistan.
"It is most of the Afghan sheep that carry the infectious tick which spreads CCHF virus in Balochistan, Punjab, and K-P," said Dr Durrani.
[Byline: Qaiser Butt]
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[CCHF virus is transmitted to people either by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers and veterinarians. The length of the incubation period depends on the mode of acquisition of the virus. Following infection by a tick bite, the incubation period is usually 1-3 days, with a maximum of 9 days. The incubation period following contact with infected blood or tissues is usually 5 to 6 days, with a documented maximum of 13 days.
Animals become infected by the bite of infected ticks, and the virus remains in their bloodstream for about one week after infection, allowing the tick-animal-tick cycle to continue when another tick bites. Although a number of tick genera are capable of becoming infected with CCHF virus, ticks of the genus _Hyalomma_ are the principal vectors. Human-to-human transmission can occur resulting from close contact with the blood, secretions, organs, or other bodily fluids of infected persons. Hospital-acquired infections can also occur due to improper sterilization of medical equipment, reuse of needles, and contamination of medical supplies.
The hosts of the CCHF virus include a wide range of wild and domestic animals such as cattle, sheep, and goats. Many birds are resistant to infection, but ostriches are susceptible and may show a high prevalence of infection in endemic areas, where they have been at the origin of human cases in Southern Africa. Generally, infected livestock carrying CCHF virus-infected ticks show no signs of illness.
It is likely that CCHF virus has been prevalent in Pakistan for some time, although, as argued in this press article, the greatest risk of infection is related to the importation of livestock for slaughter from Afghanistan and the current lack of veterinary control at border crossings.
General supportive care with treatment of symptoms is the main approach to managing CCHF in people. The antiviral drug ribavirin has been used to treat CCHF infection with apparent benefit. Both oral and intravenous formulations seem to be effective.
An interactive HealthMap of Pakistan can be accessed at http://healthmap.org/r/8qmc. - Mod.CP]
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CRIMEAN-CONGO HEMORRHAGIC FEVER - PAKISTAN (06): COMMENT
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Date: Tue 8 Oct 2013
From: Khalid Khan <khalidvet75@yahoo.com> [edited]
Tick borne diseases are a big challenge for livestock and human beings in this new scenario of emerging diseases. In livestock, there are huge occurrences of theilriosis, anaplasmosis, and XXXXXX. Some time ago, we observed mixed infections of TBDS [tick borne diseases] (hemoprotozoans) in single animals.
Tick populations [are higher], and this summer [2013] was very hard on livestock in Peshawar district and adjacent areas and districts of KP [Khyber Pakhtunkhwa].
--
Dr. Khalid Khan
SRO/PI, TBDI's
VRI, Peshawar
KPK, Pakistan
<khalidvet75@yahoo.com>
[ProMED-mail thanks Dr Khalid Khan for providing this information about the current prevalence of the tick vectors of Crimean-Congo hemorrhagic fever (CCHF) in the Khyber Pakhtunkhwa (KP) province of Pakistan.
The following is some additional relevant data about the role of ticks in the spread of CCHF:
Adult ticks attach to cattle, sheep, goats, or human beings. Livestock show no overt signs of disease, and farmers and slaughterhouse workers have little idea they have been infected until they start expressing symptoms: dizziness, muscular pain, and stiffness, and of course the signature bleeding, whereas infection in birds mostly tends to be abortive (with the exception of ostriches in South Africa).
About 30 countries in Africa, Asia, and Europe have reported CCHF infections. The tick vector of CCHF ventures no further than 50 degrees north latitude, which cuts across Russia, Ukraine, central Europe, and France. The latter 2 regions are not considered to be at any immediate risk, since the _Hyalomma_ spp. tick vectors are present, but there is no serological evidence of CCHF.
The distribution of known cases of CCHF across the Middle East and Africa is patchy; ticks are present in the whole of this region, but in many countries, [they] seem harmless. In Africa, only South Africa, and from time to time Mauritania, face ongoing outbreaks; countries such as Tanzania and Uganda have not reported any recent outbreaks, and countries such as Angola and Algeria seem not to be at risk.
As with many vector-borne diseases, several ecological and anthropocentric factors are likely to affect the disease's occurrence: increases in bush-type habitats, for example, and increases in wild animal populations. Taken together, these factors may cause the tick to switch to human beings.
Changing patterns of agriculture and flood controls may also have played a part. In the Soviet Union, agriculture was collectivised and flood plains converted to farmland. The recent cases in Pakistan could be related to the floods of 2010 and the resultant concentration of people and livestock in certain areas. The Muslim festival of Eid al-Adha, at which sheep and goats are sacrificed, may also be a contributing factor.
Only 4 countries have reported more than 50 CCHF cases per year: Iran, Russia, Turkey, and Uzbekistan (although it could easily be the case that these countries simply have particularly efficient surveillance systems backed by proper diagnostics). A few other nations report 5-49 cases per year. Most of the time, CCHF outbreaks affect a small number of people. - Mod.CP
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1iGJ.]
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ProMED-mail is a program of the
International Society for Infectious Diseases
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Date: Tue 8 Oct 2013
From: Khalid Khan <khalidvet75@yahoo.com> [edited]
Tick borne diseases are a big challenge for livestock and human beings in this new scenario of emerging diseases. In livestock, there are huge occurrences of theilriosis, anaplasmosis, and XXXXXX. Some time ago, we observed mixed infections of TBDS [tick borne diseases] (hemoprotozoans) in single animals.
Tick populations [are higher], and this summer [2013] was very hard on livestock in Peshawar district and adjacent areas and districts of KP [Khyber Pakhtunkhwa].
--
Dr. Khalid Khan
SRO/PI, TBDI's
VRI, Peshawar
KPK, Pakistan
<khalidvet75@yahoo.com>
[ProMED-mail thanks Dr Khalid Khan for providing this information about the current prevalence of the tick vectors of Crimean-Congo hemorrhagic fever (CCHF) in the Khyber Pakhtunkhwa (KP) province of Pakistan.
The following is some additional relevant data about the role of ticks in the spread of CCHF:
Adult ticks attach to cattle, sheep, goats, or human beings. Livestock show no overt signs of disease, and farmers and slaughterhouse workers have little idea they have been infected until they start expressing symptoms: dizziness, muscular pain, and stiffness, and of course the signature bleeding, whereas infection in birds mostly tends to be abortive (with the exception of ostriches in South Africa).
About 30 countries in Africa, Asia, and Europe have reported CCHF infections. The tick vector of CCHF ventures no further than 50 degrees north latitude, which cuts across Russia, Ukraine, central Europe, and France. The latter 2 regions are not considered to be at any immediate risk, since the _Hyalomma_ spp. tick vectors are present, but there is no serological evidence of CCHF.
The distribution of known cases of CCHF across the Middle East and Africa is patchy; ticks are present in the whole of this region, but in many countries, [they] seem harmless. In Africa, only South Africa, and from time to time Mauritania, face ongoing outbreaks; countries such as Tanzania and Uganda have not reported any recent outbreaks, and countries such as Angola and Algeria seem not to be at risk.
As with many vector-borne diseases, several ecological and anthropocentric factors are likely to affect the disease's occurrence: increases in bush-type habitats, for example, and increases in wild animal populations. Taken together, these factors may cause the tick to switch to human beings.
Changing patterns of agriculture and flood controls may also have played a part. In the Soviet Union, agriculture was collectivised and flood plains converted to farmland. The recent cases in Pakistan could be related to the floods of 2010 and the resultant concentration of people and livestock in certain areas. The Muslim festival of Eid al-Adha, at which sheep and goats are sacrificed, may also be a contributing factor.
Only 4 countries have reported more than 50 CCHF cases per year: Iran, Russia, Turkey, and Uzbekistan (although it could easily be the case that these countries simply have particularly efficient surveillance systems backed by proper diagnostics). A few other nations report 5-49 cases per year. Most of the time, CCHF outbreaks affect a small number of people. - Mod.CP
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1iGJ.]
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CRIMEAN-CONGO HEMORRHAGIC FEVER - PAKISTAN (07): (PUNJAB) FATAL
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Date: Tue 22 Oct 2013
Source: The Frontier Post [edited]
http://www.thefrontierpost.com/article/49385/
A patient who had symptoms of Crimean-Congo hemorrhagic fever (CCHF) died on Tuesday [22 Oct 2013] in Lahore.
CCHF is a tickborne viral disease which is mainly transferred to humans from pets [see commentary]. Its symptoms include fever, bloody urine, vomiting, and nose bleeding. 30 per cent of the cases result in death on the 2nd week of the illness.
According to [local] sources, a 31 year old person, a suspected case of CCHF, was under treatment at a private clinic in the Ferozepur Road area of Lahore. He was brought to the hospital 5 days ago but died of the illness. The doctors said that blood samples of the patient have been sent to the National Institute of Health. A family member said the man's health destabilized after he visited a local cattle market to purchase a sacrificial animal.
This was the 1st death caused by CCHF in Punjab; however, the provincial Health Department has not, so far, confirmed diagnosis of the cause of death officially.
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[Although this may be the 1st death from the disease in Punjab province, CCHF is no longer rare in Pakistan, and it becomes particularly evident during the periods when animals are sacrificed during religious rituals.
CCHF virus is transmitted to people either directly by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers, and veterinarians. The length of the incubation period depends on the mode of acquisition of the virus. Following infection by a tick bite, the incubation period is usually 1-3 days, with a maximum of 9 days. The incubation period following contact with infected blood or tissues is usually 5 to 6 days, with a documented maximum of 13 days.
It is not correct to state that the disease is transmitted mainly to humans from pets. CCHF is a tickborne disease, and humans acquire infection directly by tick bite or by contact with the blood of infected livestock. Confirmation of the diagnosis by laboratory diagnostics is awaited.
A map of the provinces of Pakistan showing the location of Punjab province can be accessed at http://www.mapsofworld.com/pakistan/pak ... l-map.html. - Mod.CP
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1iGJ.]
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Date: Tue 22 Oct 2013
Source: The Frontier Post [edited]
http://www.thefrontierpost.com/article/49385/
A patient who had symptoms of Crimean-Congo hemorrhagic fever (CCHF) died on Tuesday [22 Oct 2013] in Lahore.
CCHF is a tickborne viral disease which is mainly transferred to humans from pets [see commentary]. Its symptoms include fever, bloody urine, vomiting, and nose bleeding. 30 per cent of the cases result in death on the 2nd week of the illness.
According to [local] sources, a 31 year old person, a suspected case of CCHF, was under treatment at a private clinic in the Ferozepur Road area of Lahore. He was brought to the hospital 5 days ago but died of the illness. The doctors said that blood samples of the patient have been sent to the National Institute of Health. A family member said the man's health destabilized after he visited a local cattle market to purchase a sacrificial animal.
This was the 1st death caused by CCHF in Punjab; however, the provincial Health Department has not, so far, confirmed diagnosis of the cause of death officially.
--
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ProMED-mail
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[Although this may be the 1st death from the disease in Punjab province, CCHF is no longer rare in Pakistan, and it becomes particularly evident during the periods when animals are sacrificed during religious rituals.
CCHF virus is transmitted to people either directly by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers, and veterinarians. The length of the incubation period depends on the mode of acquisition of the virus. Following infection by a tick bite, the incubation period is usually 1-3 days, with a maximum of 9 days. The incubation period following contact with infected blood or tissues is usually 5 to 6 days, with a documented maximum of 13 days.
It is not correct to state that the disease is transmitted mainly to humans from pets. CCHF is a tickborne disease, and humans acquire infection directly by tick bite or by contact with the blood of infected livestock. Confirmation of the diagnosis by laboratory diagnostics is awaited.
A map of the provinces of Pakistan showing the location of Punjab province can be accessed at http://www.mapsofworld.com/pakistan/pak ... l-map.html. - Mod.CP
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1iGJ.]
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CRIMEAN-CONGO HEMORRHAGIC FEVER - PAKISTAN (08): (PUNJAB) FATAL
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Date: Thu 7 Nov 2013
Source: Pakistan Today [edited]
http://www.pakistantoday.com.pk/2013/11 ... rises-to-3
A patient succumbed to Crimean-Congo hemorrhagic fever (CCHF) virus, increasing the death toll to 3 [in Punjab province].
The Health Department has confirmed the death toll. According to local reports, a patient who had symptoms of CCHF died in Lahore [Punjab province] on Thursday [7 Nov 2013].
CCHF is a tick-borne viral disease which is mainly transferred to humans from pets [more probably agricultural livestock]. Its symptoms include fever, flu, bloody urine, vomiting and nose bleeding. About 30 percent of the cases result in death on the 2nd week of the illness.
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[This was the 3rd death caused by CCHF virus infection in Punjab province in recent days [see: Crimean-Congo hem. fever - Pakistan (07): (PB) fatal 20131023.2017084]. However, the provincial Health Department has not, so far, confirmed diagnosis of the cause of death officially.
CCHF virus is transmitted to people either directly by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers, and veterinarians. The length of the incubation period depends on the mode of acquisition of the virus. Following infection by a tick bite, the incubation period is usually 1-3 days, with a maximum of 9 days. The incubation period following contact with infected blood or tissues is usually 5-6 days, with a documented maximum of 13 days. CCHF is a tick-borne disease, and humans acquire infection directly by tick bite or by contact with the blood of infected livestock. Confirmation of the diagnosis by laboratory diagnostics is awaited.
Recently Zhaorui Zhou and colleagues have analysed "Reassortment and migration analysis of Crimean-Congo haemorrhagic fever virus" [J. Gen. Virol. November 2013 vol. 94 no. Pt 11 2536-2548 http://vir.sgmjournals.org/content/94/P ... 6.abstract], and concluded from phylogenetic analyses that migration depended greatly on the nature of the hosts of the tick vector. In Africa, long-distance migration occurred frequently where the tick vector parasitised birds, whereas short-range migration was observed where the tick vector was carried predominantly by domestic livestock. In the case of Pakistan, there was clear evidence from phylogenetic analyses that CCHF virus was migrating into Pakistan from Afghanistan.
A map of the provinces of Pakistan showing the location of Punjab province can be accessed at http://www.mapsofworld.com/pakistan/pak ... l-map.html. A HealthMap/ProMED-mail interactive map is at http://healthmap.org/r/1kdg. - Mod.CP]
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Date: Thu 7 Nov 2013
Source: Pakistan Today [edited]
http://www.pakistantoday.com.pk/2013/11 ... rises-to-3
A patient succumbed to Crimean-Congo hemorrhagic fever (CCHF) virus, increasing the death toll to 3 [in Punjab province].
The Health Department has confirmed the death toll. According to local reports, a patient who had symptoms of CCHF died in Lahore [Punjab province] on Thursday [7 Nov 2013].
CCHF is a tick-borne viral disease which is mainly transferred to humans from pets [more probably agricultural livestock]. Its symptoms include fever, flu, bloody urine, vomiting and nose bleeding. About 30 percent of the cases result in death on the 2nd week of the illness.
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Communicated by:
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<promed@promedmail.org>
[This was the 3rd death caused by CCHF virus infection in Punjab province in recent days [see: Crimean-Congo hem. fever - Pakistan (07): (PB) fatal 20131023.2017084]. However, the provincial Health Department has not, so far, confirmed diagnosis of the cause of death officially.
CCHF virus is transmitted to people either directly by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers, and veterinarians. The length of the incubation period depends on the mode of acquisition of the virus. Following infection by a tick bite, the incubation period is usually 1-3 days, with a maximum of 9 days. The incubation period following contact with infected blood or tissues is usually 5-6 days, with a documented maximum of 13 days. CCHF is a tick-borne disease, and humans acquire infection directly by tick bite or by contact with the blood of infected livestock. Confirmation of the diagnosis by laboratory diagnostics is awaited.
Recently Zhaorui Zhou and colleagues have analysed "Reassortment and migration analysis of Crimean-Congo haemorrhagic fever virus" [J. Gen. Virol. November 2013 vol. 94 no. Pt 11 2536-2548 http://vir.sgmjournals.org/content/94/P ... 6.abstract], and concluded from phylogenetic analyses that migration depended greatly on the nature of the hosts of the tick vector. In Africa, long-distance migration occurred frequently where the tick vector parasitised birds, whereas short-range migration was observed where the tick vector was carried predominantly by domestic livestock. In the case of Pakistan, there was clear evidence from phylogenetic analyses that CCHF virus was migrating into Pakistan from Afghanistan.
A map of the provinces of Pakistan showing the location of Punjab province can be accessed at http://www.mapsofworld.com/pakistan/pak ... l-map.html. A HealthMap/ProMED-mail interactive map is at http://healthmap.org/r/1kdg. - Mod.CP]
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CRIMEAN-CONGO HEMORRHAGIC FEVER - INDIA (04): (GUJARAT), INCREASING INCIDENCE
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Date: 4 Dec 2013
Source: The Indian Express [edited]
http://www.indianexpress.com/news/congo ... r/1202997/
Outbreaks of Crimean-Congo hemorrhagic fever [CCHF] seem to have doubled in Gujarat, the 1st state to have reported the prevalence of this tick-borne viral disease in the country.
In the last 3 years [2011-2013] alone, there have been 30 positive cases and 14 deaths due to CCHF, half of which were reported in a cattle-rearing community known as the Bharwads, stated experts who participated in the day-long conference "Healthy Gujarat: Agenda For Action," organised by the Gujarat Health and Family Welfare Department on Tuesday [3 Dec 2013].
"The 1st instance of CCHF was detected in Kolat village near Ahmedabad in January 2011. That year, there were 4 outbreaks of CCHF. The year 2012 was reportedly milder, with 2 outbreaks. However, in 2013, there were as many as 8 outbreaks," said Dr Kamlesh Upadhyay, a professor in the Department of Medicine at Ahmedabad-based BJ Medical College & Civil Hospital.
"In the last 3 years, there have been 30 positive cases of virus infection, 50 percent of which are from the Bharwad community," added Upadhyay, who was speaking on the topic of "Disease Burden" of Gujarat. "Today, there are 14 sites in Gujarat from where CCHF has been reported," he said.
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[Crimean-Congo haemorrhagic fever (CCHF) outbreaks have a case fatality rate of up to 40 per cent. The virus is primarily transmitted to people from ticks harboured by livestock animals. Human-to-human transmission can occur resulting from close contact with the blood, secretions, organs, or other bodily fluids of those infected. Infected domestic animals do not usually show signs of infection, which may contribute to the general lack of awareness of the disease even in endemic areas and a toleration of tick bites.
CCHF is endemic in Africa, the Balkans, the Middle East and Asia, in countries south of the 50th parallel north. There is no vaccine available for either people or animals.
A map of the states and territories of India showing the location of Gujarat in the northwest can be accessed at http://www.mapsofindia.com/maps/india/i ... al-map.gif. - Mod.CP
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1pSH.]
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Date: 4 Dec 2013
Source: The Indian Express [edited]
http://www.indianexpress.com/news/congo ... r/1202997/
Outbreaks of Crimean-Congo hemorrhagic fever [CCHF] seem to have doubled in Gujarat, the 1st state to have reported the prevalence of this tick-borne viral disease in the country.
In the last 3 years [2011-2013] alone, there have been 30 positive cases and 14 deaths due to CCHF, half of which were reported in a cattle-rearing community known as the Bharwads, stated experts who participated in the day-long conference "Healthy Gujarat: Agenda For Action," organised by the Gujarat Health and Family Welfare Department on Tuesday [3 Dec 2013].
"The 1st instance of CCHF was detected in Kolat village near Ahmedabad in January 2011. That year, there were 4 outbreaks of CCHF. The year 2012 was reportedly milder, with 2 outbreaks. However, in 2013, there were as many as 8 outbreaks," said Dr Kamlesh Upadhyay, a professor in the Department of Medicine at Ahmedabad-based BJ Medical College & Civil Hospital.
"In the last 3 years, there have been 30 positive cases of virus infection, 50 percent of which are from the Bharwad community," added Upadhyay, who was speaking on the topic of "Disease Burden" of Gujarat. "Today, there are 14 sites in Gujarat from where CCHF has been reported," he said.
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[Crimean-Congo haemorrhagic fever (CCHF) outbreaks have a case fatality rate of up to 40 per cent. The virus is primarily transmitted to people from ticks harboured by livestock animals. Human-to-human transmission can occur resulting from close contact with the blood, secretions, organs, or other bodily fluids of those infected. Infected domestic animals do not usually show signs of infection, which may contribute to the general lack of awareness of the disease even in endemic areas and a toleration of tick bites.
CCHF is endemic in Africa, the Balkans, the Middle East and Asia, in countries south of the 50th parallel north. There is no vaccine available for either people or animals.
A map of the states and territories of India showing the location of Gujarat in the northwest can be accessed at http://www.mapsofindia.com/maps/india/i ... al-map.gif. - Mod.CP
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1pSH.]
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CRIMEAN-CONGO HEMORRHAGIC FEVER - TURKEY: (SINOP)
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Date: Wed 16 Apr 2014
Source: Turkish Press, Anadolu Agency (AA) report [edited]
http://www.turkishpress.com/news/402305/
The Crimean-Congo haemorrhagic fever (CCHF) virus was found in the blood of a person who died on Sunday [13 Apr 2014] in Turkey's Istanbul.
According to information given to an AA correspondent, a 56-year-old man, who ranches in Kavak village of Boyabat district [Sinop province], removed ticks on his bovine animal on 4 Apr [2014]. On the following day, he was given serum [IV fluids?] after he went to hospital with complaints of weakness and vomit. He went to a hospital again in Kastamonu city, then he was sent to Istanbul with suspected CCHF. However, he lost his life despite all efforts.
The man's blood samples were sent to a laboratory, [found the CCHF virus in it]. Sinop Public Health Director Dr Tahsin Gokhan Telatar told AA that the test results of the blood samples show that the man died due to CCHF.
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<promed@promedmail.org>
[Crimean-Congo hemorrhagic fever virus (CCHFV) is endemic in Africa, the Balkans, the Middle East, and Asia, in countries south of the 50th parallel north. Cases have occurred sporadically in Turkey. CCHFV is tickborne virus in the genus _Nairovirus_, family _Bunyaviridae_. CCHFV can cause severe viral haemorrhagic fever outbreaks, with a case fatality rate of 10-40 per cent.
Mod.CP (see ProMED-mail archive 20130501.1684736) cited information summarized from a review in The Lancet by Talha Khan Burki (Lancet 2012; 380(9857): 1897-8. doi:10.1016/S0140-6736(12)62097-2; http://www.thelancet.com/journals/lance ... 2/fulltext). In its immature form, the tick feeds on small mammals. Later, the adult tick attaches itself to cattle, sheep, goats, or human beings. Livestock show no overt signs of disease, and farmers and slaughterhouse workers have little idea they have been infected until they start expressing symptoms: dizziness, muscular pain, and stiffness, and of course the signature bleeding. Whereas infection in birds mostly tends to be abortive, ostriches are important hosts. In the mid 1990s, South Africa saw a CCHF outbreak at an ostrich abattoir. About 30 countries in Africa, Asia, and Europe have reported CCHF. The tick ventures no further than 50 deg north latitude, which cuts across Russia, Ukraine, central Europe, and France; the latter 2 regions are not considered to be at any immediate risk, the _Hyalomma_ spp ticks are present but there is no serological evidence of CCHF. The distribution of known cases across the Middle East and Africa is patchy -- ticks are present in the whole of this region but in many countries it seems harmless. In Africa, only South Africa, and from time to time Mauritania, face ongoing outbreaks; countries such as Tanzania and Uganda have not reported any recent outbreaks; and countries such as Angola and Algeria seem not to be at risk.
Changing patterns of agriculture and flood control may also have played a part. In Turkey affected parts of central Anatolia had been more or less abandoned in the late 1990s due to terrorist activity. Hunting and farming resumed in 2001, and ticks were able to fasten onto the influx of cattle and sheep. The following year [2002], Turkey confirmed its 1st case of CCHF and numbers have steadily increased ever since (which may simply be due to the increased surveillance).
Only 4 countries report more than 50 cases per year: Iran, Russia, Turkey, and Uzbekistan (although, it could easily be the case that these countries simply have particularly efficient surveillance systems backed by proper diagnostics).
Boyabat is a district of Sinop Province in the Black Sea region of Turkey. A HealthMap/ProMED-mail map showing the location of Sinop province can be accessed at http://healthmap.org/promed/p/38602. - Mod.TY]
*************************************************
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: Wed 16 Apr 2014
Source: Turkish Press, Anadolu Agency (AA) report [edited]
http://www.turkishpress.com/news/402305/
The Crimean-Congo haemorrhagic fever (CCHF) virus was found in the blood of a person who died on Sunday [13 Apr 2014] in Turkey's Istanbul.
According to information given to an AA correspondent, a 56-year-old man, who ranches in Kavak village of Boyabat district [Sinop province], removed ticks on his bovine animal on 4 Apr [2014]. On the following day, he was given serum [IV fluids?] after he went to hospital with complaints of weakness and vomit. He went to a hospital again in Kastamonu city, then he was sent to Istanbul with suspected CCHF. However, he lost his life despite all efforts.
The man's blood samples were sent to a laboratory, [found the CCHF virus in it]. Sinop Public Health Director Dr Tahsin Gokhan Telatar told AA that the test results of the blood samples show that the man died due to CCHF.
--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[Crimean-Congo hemorrhagic fever virus (CCHFV) is endemic in Africa, the Balkans, the Middle East, and Asia, in countries south of the 50th parallel north. Cases have occurred sporadically in Turkey. CCHFV is tickborne virus in the genus _Nairovirus_, family _Bunyaviridae_. CCHFV can cause severe viral haemorrhagic fever outbreaks, with a case fatality rate of 10-40 per cent.
Mod.CP (see ProMED-mail archive 20130501.1684736) cited information summarized from a review in The Lancet by Talha Khan Burki (Lancet 2012; 380(9857): 1897-8. doi:10.1016/S0140-6736(12)62097-2; http://www.thelancet.com/journals/lance ... 2/fulltext). In its immature form, the tick feeds on small mammals. Later, the adult tick attaches itself to cattle, sheep, goats, or human beings. Livestock show no overt signs of disease, and farmers and slaughterhouse workers have little idea they have been infected until they start expressing symptoms: dizziness, muscular pain, and stiffness, and of course the signature bleeding. Whereas infection in birds mostly tends to be abortive, ostriches are important hosts. In the mid 1990s, South Africa saw a CCHF outbreak at an ostrich abattoir. About 30 countries in Africa, Asia, and Europe have reported CCHF. The tick ventures no further than 50 deg north latitude, which cuts across Russia, Ukraine, central Europe, and France; the latter 2 regions are not considered to be at any immediate risk, the _Hyalomma_ spp ticks are present but there is no serological evidence of CCHF. The distribution of known cases across the Middle East and Africa is patchy -- ticks are present in the whole of this region but in many countries it seems harmless. In Africa, only South Africa, and from time to time Mauritania, face ongoing outbreaks; countries such as Tanzania and Uganda have not reported any recent outbreaks; and countries such as Angola and Algeria seem not to be at risk.
Changing patterns of agriculture and flood control may also have played a part. In Turkey affected parts of central Anatolia had been more or less abandoned in the late 1990s due to terrorist activity. Hunting and farming resumed in 2001, and ticks were able to fasten onto the influx of cattle and sheep. The following year [2002], Turkey confirmed its 1st case of CCHF and numbers have steadily increased ever since (which may simply be due to the increased surveillance).
Only 4 countries report more than 50 cases per year: Iran, Russia, Turkey, and Uzbekistan (although, it could easily be the case that these countries simply have particularly efficient surveillance systems backed by proper diagnostics).
Boyabat is a district of Sinop Province in the Black Sea region of Turkey. A HealthMap/ProMED-mail map showing the location of Sinop province can be accessed at http://healthmap.org/promed/p/38602. - Mod.TY]
-
Birgitt
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Krim-Kongo Hämorrhagisches Fieber in Georgien
CRIMEAN-CONGO HEMORRHAGIC FEVER - GEORGIA
*****************************************
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: Wed 21 May 2014
Source: News Georgia [in Georgian, trans. Google, edited]
http://www.newsgeorgia.ru/incidents/201 ... 70129.html
In April this year [2014] in Georgia, 2 people died from Crimean-Congo [hemorrhagic] fever; both were females, one 34 and one 77 years old, said the head of the department of infectious diseases of the National Center for Disease Control, Hatuna Zahashvili.
According to the agency InterPressNews, just this year [2014] in Georgia, 5 cases of Crimean-Congo fever were reported.
"In 2014, 5 cases of Crimean-Congo fever have been reported. This is quite a serious disease, which is carried by [transmitted by] ticks. So far, cases have been recorded in Kartli and Samtskhe-Javakheti. It is known that Tbilisi is also an endemic area, as in past years, we have had cases of Crimean-Congo fever in the capital. This disease is mostly acquired after warming [temperatures], when ticks become active," said Zahashvili.
Crimean-Congo hemorrhagic fever (also known as hemorrhagic fever Crimean-Congo-Khazer, Crimean-Congo fever, Central Asian hemorrhagic fever, karahalak) is an acute zoonotic viral disease associated with natural foci. It is characterized by a 2-phase fever, general intoxication, and a severe bleeding syndrome.
Reservoirs of the virus are wild small mammals: a wild mouse, a small squirrel, hares, and eared hedgehogs. Carriers and vectors are ticks, mainly of the genus _Hyalomma_. Disease occurrence is seasonal, peaking from May-August in our area. In 80 per cent of cases, ill persons are those aged 20-60 years. Mortality resulting from the disease is up to 40 per cent.
The incubation period lasts from 1-14 days (usually 2-7 days). The disease begins abruptly; the body temperature rises rapidly, and even in mild forms of the disease reaches 39-40 C [102-104 F]. The initial (pre-hemorrhagic) period is marked only by signs of intoxication, characteristic of many infectious diseases. The initial period often lasts 3-4 days (from 1-7 days). This period is marked by high fever, weakness, fatigue, body aches all over, and severe headache and pain in muscles and joints.
Less common manifestations include the initial period of dizziness, impaired consciousness, severe pain in the calf muscles, and signs of inflammation of the upper respiratory tract. In some patients, before the onset of the hemorrhagic period, characteristic symptoms of the disease occur, which are: repeated vomiting not related to food intake, lower back pain, and abdominal pain, mainly in the epigastric region.
A consistent symptom is fever, which lasts an average of 7-8 days, especially typical for the Crimean-Congo hemorrhagic fever temperature curve. In particular, when the hemorrhagic syndrome appears, there is a marked reduction in body temperature; after 1-2 days, the body temperature rises again, a result characteristic for this disease, the "2-peak" temperature curve.
The hemorrhagic period corresponds to the period of febrile disease; its severity determines the severity and outcome of disease. In the majority of patients, on the 2nd-4th day of illness (at least on the 5th-7th day), hemorrhagic rash appears on the skin and mucous membranes with hematoma at the bite site, and there may be internal bleeding. Fever lasts for 10-12 days. Normalization of body temperature and cessation of bleeding characterizes the transition to a period of convalescence.
--
communicated by:
ProMED-mail
<promed@promedmail.org>
[This is the 2nd case of Crimean-Congo hemorrhagic fever (CCHF) in Georgia that ProMED-mail has posted. The 1st report was posted in September 2009. As noted in ProMED-mail archive no. 20140418.2413017, CCHF virus is endemic in Africa, the Balkans, the Middle East, and Asia, in countries south of the 50th parallel north. CCHFV is a tickborne virus in the genus _Nairovirus_, family _Bunyaviridae_. CCHF virus can cause severe viral haemorrhagic fever outbreaks, with a case fatality rate of 10-40 per cent.
Mod.CP (see ProMED-mail archive 20130501.1684736) cited information summarized from a review in The Lancet by Talha Khan Burki (Lancet 2012; 380(9857): 1897-8. doi:10.1016/S0140-6736(12)62097-2; http://www.thelancet.com/journals/lance ... 2/fulltext). In its immature form, the tick feeds on small mammals. Later, the adult tick attaches itself to cattle, sheep, goats, or human beings. Livestock show no overt signs of disease, and farmers and slaughterhouse workers have little idea they have been infected until they start expressing symptoms: dizziness, muscular pain, and stiffness, and of course the signature bleeding. Whereas infection in birds mostly tends to be abortive, ostriches are important hosts. In the mid 1990s, South Africa saw a CCHF outbreak at an ostrich abattoir.
About 30 countries in Africa, Asia, and Europe have reported CCHF. The tick ventures no further than 50 degrees north latitude, which cuts across Russia, Ukraine, central Europe, and France; the latter 2 regions are not considered to be at any immediate risk; the _Hyalomma_ spp. ticks are present, but there is no serological evidence of CCHF. The distribution of known cases across the Middle East and Africa is patchy; ticks are present in the whole of this region, but in many countries, it seems harmless. In Africa, only South Africa, and from time to time Mauritania, face ongoing outbreaks; countries such as Tanzania and Uganda have not reported any recent outbreaks; and countries such as Angola and Algeria seem not to be at risk.
Only 4 countries report more than 50 cases per year: Iran, Russia, Turkey, and Uzbekistan (although, it could easily be the case that these countries simply have particularly efficient surveillance systems backed by proper diagnostics).
A HealthMap/ProMED-map of Georgia can be accessed at http://healthmap.org/promed/p/36365. - Mod.TY]
*****************************************
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: Wed 21 May 2014
Source: News Georgia [in Georgian, trans. Google, edited]
http://www.newsgeorgia.ru/incidents/201 ... 70129.html
In April this year [2014] in Georgia, 2 people died from Crimean-Congo [hemorrhagic] fever; both were females, one 34 and one 77 years old, said the head of the department of infectious diseases of the National Center for Disease Control, Hatuna Zahashvili.
According to the agency InterPressNews, just this year [2014] in Georgia, 5 cases of Crimean-Congo fever were reported.
"In 2014, 5 cases of Crimean-Congo fever have been reported. This is quite a serious disease, which is carried by [transmitted by] ticks. So far, cases have been recorded in Kartli and Samtskhe-Javakheti. It is known that Tbilisi is also an endemic area, as in past years, we have had cases of Crimean-Congo fever in the capital. This disease is mostly acquired after warming [temperatures], when ticks become active," said Zahashvili.
Crimean-Congo hemorrhagic fever (also known as hemorrhagic fever Crimean-Congo-Khazer, Crimean-Congo fever, Central Asian hemorrhagic fever, karahalak) is an acute zoonotic viral disease associated with natural foci. It is characterized by a 2-phase fever, general intoxication, and a severe bleeding syndrome.
Reservoirs of the virus are wild small mammals: a wild mouse, a small squirrel, hares, and eared hedgehogs. Carriers and vectors are ticks, mainly of the genus _Hyalomma_. Disease occurrence is seasonal, peaking from May-August in our area. In 80 per cent of cases, ill persons are those aged 20-60 years. Mortality resulting from the disease is up to 40 per cent.
The incubation period lasts from 1-14 days (usually 2-7 days). The disease begins abruptly; the body temperature rises rapidly, and even in mild forms of the disease reaches 39-40 C [102-104 F]. The initial (pre-hemorrhagic) period is marked only by signs of intoxication, characteristic of many infectious diseases. The initial period often lasts 3-4 days (from 1-7 days). This period is marked by high fever, weakness, fatigue, body aches all over, and severe headache and pain in muscles and joints.
Less common manifestations include the initial period of dizziness, impaired consciousness, severe pain in the calf muscles, and signs of inflammation of the upper respiratory tract. In some patients, before the onset of the hemorrhagic period, characteristic symptoms of the disease occur, which are: repeated vomiting not related to food intake, lower back pain, and abdominal pain, mainly in the epigastric region.
A consistent symptom is fever, which lasts an average of 7-8 days, especially typical for the Crimean-Congo hemorrhagic fever temperature curve. In particular, when the hemorrhagic syndrome appears, there is a marked reduction in body temperature; after 1-2 days, the body temperature rises again, a result characteristic for this disease, the "2-peak" temperature curve.
The hemorrhagic period corresponds to the period of febrile disease; its severity determines the severity and outcome of disease. In the majority of patients, on the 2nd-4th day of illness (at least on the 5th-7th day), hemorrhagic rash appears on the skin and mucous membranes with hematoma at the bite site, and there may be internal bleeding. Fever lasts for 10-12 days. Normalization of body temperature and cessation of bleeding characterizes the transition to a period of convalescence.
--
communicated by:
ProMED-mail
<promed@promedmail.org>
[This is the 2nd case of Crimean-Congo hemorrhagic fever (CCHF) in Georgia that ProMED-mail has posted. The 1st report was posted in September 2009. As noted in ProMED-mail archive no. 20140418.2413017, CCHF virus is endemic in Africa, the Balkans, the Middle East, and Asia, in countries south of the 50th parallel north. CCHFV is a tickborne virus in the genus _Nairovirus_, family _Bunyaviridae_. CCHF virus can cause severe viral haemorrhagic fever outbreaks, with a case fatality rate of 10-40 per cent.
Mod.CP (see ProMED-mail archive 20130501.1684736) cited information summarized from a review in The Lancet by Talha Khan Burki (Lancet 2012; 380(9857): 1897-8. doi:10.1016/S0140-6736(12)62097-2; http://www.thelancet.com/journals/lance ... 2/fulltext). In its immature form, the tick feeds on small mammals. Later, the adult tick attaches itself to cattle, sheep, goats, or human beings. Livestock show no overt signs of disease, and farmers and slaughterhouse workers have little idea they have been infected until they start expressing symptoms: dizziness, muscular pain, and stiffness, and of course the signature bleeding. Whereas infection in birds mostly tends to be abortive, ostriches are important hosts. In the mid 1990s, South Africa saw a CCHF outbreak at an ostrich abattoir.
About 30 countries in Africa, Asia, and Europe have reported CCHF. The tick ventures no further than 50 degrees north latitude, which cuts across Russia, Ukraine, central Europe, and France; the latter 2 regions are not considered to be at any immediate risk; the _Hyalomma_ spp. ticks are present, but there is no serological evidence of CCHF. The distribution of known cases across the Middle East and Africa is patchy; ticks are present in the whole of this region, but in many countries, it seems harmless. In Africa, only South Africa, and from time to time Mauritania, face ongoing outbreaks; countries such as Tanzania and Uganda have not reported any recent outbreaks; and countries such as Angola and Algeria seem not to be at risk.
Only 4 countries report more than 50 cases per year: Iran, Russia, Turkey, and Uzbekistan (although, it could easily be the case that these countries simply have particularly efficient surveillance systems backed by proper diagnostics).
A HealthMap/ProMED-map of Georgia can be accessed at http://healthmap.org/promed/p/36365. - Mod.TY]
-
Birgitt
- Moderator
- Beiträge: 35199
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Krim-Kongo Hämorrhagisches Fieber in Pakistan
CRIMEAN-CONGO HEMORRHAGIC FEVER - PAKISTAN
******************************************
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: Fri 23 May 2014
Source: The Express Tribune [edited]
http://tribune.com.pk/story/711875/dead ... r-at-pims/
At the Pakistan Institute of Medical Sciences (Pims), 3 patients believed to have Crimean-Congo hemorrhagic fever (CCHF) -- one later confirmed -- died at Pims in April and May this year [2014], Pims spokesperson Dr Ayesha Eshani said.
A senior physician sharing details about the most recent CCHF patient, said a man, an Afghan national, tested positive for CCHF and died late on Wednesday [21 May 2014]. According to his travel history, he came to Peshawar [Khyber-Pakhtunkhwa Province] from Afghanistan and then traveled to Islamabad, where he fell ill and was admitted to Pims.
The physician added that 2 other patients were suspected of having the disease. The Pims administration has started monitoring their staff to ensure that none of them has been affected by the viral disease.
[byline: Sehrish Wasif]
--
communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[It is not clear from this report if the confirmed CCHF case mentioned above acquired his infection in Afghanistan or in Pakistan. The other 2 suspected cases presumably were infected at unnamed locations in Pakistan. No details of the circumstances of exposure to CCHF virus are provided, nor are the details concerning the 2 suspected cases.
As noted in ProMED-mail archive no. 20140418.2413017, CCHF virus is endemic in Africa, the Balkans, the Middle East, and Asia, in countries south of the 50th parallel north. Cases occur with some frequency in Pakistan. CCHF virus is a tickborne virus in the genus _Nairovirus_, family _Bunyaviridae_. CCHF virus can cause severe viral haemorrhagic fever outbreaks, with a case fatality rate of 10-40 per cent. The virus is transmitted by _Hyalomma_ spp. ticks or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers, and veterinarians. The length of the incubation period depends on the mode of acquisition of the virus. Following infection by a tick bite, the incubation period is usually 1-3 days, with a maximum of 9 days, suggesting that the confirmed case above acquired the infection in Pakistan.
A map of the provinces of Pakistan showing the locations mentioned above can be accessed at http://www.mapsofworld.com/pakistan/pak ... l-map.html, and a HealthMap/ProMED-mail interactive map at http://healthmap.org/promed/p/140. - Mod.TY]
******************************************
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: Fri 23 May 2014
Source: The Express Tribune [edited]
http://tribune.com.pk/story/711875/dead ... r-at-pims/
At the Pakistan Institute of Medical Sciences (Pims), 3 patients believed to have Crimean-Congo hemorrhagic fever (CCHF) -- one later confirmed -- died at Pims in April and May this year [2014], Pims spokesperson Dr Ayesha Eshani said.
A senior physician sharing details about the most recent CCHF patient, said a man, an Afghan national, tested positive for CCHF and died late on Wednesday [21 May 2014]. According to his travel history, he came to Peshawar [Khyber-Pakhtunkhwa Province] from Afghanistan and then traveled to Islamabad, where he fell ill and was admitted to Pims.
The physician added that 2 other patients were suspected of having the disease. The Pims administration has started monitoring their staff to ensure that none of them has been affected by the viral disease.
[byline: Sehrish Wasif]
--
communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[It is not clear from this report if the confirmed CCHF case mentioned above acquired his infection in Afghanistan or in Pakistan. The other 2 suspected cases presumably were infected at unnamed locations in Pakistan. No details of the circumstances of exposure to CCHF virus are provided, nor are the details concerning the 2 suspected cases.
As noted in ProMED-mail archive no. 20140418.2413017, CCHF virus is endemic in Africa, the Balkans, the Middle East, and Asia, in countries south of the 50th parallel north. Cases occur with some frequency in Pakistan. CCHF virus is a tickborne virus in the genus _Nairovirus_, family _Bunyaviridae_. CCHF virus can cause severe viral haemorrhagic fever outbreaks, with a case fatality rate of 10-40 per cent. The virus is transmitted by _Hyalomma_ spp. ticks or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers, and veterinarians. The length of the incubation period depends on the mode of acquisition of the virus. Following infection by a tick bite, the incubation period is usually 1-3 days, with a maximum of 9 days, suggesting that the confirmed case above acquired the infection in Pakistan.
A map of the provinces of Pakistan showing the locations mentioned above can be accessed at http://www.mapsofworld.com/pakistan/pak ... l-map.html, and a HealthMap/ProMED-mail interactive map at http://healthmap.org/promed/p/140. - Mod.TY]
-
Birgitt
- Moderator
- Beiträge: 35199
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Krim-Kongo Hämorrhagisches Fieber in Pakistan
CRIMEAN-CONGO HEMORRHAGIC FEVER - PAKISTAN (02)
***********************************************
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: Wed 21 May 2014
Source: WHO Weekly Epidemiological Bulletin, Disease early warning system and response [DEWS] in Pakistan [edited]
http://www.emro.who.int/images/stories/ ... 4.pdf?ua=1
Case 1. On 9 May 2014, one CCHF [Crimean-Congo hemorrhagic fever] case was reported from FJCH, Quetta [Balochistan province]. The case was shepherd. He developed high grade fever with bleeding rectum [anus]and mouth a week before and became unconscious. Laboratory investigation revealed Hb [hemoglobin] 11.2 g/dl, platelets 28 000/cmm, urea 120 mg per cent, creatinine 2.2 mg per cent. Malaria was positive and his LFTs were deranged. A blood sample was collected earlier which was found positive for CCHF. There was no history of travel. Supportive treatment along with 8 pints of platelets was transfused but patient developed renal failure and passed away on 9 May 2014. No more cases were identified in the family or surrounding area.
Case 2. On 13 May 2014, one CCHF case aged 40 years was admitted in Isolation Room of Khyber Teaching Hospital, Peshawar with history of fever, myalgia, mucosal bleeding and hypotension. A surveillance Officer of DEWS [disease early warning system] investigated the case. The case is milkman and belongs to Saraey Norang in Lakki district [Khyber Pakhtunkhwa province]. He worked in a private farm in Karak [district, Khyber Pakhtunkhwa province] when he developed the symptoms. His platelet count wasless than 50 000/mm3. A blood sample was taken and sent to the NIH [National Institute if Health, Pakistan] and was found positive for CCHF. Barrier nursing was ensured in the hospital [to protect the staff], but the patient did not survive; he expired on 14 May 2014. The Surveillance Officer and the DoH [Health district] in DIKhan was informed and requested to conduct a field investigation in Lakki.
--
Communicated by:
Ronan Kelly
<ronankelly@comcast.net>
[It is not clear if these 2 cases are the ones reported as suspected in the ProMED-mail post of 23 May 2014 (archive no. 20140524.2496690) and have been confirmed subsequently or are additional new cases. Case 1, and probably case 2, had contact with livestock. CCHF virus is transmitted to livestock via _Hyalomma_ spp. ticks, and people usually acquire infection with this virus from infected livestock. Nosocomial infections occur as well, so the barrier nursing mentioned in the hospital that attended case 2 is important.
A map of the provinces of Pakistan showing the locations mentioned above can be accessed at http://www.mapsofworld.com/pakistan/pak ... l-map.html, and a HealthMap/ProMED-mail interactive map at http://healthmap.org/promed/p/140. - Mod.TY]
***********************************************
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: Wed 21 May 2014
Source: WHO Weekly Epidemiological Bulletin, Disease early warning system and response [DEWS] in Pakistan [edited]
http://www.emro.who.int/images/stories/ ... 4.pdf?ua=1
Case 1. On 9 May 2014, one CCHF [Crimean-Congo hemorrhagic fever] case was reported from FJCH, Quetta [Balochistan province]. The case was shepherd. He developed high grade fever with bleeding rectum [anus]and mouth a week before and became unconscious. Laboratory investigation revealed Hb [hemoglobin] 11.2 g/dl, platelets 28 000/cmm, urea 120 mg per cent, creatinine 2.2 mg per cent. Malaria was positive and his LFTs were deranged. A blood sample was collected earlier which was found positive for CCHF. There was no history of travel. Supportive treatment along with 8 pints of platelets was transfused but patient developed renal failure and passed away on 9 May 2014. No more cases were identified in the family or surrounding area.
Case 2. On 13 May 2014, one CCHF case aged 40 years was admitted in Isolation Room of Khyber Teaching Hospital, Peshawar with history of fever, myalgia, mucosal bleeding and hypotension. A surveillance Officer of DEWS [disease early warning system] investigated the case. The case is milkman and belongs to Saraey Norang in Lakki district [Khyber Pakhtunkhwa province]. He worked in a private farm in Karak [district, Khyber Pakhtunkhwa province] when he developed the symptoms. His platelet count wasless than 50 000/mm3. A blood sample was taken and sent to the NIH [National Institute if Health, Pakistan] and was found positive for CCHF. Barrier nursing was ensured in the hospital [to protect the staff], but the patient did not survive; he expired on 14 May 2014. The Surveillance Officer and the DoH [Health district] in DIKhan was informed and requested to conduct a field investigation in Lakki.
--
Communicated by:
Ronan Kelly
<ronankelly@comcast.net>
[It is not clear if these 2 cases are the ones reported as suspected in the ProMED-mail post of 23 May 2014 (archive no. 20140524.2496690) and have been confirmed subsequently or are additional new cases. Case 1, and probably case 2, had contact with livestock. CCHF virus is transmitted to livestock via _Hyalomma_ spp. ticks, and people usually acquire infection with this virus from infected livestock. Nosocomial infections occur as well, so the barrier nursing mentioned in the hospital that attended case 2 is important.
A map of the provinces of Pakistan showing the locations mentioned above can be accessed at http://www.mapsofworld.com/pakistan/pak ... l-map.html, and a HealthMap/ProMED-mail interactive map at http://healthmap.org/promed/p/140. - Mod.TY]
-
Birgitt
- Moderator
- Beiträge: 35199
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Krim-Kongo Hämorrhagisches Fieber in Pakistan
CRIMEAN-CONGO HEMORRHAGIC FEVER - PAKISTAN (03): AFGHANISTAN SUSPECTED
**********************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
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[1]
Date: Sun 25 May 2014
Source: a correspondent who has requested anonymity
I am investigating this outbreak. The 1st patient landed in Peshawar, came from Kabul, Afghanistan, and was an animal handler by profession. On 3 May 2014, he came to Peshawar, admitted in a private hospital then shifted same day to a public sector hospital in Peshawar and on 5 May 2014 he was referred to PIMS [Pakistan Institute of Medical Sciences], Islamabad, where he remained alive for 20 hours and expired on 6 May 2014. He had high-grade fever, bleeding from gums, nostrils, and rectum. He also had hemorrhagic spots on his body. He was negative for dengue, however his CCHF [Crimean Congo hemorrhagic fever] status could not be confirmed. His dead body was taken back to Kabul. He was 45 years old.
The 2nd patient was a 92-year-old retired government employee from Kohat, based in the Islamabad rural area. He was admitted in PIMS on 15 May 2014 with high grade fever and bleeding from gums, nose, and injection site. His sample was negative for dengue and positive for CCHF from NIH Islamabad. He died on 18 May 2014 and his dead body was taken back to Aurakzai agency for burial. One of his nephews who had taken care of the patient and his dead body is having symptoms now and is under investigation. The fatal case was in contact with animals.
The 3rd patient was a 24-year-old taxi driver, with no direct contact with animals, who presented to PIMS with bleeding symptoms and expired within 14 hours of admission. He was from Wah Cantt, Rawalpindi. His sample for dengue was negative, however no sample was taken for CCHF.
--
Communicated by:
a correspondent who has requested anonymity
******
[2]
Date: Wed 28 May 2014
Source: a correspondent who has requested anonymity
The nephew of the fatal case who was taking care of him in hospital and had also bathed his dead body [see [1] above], is positive for CCHF. He is stable and is not willing to be admitted in hospital. He went back to his native village in Aurakzai agency. All contacts are under observation and stable. [without symptoms? - Mod.JW]
--
Communicated by:
a correspondent who has requested anonymity
[These 3 patients are in addition to the 3 reported in previous posts (see ProMED-mail archives below). Only the 2nd case was laboratory confirmed, but the bleeding symptoms of the others strongly suggested CCHF. The suspected case from Kabul above died 2 weeks before the Afghanistan national reported in ProMED post 20140524.2496690. CCHF is endemic in the region of northwestern Pakistan/Afghanistan and neighboring Iran.
ProMED-mail always respects requests to withhold the identity of report submitters. It may be the only way to quickly warn public health personnel to be on the lookout for cases and take barrier nursing precautions when treating patients.
A map of Afghanistan and Pakistan showing most of the cities mentioned can be seen at
http://www.iljournal.it/wp-content/uplo ... nistan.png.
Rawalpindi is halfway between Islamabad and Lahore. - Mod.JW]
**********************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
[1]
Date: Sun 25 May 2014
Source: a correspondent who has requested anonymity
I am investigating this outbreak. The 1st patient landed in Peshawar, came from Kabul, Afghanistan, and was an animal handler by profession. On 3 May 2014, he came to Peshawar, admitted in a private hospital then shifted same day to a public sector hospital in Peshawar and on 5 May 2014 he was referred to PIMS [Pakistan Institute of Medical Sciences], Islamabad, where he remained alive for 20 hours and expired on 6 May 2014. He had high-grade fever, bleeding from gums, nostrils, and rectum. He also had hemorrhagic spots on his body. He was negative for dengue, however his CCHF [Crimean Congo hemorrhagic fever] status could not be confirmed. His dead body was taken back to Kabul. He was 45 years old.
The 2nd patient was a 92-year-old retired government employee from Kohat, based in the Islamabad rural area. He was admitted in PIMS on 15 May 2014 with high grade fever and bleeding from gums, nose, and injection site. His sample was negative for dengue and positive for CCHF from NIH Islamabad. He died on 18 May 2014 and his dead body was taken back to Aurakzai agency for burial. One of his nephews who had taken care of the patient and his dead body is having symptoms now and is under investigation. The fatal case was in contact with animals.
The 3rd patient was a 24-year-old taxi driver, with no direct contact with animals, who presented to PIMS with bleeding symptoms and expired within 14 hours of admission. He was from Wah Cantt, Rawalpindi. His sample for dengue was negative, however no sample was taken for CCHF.
--
Communicated by:
a correspondent who has requested anonymity
******
[2]
Date: Wed 28 May 2014
Source: a correspondent who has requested anonymity
The nephew of the fatal case who was taking care of him in hospital and had also bathed his dead body [see [1] above], is positive for CCHF. He is stable and is not willing to be admitted in hospital. He went back to his native village in Aurakzai agency. All contacts are under observation and stable. [without symptoms? - Mod.JW]
--
Communicated by:
a correspondent who has requested anonymity
[These 3 patients are in addition to the 3 reported in previous posts (see ProMED-mail archives below). Only the 2nd case was laboratory confirmed, but the bleeding symptoms of the others strongly suggested CCHF. The suspected case from Kabul above died 2 weeks before the Afghanistan national reported in ProMED post 20140524.2496690. CCHF is endemic in the region of northwestern Pakistan/Afghanistan and neighboring Iran.
ProMED-mail always respects requests to withhold the identity of report submitters. It may be the only way to quickly warn public health personnel to be on the lookout for cases and take barrier nursing precautions when treating patients.
A map of Afghanistan and Pakistan showing most of the cities mentioned can be seen at
http://www.iljournal.it/wp-content/uplo ... nistan.png.
Rawalpindi is halfway between Islamabad and Lahore. - Mod.JW]
-
Birgitt
- Moderator
- Beiträge: 35199
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Krim-Kongo Hämorrhagisches Fieber in Russland und Bulgarien
CRIMEAN-CONGO HEMORRHAGIC FEVER - RUSSIA (02): UK ex BULGARIA
*************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this posting:
[1] Russia (Volgograd)
[2] Russia (Dagestan)
[3] Russia (Rostov)
[4] UK ex Bulgaria
******
[1] Russia (Volgograd)
Date: Thu 26 Jun 2014
Source: Oblvestri [in Russian, trans. Mod.NR, edited]
http://oblvesti.ru/v-volgogradskoi-obla ... radki.html
In the Volgograd region, 6 cases of Crimean hemorrhagic fever have been registered. According to the press service of Rospotrebnadzora in Volgograd region, the results of an epidemiological survey showed that all patients were infected by a tick bites during haymaking or while caring for animals. Affected residents are from Kotel'nikovskii, October, and Chernishkovski Surovikinskogo districts.
In total, 705 people were affected with tick bites, including 218 children under the age of 14 years, and 9 of them were under medical supervision in an infectious diseases hospital.
Generally, Crimean hemorrhagic fever has been observed in our area since 2000, and the tick is both a carrier and a source. For the past 14 years, there were 115 cases of CCHF, 10 of them fatal because affected people were admitted to the hospital in later stages.
--
Communicated by:
ProMED-RUS
<promed@promedmail.org>
[There have been cases of Crimean-Congo hemorrhagic fever (CCHF) virus infections in Volgograd relatively frequently. The above report underscores the need to prevent tick bites, remove ticks quickly and promptly seek medical attention if symptoms appear.
Mod.CP noted that Volgograd Oblast is a federal subject of Russia (an oblast). Its administrative center is the city of Volgograd. Population: 2 610 161 (2010 census). The Southern Federal District of Russia is one of the 8 federal districts of Russia. Its territory lies mostly on the Pontic-Caspian steppe. The Southern Federal District was previously named the North Caucasian Federal District when it was founded in May 2000 but was renamed soon after for administrative reasons. On 19 Jan 2010, the Southern Federal District was split in 2, with its former southern territories forming a new North Caucasian Federal District. Its population was 13 854 334 (62.4 percent urban), according to the 2010 census, living on an area of 589 200 square km (227 500 square miles).
A ProMED-mail HealthMap showing the location of Volgograd can be accessed at http://healthmap.org/promed/p/412. - Mod.TY]
******
[2] Russia (Dagestan)
Date: Fri 27 Jun 2014
Source: RIA Dagestan [in Russian, trans. Mod.NR, edited]
http://www.riadagestan.ru/news/health/d ... hala_goda/
For the current period in 2014, 2 cases of Crimean-Congo hemorrhagic fever were reported in Dagestan, reported RIA Dagestan, the press service of Rospotrebnadzor.
Starting from April 2014, Rospotrebnadzor of the Republic of Dagestan started conducting weekly monitoring of infections transmitted by ticks (Crimean hemorrhagic fever, tick-borne encephalitis virus, tick-borne borreliosis _Ixodes_ [tick bites] and others) in order to ensure sanitary and epidemiological welfare of the population.
According to the monitoring as of 25 Jun [2014], 323 people, 128 of them children under 14 years, from 29 administrative territories applied for medical care due to tick bites; 28 people, including 10 children under 14 years, are hospitalized for medical observation. So far, 2 cases of Crimean-Congo hemorrhagic fever have been registered in Tarumovsky region.
--
Communicated by:
ProMED-RUS
<promed@promedmail.org>
[A HealthMap/ProMED-mail map showing the location of Dagestan can be accessed at http://healthmap.org/promed/p/396. - Mod.TY]
******
[3] Russia (Rostov)
Date: Fri 27 Jun 2014
Source: Komsomolskaya Pravda [in Russian, trans. Mod.NR, edited]
http://www.kp.ru/online/news/1775218/
In Rostov, 2 people died from the bite of ticks. It is known that one of them is a resident of Rostov, and the 2nd is from Peschanokopsky district. The Rostov resident was affected by tick [bite] during outdoor recreation, while a 55-year-old villager had a tick bite while mowing grass.
According to the regional Rospotrebnadzor, since the beginning of the year, 39 people have been affected by the bite of ticks. All of them were diagnosed with Crimean-Congo hemorrhagic fever [virus infections].
Overall, the doctors in this time admitted 4275 people with tick bites, 1/4th of them children and adolescents.
--
Communicated by:
ProMED-RUS
<promed@promedmail.org>
[Cases of Crimean-Congo hemorrhagic fever (CCHF) in the Southern Federal District were registered since April 2014. The 1st CCHF case in this region appeared in the Rostov region. There were also cases of CCHF in the Stavropol Territory. - Corr.BA]
[In the ProMED-mail post of 27 Aug 2013 (archive no. 20130827.1906334), Mod.CP noted, "The Rostov region includes natural foci of CCHF virus infection. In 2012, 41 cases of CCHF were recorded in the region, and there were 48 cases in 2011, including 8 cases belonging to a nosocomial cluster. The maximum number of cases (81 patients) was recorded in 2008.
Rostov Oblast is a federal region of Russia, located in the Southern Federal District. Rostov Oblast has an area of 100 800 square km (38 900 sq mi) and a population of 4 277 976 (2010 census), making it the 6th most populous federal subject in Russia. Its administrative center is the city of Rostov-on-Don, which also became the administrative center of the Southern Federal District in 2002."
A map showing the location of Rostov Oblast can be accessed at https://en.wikipedia.org/wiki/File:Map_ ... -03%29.svg. A map of Rostov Oblast can be seen at http://map.rin.ru/cgi-bin/main_e.pl?Region=rostov, and a HealthMap/ProMED-mail interactive map at http://healthmap.org/promed/p/426. - Mod.TY]
******
[4] UK ex Bulgaria
Date: Thu 3 Jul 2014
Source: GOV.UK, Public Health England press release [edited]
https://www.gov.uk/government/news/crim ... fied-in-uk
PHE [Public Health England] is aware of a laboratory-confirmed case of CCHF in a UK traveller who was bitten by a tick while on holiday in Bulgaria. The patient is responding well to treatment and there is no risk to the general population.
As a precautionary measure, close contacts of the patient, including hospital staff involved in the patient's care, will be given health advice and encouraged to contact their GP if they experience symptoms.
Although Crimean-Congo haemorrhagic fever (CCHF) can be acquired from an infected person, this would require direct contact with their blood or body fluids, and the risk even for close contacts is considered very low.
This is the 2nd laboratory-confirmed case of CCHF in the UK, following the diagnosis in 2012 of CCHF in a UK resident who had recently returned from Afghanistan.
CCHF is the commonest viral haemorrhagic fever worldwide. It is not found in the UK but is endemic in many countries in Africa, the Middle East, Asia and Eastern Europe, including Turkey and Bulgaria.
People most at risk are agricultural workers, healthcare workers and military personnel deployed to endemic areas. CCHF is most often transmitted by a tick bite, but can also be spread through contact with infected patients or animals.
Dr Tim Brooks, Head of Public Health England's (PHE's) Rare and Imported Pathogens Laboratory (RIPL), said: "It's extremely rare to see a case of Crimean-Congo haemorrhagic fever in the UK, and it's important to note there is no risk to the general population. As a precaution, close contacts of the patient will be contacted and monitored, but the risk of transmission is very low and would require direct contact with bodily fluids."
Notes to editors:
PHE is unable to disclose information on the hospital where this patient is being treated, due to patient confidentiality.
Crimean-Congo haemorrhagic fever (CCHF) is a viral haemorrhagic fever caused by a virus of the Nairovirus group. CCHF is a zoonosis, and infects a range of domestic and wild animals. It is spread via the bite of an infected tick. CCHF was 1st described in Crimea in 1944, among soldiers and agricultural workers, and in 1969 it was recognised that the virus causing the disease was identical to a virus isolated from a child in the Congo in 1956.
Symptoms of CCHF include fever, muscle aches, dizziness, neck pain and stiffness, backache, headache, sore eyes and sensitivity to light. Nausea, vomiting and sore throat may also occur, with diarrhoea and abdominal pain.
CCHF should be not be confused with Ebola haemorrhagic fever, and there is no connection between this incident and the current outbreak of Ebola in West Africa.
--
Communicated by:
Tony Ellam
Consultant, Communicable Disease Control (retired)
<tonypj@meadlane.freeserve.co.uk>
[ProMED thanks Tony Ellam for sending in this report. He also provided another report (http://nathnac.org/pro/clinical_updates ... 040714.htm) that has some useful information as follows:
"Advice for travellers:
- Travel-associated cases are rarely reported and the risk of CCHF to tourist travellers visiting endemic areas is very low provided precautions are taken. The majority of cases of CCHF occur amongst those working in agriculture including animal husbandry, veterinarians or animal slaughter workers.
- Healthcare workers are at risk from direct (unprotected) contact with the blood, body fluids or tissues of an infected person.
- Travellers to affected areas are advised to take measures to minimise their exposure to ticks. These include:
-- Wear clothing with long sleeves and long trousers (tucked into socks), which can be treated with insecticide sprays such as permethrin.
-- Apply insect repellent (DEET) to exposed skin.
-- Check the body for ticks regularly. Larval ticks are tiny and difficult to see. Adult ticks, once they have fed and become engorged, may be the size of a coffee bean. Common areas for ticks to attach are at the hair-line, behind the ears, elbows, backs of knees, groin and armpits.
-- Remove ticks as soon as possible by using a pair of tweezers or tick remover. The tweezers should be placed as close as possible to the skin and then the tick pulled slowly, ensuring the mouth parts are removed. Care needs to be taken not to squeeze the stomach contents into the site of the bite.
- Animal handlers should take precautions to avoid exposure to blood and tissues of livestock and healthcare workers should observe appropriate infection control measures.
There is no vaccine to prevent CCHF.
Outbreaks of CCHF are listed in the NaTHNaC Outbreak Surveillance Database.
Advice for Health Professionals:
- Health professionals who suspect a case of CCHF in a traveller should consult their local infectious disease specialist.
- A VHF [viral hemorrhagic fever] risk assessment protocol is available for health professionals who are assessing unwell returning travelers."
This report also lists several relevant references.
British health providers were alert in making the diagnosis quickly, implementing appropriate barrier nursing and informing close contacts of the patient. This case illustrates the fact that in this age of rapid international transportation, individuals infected with CCHF virus can turn up anywhere in the world. Good travel histories of patients are essential.
A HealthMap/ProMED-mail map of Bulgaria can be accessed at http://healthmap.org/promed/p/81. - Mod.TY]
*************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this posting:
[1] Russia (Volgograd)
[2] Russia (Dagestan)
[3] Russia (Rostov)
[4] UK ex Bulgaria
******
[1] Russia (Volgograd)
Date: Thu 26 Jun 2014
Source: Oblvestri [in Russian, trans. Mod.NR, edited]
http://oblvesti.ru/v-volgogradskoi-obla ... radki.html
In the Volgograd region, 6 cases of Crimean hemorrhagic fever have been registered. According to the press service of Rospotrebnadzora in Volgograd region, the results of an epidemiological survey showed that all patients were infected by a tick bites during haymaking or while caring for animals. Affected residents are from Kotel'nikovskii, October, and Chernishkovski Surovikinskogo districts.
In total, 705 people were affected with tick bites, including 218 children under the age of 14 years, and 9 of them were under medical supervision in an infectious diseases hospital.
Generally, Crimean hemorrhagic fever has been observed in our area since 2000, and the tick is both a carrier and a source. For the past 14 years, there were 115 cases of CCHF, 10 of them fatal because affected people were admitted to the hospital in later stages.
--
Communicated by:
ProMED-RUS
<promed@promedmail.org>
[There have been cases of Crimean-Congo hemorrhagic fever (CCHF) virus infections in Volgograd relatively frequently. The above report underscores the need to prevent tick bites, remove ticks quickly and promptly seek medical attention if symptoms appear.
Mod.CP noted that Volgograd Oblast is a federal subject of Russia (an oblast). Its administrative center is the city of Volgograd. Population: 2 610 161 (2010 census). The Southern Federal District of Russia is one of the 8 federal districts of Russia. Its territory lies mostly on the Pontic-Caspian steppe. The Southern Federal District was previously named the North Caucasian Federal District when it was founded in May 2000 but was renamed soon after for administrative reasons. On 19 Jan 2010, the Southern Federal District was split in 2, with its former southern territories forming a new North Caucasian Federal District. Its population was 13 854 334 (62.4 percent urban), according to the 2010 census, living on an area of 589 200 square km (227 500 square miles).
A ProMED-mail HealthMap showing the location of Volgograd can be accessed at http://healthmap.org/promed/p/412. - Mod.TY]
******
[2] Russia (Dagestan)
Date: Fri 27 Jun 2014
Source: RIA Dagestan [in Russian, trans. Mod.NR, edited]
http://www.riadagestan.ru/news/health/d ... hala_goda/
For the current period in 2014, 2 cases of Crimean-Congo hemorrhagic fever were reported in Dagestan, reported RIA Dagestan, the press service of Rospotrebnadzor.
Starting from April 2014, Rospotrebnadzor of the Republic of Dagestan started conducting weekly monitoring of infections transmitted by ticks (Crimean hemorrhagic fever, tick-borne encephalitis virus, tick-borne borreliosis _Ixodes_ [tick bites] and others) in order to ensure sanitary and epidemiological welfare of the population.
According to the monitoring as of 25 Jun [2014], 323 people, 128 of them children under 14 years, from 29 administrative territories applied for medical care due to tick bites; 28 people, including 10 children under 14 years, are hospitalized for medical observation. So far, 2 cases of Crimean-Congo hemorrhagic fever have been registered in Tarumovsky region.
--
Communicated by:
ProMED-RUS
<promed@promedmail.org>
[A HealthMap/ProMED-mail map showing the location of Dagestan can be accessed at http://healthmap.org/promed/p/396. - Mod.TY]
******
[3] Russia (Rostov)
Date: Fri 27 Jun 2014
Source: Komsomolskaya Pravda [in Russian, trans. Mod.NR, edited]
http://www.kp.ru/online/news/1775218/
In Rostov, 2 people died from the bite of ticks. It is known that one of them is a resident of Rostov, and the 2nd is from Peschanokopsky district. The Rostov resident was affected by tick [bite] during outdoor recreation, while a 55-year-old villager had a tick bite while mowing grass.
According to the regional Rospotrebnadzor, since the beginning of the year, 39 people have been affected by the bite of ticks. All of them were diagnosed with Crimean-Congo hemorrhagic fever [virus infections].
Overall, the doctors in this time admitted 4275 people with tick bites, 1/4th of them children and adolescents.
--
Communicated by:
ProMED-RUS
<promed@promedmail.org>
[Cases of Crimean-Congo hemorrhagic fever (CCHF) in the Southern Federal District were registered since April 2014. The 1st CCHF case in this region appeared in the Rostov region. There were also cases of CCHF in the Stavropol Territory. - Corr.BA]
[In the ProMED-mail post of 27 Aug 2013 (archive no. 20130827.1906334), Mod.CP noted, "The Rostov region includes natural foci of CCHF virus infection. In 2012, 41 cases of CCHF were recorded in the region, and there were 48 cases in 2011, including 8 cases belonging to a nosocomial cluster. The maximum number of cases (81 patients) was recorded in 2008.
Rostov Oblast is a federal region of Russia, located in the Southern Federal District. Rostov Oblast has an area of 100 800 square km (38 900 sq mi) and a population of 4 277 976 (2010 census), making it the 6th most populous federal subject in Russia. Its administrative center is the city of Rostov-on-Don, which also became the administrative center of the Southern Federal District in 2002."
A map showing the location of Rostov Oblast can be accessed at https://en.wikipedia.org/wiki/File:Map_ ... -03%29.svg. A map of Rostov Oblast can be seen at http://map.rin.ru/cgi-bin/main_e.pl?Region=rostov, and a HealthMap/ProMED-mail interactive map at http://healthmap.org/promed/p/426. - Mod.TY]
******
[4] UK ex Bulgaria
Date: Thu 3 Jul 2014
Source: GOV.UK, Public Health England press release [edited]
https://www.gov.uk/government/news/crim ... fied-in-uk
PHE [Public Health England] is aware of a laboratory-confirmed case of CCHF in a UK traveller who was bitten by a tick while on holiday in Bulgaria. The patient is responding well to treatment and there is no risk to the general population.
As a precautionary measure, close contacts of the patient, including hospital staff involved in the patient's care, will be given health advice and encouraged to contact their GP if they experience symptoms.
Although Crimean-Congo haemorrhagic fever (CCHF) can be acquired from an infected person, this would require direct contact with their blood or body fluids, and the risk even for close contacts is considered very low.
This is the 2nd laboratory-confirmed case of CCHF in the UK, following the diagnosis in 2012 of CCHF in a UK resident who had recently returned from Afghanistan.
CCHF is the commonest viral haemorrhagic fever worldwide. It is not found in the UK but is endemic in many countries in Africa, the Middle East, Asia and Eastern Europe, including Turkey and Bulgaria.
People most at risk are agricultural workers, healthcare workers and military personnel deployed to endemic areas. CCHF is most often transmitted by a tick bite, but can also be spread through contact with infected patients or animals.
Dr Tim Brooks, Head of Public Health England's (PHE's) Rare and Imported Pathogens Laboratory (RIPL), said: "It's extremely rare to see a case of Crimean-Congo haemorrhagic fever in the UK, and it's important to note there is no risk to the general population. As a precaution, close contacts of the patient will be contacted and monitored, but the risk of transmission is very low and would require direct contact with bodily fluids."
Notes to editors:
PHE is unable to disclose information on the hospital where this patient is being treated, due to patient confidentiality.
Crimean-Congo haemorrhagic fever (CCHF) is a viral haemorrhagic fever caused by a virus of the Nairovirus group. CCHF is a zoonosis, and infects a range of domestic and wild animals. It is spread via the bite of an infected tick. CCHF was 1st described in Crimea in 1944, among soldiers and agricultural workers, and in 1969 it was recognised that the virus causing the disease was identical to a virus isolated from a child in the Congo in 1956.
Symptoms of CCHF include fever, muscle aches, dizziness, neck pain and stiffness, backache, headache, sore eyes and sensitivity to light. Nausea, vomiting and sore throat may also occur, with diarrhoea and abdominal pain.
CCHF should be not be confused with Ebola haemorrhagic fever, and there is no connection between this incident and the current outbreak of Ebola in West Africa.
--
Communicated by:
Tony Ellam
Consultant, Communicable Disease Control (retired)
<tonypj@meadlane.freeserve.co.uk>
[ProMED thanks Tony Ellam for sending in this report. He also provided another report (http://nathnac.org/pro/clinical_updates ... 040714.htm) that has some useful information as follows:
"Advice for travellers:
- Travel-associated cases are rarely reported and the risk of CCHF to tourist travellers visiting endemic areas is very low provided precautions are taken. The majority of cases of CCHF occur amongst those working in agriculture including animal husbandry, veterinarians or animal slaughter workers.
- Healthcare workers are at risk from direct (unprotected) contact with the blood, body fluids or tissues of an infected person.
- Travellers to affected areas are advised to take measures to minimise their exposure to ticks. These include:
-- Wear clothing with long sleeves and long trousers (tucked into socks), which can be treated with insecticide sprays such as permethrin.
-- Apply insect repellent (DEET) to exposed skin.
-- Check the body for ticks regularly. Larval ticks are tiny and difficult to see. Adult ticks, once they have fed and become engorged, may be the size of a coffee bean. Common areas for ticks to attach are at the hair-line, behind the ears, elbows, backs of knees, groin and armpits.
-- Remove ticks as soon as possible by using a pair of tweezers or tick remover. The tweezers should be placed as close as possible to the skin and then the tick pulled slowly, ensuring the mouth parts are removed. Care needs to be taken not to squeeze the stomach contents into the site of the bite.
- Animal handlers should take precautions to avoid exposure to blood and tissues of livestock and healthcare workers should observe appropriate infection control measures.
There is no vaccine to prevent CCHF.
Outbreaks of CCHF are listed in the NaTHNaC Outbreak Surveillance Database.
Advice for Health Professionals:
- Health professionals who suspect a case of CCHF in a traveller should consult their local infectious disease specialist.
- A VHF [viral hemorrhagic fever] risk assessment protocol is available for health professionals who are assessing unwell returning travelers."
This report also lists several relevant references.
British health providers were alert in making the diagnosis quickly, implementing appropriate barrier nursing and informing close contacts of the patient. This case illustrates the fact that in this age of rapid international transportation, individuals infected with CCHF virus can turn up anywhere in the world. Good travel histories of patients are essential.
A HealthMap/ProMED-mail map of Bulgaria can be accessed at http://healthmap.org/promed/p/81. - Mod.TY]
-
Birgitt
- Moderator
- Beiträge: 35199
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Krim-Kongo Hämorrhagisches Fieber - Importierte Fälle
CRIMEAN-CONGO HEMORRHAGIC FEVER: IMPORTED CASES, BACKGROUND
**********************************************************************
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: Sun 6 Jul 2014
Source: GIDEON (Global Infectious Disease Epidemiology Network) [edited]
http://www.gideononline.com
[The following are Dr. Berger's comments concerning the occurrence CCHF in the UK ex Bulgaria (ProMED-mail archive no. 20140705.2589487)]:
Reports of Crimean-Congo hemorrhagic fever (CCHF) related to travel are rare. The following chronology is abstracted from Gideon http://www.GideonOnline.com and the Gideon e-book series. [1]
1985 - South Africa ex Democratic Republic of Congo (fatal).
1986 - South Africa ex Tanzania (nonfatal)
1997 - An English traveler died of probable CCHF contracted in Zimbabwe.
2001 - A German tourist acquired Crimean-Congo hemorrhagic fever in Bulgaria.
2004 - A case of imported Crimean-Congo hemorrhagic fever (nonfatal) was reported in a traveler returning to France from Senegal. Infection in a 2nd French national was diagnosed locally in Senegal.
2009 - An American soldier died in a hospital in Germany after contracting Crimean-Congo hemorrhagic fever in Afghanistan.
2011 - An outbreak (4 cases) in a Pakistan hospital was related to an index patient who had arrived from Afghanistan.
2012 - A patient died of Crimean-Congo hemorrhagic fever in Scotland following acquisition of the disease in Afghanistan.
2013 - A woman died of Crimean-Congo hemorrhagic fever in Uganda following contact with her infected husband in South Sudan.
2014 - A British traveler acquired Crimean-Congo hemorrhagic fever in Bulgaria.
Reference:
[1] Berger SA. Crimean-Congo Hemorrhagic Fever: Global Status, 2014. 41 pages, 21 graphs, 658 references. Gideon e-books, http://www.gideononline.com/ebooks/dise ... al-status/.
--
Steve Berger
Geographic Medicine
Tel Aviv Medical Center
<steve@gideononline.com>
[ProMED thanks Dr. Berger for this, another one of his interesting and informative comments.
CCHF virus is widely distributed geographically, ranging from the Indian subcontinent, south and central Asia, eastern Europe (including western Russia) and into Africa. It is not surprising that travelers who visit endemic areas outside of cities or who are in contact with local animals become exposed to the virus and infected with it, becoming ill on their return to their home countries. Making an accurate diagnosis by physicians in their home countries would be a challenge. Taking good travel histories in these cases is essential, not only for making the diagnosis but for implementing measures to prevent transmission from the patient to health care workers. Given rapid international air travel, individuals infected with this virus can turn up anywhere in the world. - Mod.TY
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/81.]
**********************************************************************
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: Sun 6 Jul 2014
Source: GIDEON (Global Infectious Disease Epidemiology Network) [edited]
http://www.gideononline.com
[The following are Dr. Berger's comments concerning the occurrence CCHF in the UK ex Bulgaria (ProMED-mail archive no. 20140705.2589487)]:
Reports of Crimean-Congo hemorrhagic fever (CCHF) related to travel are rare. The following chronology is abstracted from Gideon http://www.GideonOnline.com and the Gideon e-book series. [1]
1985 - South Africa ex Democratic Republic of Congo (fatal).
1986 - South Africa ex Tanzania (nonfatal)
1997 - An English traveler died of probable CCHF contracted in Zimbabwe.
2001 - A German tourist acquired Crimean-Congo hemorrhagic fever in Bulgaria.
2004 - A case of imported Crimean-Congo hemorrhagic fever (nonfatal) was reported in a traveler returning to France from Senegal. Infection in a 2nd French national was diagnosed locally in Senegal.
2009 - An American soldier died in a hospital in Germany after contracting Crimean-Congo hemorrhagic fever in Afghanistan.
2011 - An outbreak (4 cases) in a Pakistan hospital was related to an index patient who had arrived from Afghanistan.
2012 - A patient died of Crimean-Congo hemorrhagic fever in Scotland following acquisition of the disease in Afghanistan.
2013 - A woman died of Crimean-Congo hemorrhagic fever in Uganda following contact with her infected husband in South Sudan.
2014 - A British traveler acquired Crimean-Congo hemorrhagic fever in Bulgaria.
Reference:
[1] Berger SA. Crimean-Congo Hemorrhagic Fever: Global Status, 2014. 41 pages, 21 graphs, 658 references. Gideon e-books, http://www.gideononline.com/ebooks/dise ... al-status/.
--
Steve Berger
Geographic Medicine
Tel Aviv Medical Center
<steve@gideononline.com>
[ProMED thanks Dr. Berger for this, another one of his interesting and informative comments.
CCHF virus is widely distributed geographically, ranging from the Indian subcontinent, south and central Asia, eastern Europe (including western Russia) and into Africa. It is not surprising that travelers who visit endemic areas outside of cities or who are in contact with local animals become exposed to the virus and infected with it, becoming ill on their return to their home countries. Making an accurate diagnosis by physicians in their home countries would be a challenge. Taking good travel histories in these cases is essential, not only for making the diagnosis but for implementing measures to prevent transmission from the patient to health care workers. Given rapid international air travel, individuals infected with this virus can turn up anywhere in the world. - Mod.TY
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/81.]
-
Birgitt
- Moderator
- Beiträge: 35199
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Krim-Kongo Hämorrhagisches Fieber in Kasachstan und Pakistan
CRIMEAN-CONGO HEMORRHAGIC FEVER - KAZAKHSTAN, PAKISTAN
******************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this post:
[1] Kazakhstan
[2] Pakistan
******
[1] Kazakhstan
Date: Thu 10 Jul 2014
Source: Tengri News [edited]
http://en.tengrinews.kz/health/Deadly-v ... an-254417/
A total of 10 people, including an ambulance crew, were hospitalized in Southern Kazakhstan Oblast on suspicions of carrying a deadly virus on Monday, 23 Jun [2014], Tengrinews reports, citing IA Novosti-Kazakhstan.
Spokesman for the South Kazahstan Oblast Department of Emergency Situations Nurlan Temirbayev said that Crimean-Congo hemorrhagic fever (CCHF) was the probable cause.
Temirbayev informed that the day before a woman fell very sick. Her relatives called an ambulance for immediate help. During examination, the doctors noticed that the woman's hand had livid spots that looked like traces of a tick bite. Ticks are frequent transmitters of CCHF. The woman was hospitalized along with 9 other people -- the ambulance crew, who were 1st to respond to the emergency call, and the woman's close relatives, who lived with her in the same house.
Later on Monday [23 Jun 2014], the diagnosis of CCHF was confirmed by a laboratory test, as stated by Deputy Head of the Department of Consumer Protection of Southern Kazakhstan Oblast Zhumagul Medetov.
"The presence of the virus has been confirmed by laboratory tests. The 31-year-old resident of Akbastau village in Kazygurt district was taken to the central district hospital's intensive care unit. Her medical condition is assessed as serious but stable. Her one-year-old child has been hospitalized as well," Medetov said.
This is the 1st case of a person being hospitalized in connection with CCHF in South Kazakhstan [This year (2014)? There have been several cases in past years (see ProMED-mail posts given below). - Mod.TY]. Emergency Department employees are going to hold community meetings with the citizens to introduce them again to the 1st signs of CCHF and teach them how to act to protect themselves against the infection.
According to WHO, CCHF has a high fatality ratio of 10 to 40 per cent and is difficult for treatment and prevention. It is endemic in Asia south of the 50th parallel north, the Balkans, the Middle East and all of Africa. Some of the symptoms include sudden muscle ache with fever, dizziness, neck and back pain, sore eyes and sensitivity to light.
[Byline: Dinara Urazova]
--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[CCHF cases have been reported with some frequency in Kazakhstan in past years. Apparently, the affected woman in the above report was infected via tick bite. _Hyalomma_ ticks are the main vectors of CCHF virus. It is not clear if the 9 ambulance workers were ill with symptoms of CCHF virus infection or not. The report implies that they were exposed via contact with the fatal case. CCHF virus infection can be acquired by contact with viremic blood, but it is difficult to envision that this exposure occurred with all 9 ambulance workers. Perhaps 1 or 2 might have had contact with the woman's blood through administration of IV fluids en route to the hospital, but it is very unlikely that all 9 would have.
A HealthMap/ProMED-mail map of Kazakhstan can be accessed at http://healthmap.org/promed/p/56. - Mod.TY]
******
[2] Pakistan
Date: Sat 12 Jul 2014
Source: The Express Tribune [edited]
http://tribune.com.pk/story/734275/stem ... er-at-hmc/
An 8th person fell victim to [Crimean-]Congo hemorrhagic fever [CCHF] at Hayatabad Medical Complex (HMC) on Friday [11 Jul 2014], said officials there. The 8 victims, including one hospital staffer and 6 Afghan nationals, all died over the last 3 months [April-July 2014]. A nurse at the hospital was also infected and remains under treatment at the hospital.
A 54-year-old from Bannu [Khyber Pakhtunkhwa province] was diagnosed with CCHF. However, This person did not survive the infectious disease and died on Friday [11 Jul 2014] -- the 2nd person from Khyber-Pakhtunkhwa to succumb to the disease, the hospital staffer being the 1st.
HMC has no separate treatment facility for such infectious diseases or specialists equipped to deal with patients with the virus. In an attempt to keep infected patients away from other in-patients, several private rooms have been marked as an isolation unit for the specific care of those with CCHF.
Human-to-human transmission
---------------------------
According to the World Health Organization (WHO), catching CCHF from another human being would require close contact with the infected person's blood, secretions, organs or other bodily fluids.
It was such contact which also ultimately led to the demise of a man, 46, who worked as a peon at HMC. Earlier in June [2014], an official of the hospital, requesting anonymity, had told The Express Tribune that the man contracted CCHF after he administered a cannula to an Afghan patient when trained doctors and nurses were unable to do so.
In a similar fashion, a 30-year-old also contracted the CCHF virus while on duty in the makeshift isolation unit, possibly without personal protective equipment (goggles, masks, gowns, caps and shoes covers).
At HMC
------
HMC CEO Dr Mumtaz Marwat lauded the efforts of the hospital staff in their management of CCHF cases despite inadequate resources.
"Private rooms 15 to 19 will be used as the isolation unit and all CCHF cases will be admitted there," said Marwat. "The mortality rate for Congo virus is high, ranging from 25 to 50 per cent."
He emphasised that doctors should use complete sets of personal protective equipment. "All such products will be available at the unit and the casualty ward."
"The availability of a sufficient number of blood and platelet bags has been ensured by the hospital's blood bank," he added. 25 to 50 bags of platelets will be available on a daily basis, said Marwat, and a daily inventory report will be communicated to all medical units.
According to Dr Wali Rehman, the focal person for CCHF, protective gear is already stocked in the hospital storage and has been issued; "More will be provided." Additional gear has been requested from the WHO, he said.
CCHF fatalities [this year, 2014]
---------------------------------
A person, 26, from Afghanistan was admitted to the hospital on 22 Apr 2014 and died on 3 May 2014. Another, a 28-year-old, also from Afghanistan, died at HMC on 5 Jun 2014, also of CCHF [virus infection]. A 40-year-old person was admitted on 12 Jun 2014 and died on 17 Jun 2014. This person was from the neighbouring country. An individual, 30, was admitted on 22 Jun 2014 and passed away on 25 Jun 2014. An 18-year-old person died on 1 Jul 2014 and an 18-year-old on 5 Jul 2014. All 3 [later cases] were from Afghanistan and died of the CCHF virus [infections] at HMC.
[Byline: Hidayat Khan]
--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[As noted in ProMED-mail archive no. 20140418.2413017, CCHF virus is endemic in Africa, the Balkans, the Middle East, and Asia, in countries south of the 50th parallel north. Cases occur with some frequency in Pakistan. CCHF virus is a tick-borne virus in the genus _Nairovirus_, family _Bunyaviridae_. CCHF virus can cause severe viral haemorrhagic fever outbreaks, with a case fatality rate of 10-40 per cent. The virus is transmitted by _Hyalomma_ spp. ticks or through contact with infected human blood or animal blood and tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers, and veterinarians. Exposure in health care facilities also occurs, as noted in the above report. The length of the incubation period depends on the mode of acquisition of the virus. Following infection by a tick bite, the incubation period is usually 1-3 days, with a maximum of 9 days.
Maps of Afghanistan and Pakistan showing most of the locations mentioned above can be accessed at http://www.iljournal.it/wp-content/uplo ... nistan.png and at http://healthmap.org/promed/p/140. - Mod.TY]
******************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
In this post:
[1] Kazakhstan
[2] Pakistan
******
[1] Kazakhstan
Date: Thu 10 Jul 2014
Source: Tengri News [edited]
http://en.tengrinews.kz/health/Deadly-v ... an-254417/
A total of 10 people, including an ambulance crew, were hospitalized in Southern Kazakhstan Oblast on suspicions of carrying a deadly virus on Monday, 23 Jun [2014], Tengrinews reports, citing IA Novosti-Kazakhstan.
Spokesman for the South Kazahstan Oblast Department of Emergency Situations Nurlan Temirbayev said that Crimean-Congo hemorrhagic fever (CCHF) was the probable cause.
Temirbayev informed that the day before a woman fell very sick. Her relatives called an ambulance for immediate help. During examination, the doctors noticed that the woman's hand had livid spots that looked like traces of a tick bite. Ticks are frequent transmitters of CCHF. The woman was hospitalized along with 9 other people -- the ambulance crew, who were 1st to respond to the emergency call, and the woman's close relatives, who lived with her in the same house.
Later on Monday [23 Jun 2014], the diagnosis of CCHF was confirmed by a laboratory test, as stated by Deputy Head of the Department of Consumer Protection of Southern Kazakhstan Oblast Zhumagul Medetov.
"The presence of the virus has been confirmed by laboratory tests. The 31-year-old resident of Akbastau village in Kazygurt district was taken to the central district hospital's intensive care unit. Her medical condition is assessed as serious but stable. Her one-year-old child has been hospitalized as well," Medetov said.
This is the 1st case of a person being hospitalized in connection with CCHF in South Kazakhstan [This year (2014)? There have been several cases in past years (see ProMED-mail posts given below). - Mod.TY]. Emergency Department employees are going to hold community meetings with the citizens to introduce them again to the 1st signs of CCHF and teach them how to act to protect themselves against the infection.
According to WHO, CCHF has a high fatality ratio of 10 to 40 per cent and is difficult for treatment and prevention. It is endemic in Asia south of the 50th parallel north, the Balkans, the Middle East and all of Africa. Some of the symptoms include sudden muscle ache with fever, dizziness, neck and back pain, sore eyes and sensitivity to light.
[Byline: Dinara Urazova]
--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[CCHF cases have been reported with some frequency in Kazakhstan in past years. Apparently, the affected woman in the above report was infected via tick bite. _Hyalomma_ ticks are the main vectors of CCHF virus. It is not clear if the 9 ambulance workers were ill with symptoms of CCHF virus infection or not. The report implies that they were exposed via contact with the fatal case. CCHF virus infection can be acquired by contact with viremic blood, but it is difficult to envision that this exposure occurred with all 9 ambulance workers. Perhaps 1 or 2 might have had contact with the woman's blood through administration of IV fluids en route to the hospital, but it is very unlikely that all 9 would have.
A HealthMap/ProMED-mail map of Kazakhstan can be accessed at http://healthmap.org/promed/p/56. - Mod.TY]
******
[2] Pakistan
Date: Sat 12 Jul 2014
Source: The Express Tribune [edited]
http://tribune.com.pk/story/734275/stem ... er-at-hmc/
An 8th person fell victim to [Crimean-]Congo hemorrhagic fever [CCHF] at Hayatabad Medical Complex (HMC) on Friday [11 Jul 2014], said officials there. The 8 victims, including one hospital staffer and 6 Afghan nationals, all died over the last 3 months [April-July 2014]. A nurse at the hospital was also infected and remains under treatment at the hospital.
A 54-year-old from Bannu [Khyber Pakhtunkhwa province] was diagnosed with CCHF. However, This person did not survive the infectious disease and died on Friday [11 Jul 2014] -- the 2nd person from Khyber-Pakhtunkhwa to succumb to the disease, the hospital staffer being the 1st.
HMC has no separate treatment facility for such infectious diseases or specialists equipped to deal with patients with the virus. In an attempt to keep infected patients away from other in-patients, several private rooms have been marked as an isolation unit for the specific care of those with CCHF.
Human-to-human transmission
---------------------------
According to the World Health Organization (WHO), catching CCHF from another human being would require close contact with the infected person's blood, secretions, organs or other bodily fluids.
It was such contact which also ultimately led to the demise of a man, 46, who worked as a peon at HMC. Earlier in June [2014], an official of the hospital, requesting anonymity, had told The Express Tribune that the man contracted CCHF after he administered a cannula to an Afghan patient when trained doctors and nurses were unable to do so.
In a similar fashion, a 30-year-old also contracted the CCHF virus while on duty in the makeshift isolation unit, possibly without personal protective equipment (goggles, masks, gowns, caps and shoes covers).
At HMC
------
HMC CEO Dr Mumtaz Marwat lauded the efforts of the hospital staff in their management of CCHF cases despite inadequate resources.
"Private rooms 15 to 19 will be used as the isolation unit and all CCHF cases will be admitted there," said Marwat. "The mortality rate for Congo virus is high, ranging from 25 to 50 per cent."
He emphasised that doctors should use complete sets of personal protective equipment. "All such products will be available at the unit and the casualty ward."
"The availability of a sufficient number of blood and platelet bags has been ensured by the hospital's blood bank," he added. 25 to 50 bags of platelets will be available on a daily basis, said Marwat, and a daily inventory report will be communicated to all medical units.
According to Dr Wali Rehman, the focal person for CCHF, protective gear is already stocked in the hospital storage and has been issued; "More will be provided." Additional gear has been requested from the WHO, he said.
CCHF fatalities [this year, 2014]
---------------------------------
A person, 26, from Afghanistan was admitted to the hospital on 22 Apr 2014 and died on 3 May 2014. Another, a 28-year-old, also from Afghanistan, died at HMC on 5 Jun 2014, also of CCHF [virus infection]. A 40-year-old person was admitted on 12 Jun 2014 and died on 17 Jun 2014. This person was from the neighbouring country. An individual, 30, was admitted on 22 Jun 2014 and passed away on 25 Jun 2014. An 18-year-old person died on 1 Jul 2014 and an 18-year-old on 5 Jul 2014. All 3 [later cases] were from Afghanistan and died of the CCHF virus [infections] at HMC.
[Byline: Hidayat Khan]
--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[As noted in ProMED-mail archive no. 20140418.2413017, CCHF virus is endemic in Africa, the Balkans, the Middle East, and Asia, in countries south of the 50th parallel north. Cases occur with some frequency in Pakistan. CCHF virus is a tick-borne virus in the genus _Nairovirus_, family _Bunyaviridae_. CCHF virus can cause severe viral haemorrhagic fever outbreaks, with a case fatality rate of 10-40 per cent. The virus is transmitted by _Hyalomma_ spp. ticks or through contact with infected human blood or animal blood and tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers, and veterinarians. Exposure in health care facilities also occurs, as noted in the above report. The length of the incubation period depends on the mode of acquisition of the virus. Following infection by a tick bite, the incubation period is usually 1-3 days, with a maximum of 9 days.
Maps of Afghanistan and Pakistan showing most of the locations mentioned above can be accessed at http://www.iljournal.it/wp-content/uplo ... nistan.png and at http://healthmap.org/promed/p/140. - Mod.TY]
-
Birgitt
- Moderator
- Beiträge: 35199
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Krim-Kongo Hämorrhagisches Fieber in Pakistan
CRIMEAN-CONGO HEMORRHAGIC FEVER - PAKISTAN (04)
***********************************************
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: Sun 13 Jul 2014
Source: Pakistan Today [edited]
http://www.pakistantoday.com.pk/2014/07 ... -peshawar/
A patient with Crimean-Congo haemorrhagic fever (CCHF) passed away at a Peshawar [Khyber-Pakhtunkhwa province] hospital on Saturday [12 Jul 2014] as cases of the deadly disease continue to pile up, local media reports said on Sunday [13 Jul 2014].
According to media reports, 3 patients suffering from CCHF were brought to Peshawar's Hayatabad Medical Complex [HMC] on Friday [11 Jul 2014]. They were identified as 57-year-old person from Peshawar, and a man and woman, from Afghanistan. The man died the next day.
As per the hospital data, 11 Congo virus patients, including 6 from Afghanistan and one staffer, have been brought to HMC. Of these 11, 5 have died.
Transmission modes
------------------
According to the World Health Organization, CCHF is primarily transmitted to people from ticks and livestock. Humans can catch the virus from other humans if they come in close contact with the infected person's blood, secretions, organs or other bodily fluids.
A study published in the journal Frontiers in Physiology in July 2012 states, "Vector-borne diseases (such as CCHF or dengue fever) in people, as well as livestock, are common in K-P [Khyber-Pakhtunkhwa province] and FATA [Federally Administered Tribal Areas] due to the limited use of vector control measures and access to livestock vaccines." [Dengue virus does not infect livestock. - Mod.TY]
"CCHF outbreaks typically occur following the migrations of nomadic people and livestock to district centres where they bring animals to sell and slaughter," the study adds.
--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[The number of CCHF virus infections has increased from 8 on 12 Jul 2014 to 11 infections 4 days later. CCHF virus is endemic in Pakistan and Afganistan. It is not clear if 2 of these infections above were acquired in Pakistan or in Afganistan. CCHF virus is a tick-borne virus in the genus _Nairovirus_, family _Bunyaviridae_. The virus can cause severe viral hemorrhagic fever outbreaks, with a case fatality rate of 10-40 per cent. The virus is transmitted by _Hyalomma_ spp. ticks or through contact with infected human blood or animal blood and tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers, and veterinarians. Exposure in health care facilities also occurs. The length of the incubation period depends on the mode of acquisition of the virus. Following infection by a tick bite, the incubation period is usually 1-3 days, with a maximum of 9 days.
Maps of Afghanistan and Pakistan can be accessed at http://www.iljournal.it/wp-content/uplo ... nistan.png and at http://healthmap.org/promed/p/140. - Mod.TY]
***********************************************
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: Sun 13 Jul 2014
Source: Pakistan Today [edited]
http://www.pakistantoday.com.pk/2014/07 ... -peshawar/
A patient with Crimean-Congo haemorrhagic fever (CCHF) passed away at a Peshawar [Khyber-Pakhtunkhwa province] hospital on Saturday [12 Jul 2014] as cases of the deadly disease continue to pile up, local media reports said on Sunday [13 Jul 2014].
According to media reports, 3 patients suffering from CCHF were brought to Peshawar's Hayatabad Medical Complex [HMC] on Friday [11 Jul 2014]. They were identified as 57-year-old person from Peshawar, and a man and woman, from Afghanistan. The man died the next day.
As per the hospital data, 11 Congo virus patients, including 6 from Afghanistan and one staffer, have been brought to HMC. Of these 11, 5 have died.
Transmission modes
------------------
According to the World Health Organization, CCHF is primarily transmitted to people from ticks and livestock. Humans can catch the virus from other humans if they come in close contact with the infected person's blood, secretions, organs or other bodily fluids.
A study published in the journal Frontiers in Physiology in July 2012 states, "Vector-borne diseases (such as CCHF or dengue fever) in people, as well as livestock, are common in K-P [Khyber-Pakhtunkhwa province] and FATA [Federally Administered Tribal Areas] due to the limited use of vector control measures and access to livestock vaccines." [Dengue virus does not infect livestock. - Mod.TY]
"CCHF outbreaks typically occur following the migrations of nomadic people and livestock to district centres where they bring animals to sell and slaughter," the study adds.
--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[The number of CCHF virus infections has increased from 8 on 12 Jul 2014 to 11 infections 4 days later. CCHF virus is endemic in Pakistan and Afganistan. It is not clear if 2 of these infections above were acquired in Pakistan or in Afganistan. CCHF virus is a tick-borne virus in the genus _Nairovirus_, family _Bunyaviridae_. The virus can cause severe viral hemorrhagic fever outbreaks, with a case fatality rate of 10-40 per cent. The virus is transmitted by _Hyalomma_ spp. ticks or through contact with infected human blood or animal blood and tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers, and veterinarians. Exposure in health care facilities also occurs. The length of the incubation period depends on the mode of acquisition of the virus. Following infection by a tick bite, the incubation period is usually 1-3 days, with a maximum of 9 days.
Maps of Afghanistan and Pakistan can be accessed at http://www.iljournal.it/wp-content/uplo ... nistan.png and at http://healthmap.org/promed/p/140. - Mod.TY]
-
Birgitt
- Moderator
- Beiträge: 35199
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Krim-Kongo Hämorrhagisches Fieber in Pakistan
CRIMEAN-CONGO HEMORRHAGIC FEVER - PAKISTAN (05)
***********************************************
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: Tue 22 Jul 2014
Source: The Express Tribune [edited]
http://tribune.com.pk/story/738897/heal ... fe-at-hmc/
Last week, 3 patients from Afghanistan suspected to be suffering from Congo fever were admitted to the hospital. The National Institute of Health (NIH), Islamabad on Monday [21 Jul 2014] confirmed that one of them, age 15, tested positive for the virus, while the results of a man, age 55, and another man are still awaited.
HMC [Hayatabad Medical Complex] spokesperson on infectious diseases, Dr Wali Rehman said 12 patients suffering from the virus have been brought to HMC so far this year [2014], of whom 6 have died. He said it takes up to 15 days for the results of the blood tests to arrive from NIH.
Dr Rehman said personal protection equipment has been provided to the hospital staff, and no one is allowed to visit the isolation wards without gowns, gloves and masks. He added that 4 private rooms at HMC have been declared isolation units for [Crimean-] Congo patients and that any individual brought to the casualty department with the symptoms will be directly admitted to the isolation ward.
[byline: Asad Zia]
--
communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[The number of CCHF virus infections has increased from 8 on 12 Jul 2014 to 11 infections 4 days later, and now there are 12 on 22 Jul 2014.
CCHF virus is endemic in Pakistan and Afghanistan. It is not clear how many of these infections were acquired in Pakistan or in Afghanistan. It is good to see that barrier nursing and personal protective measures are being taken in the hospital.
CCHF virus is a tickborne virus in the genus _Nairovirus_, family _Bunyaviridae_. The virus can cause severe viral hemorrhagic fever outbreaks, with a case fatality rate of 10-40 per cent. The virus is transmitted by _Hyalomma_ spp. ticks or through contact with infected human blood or animal blood and tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers, and veterinarians. Exposure in health care facilities also occurs. The length of the incubation period depends on the mode of acquisition of the virus. Following infection by a tick bite, the incubation period is usually 1-3 days, with a maximum of 9 days.
Maps of Afghanistan and Pakistan can be accessed at http://www.iljournal.it/wp-content/uplo ... nistan.png and at http://healthmap.org/promed/p/140. - Mod.TY]
***********************************************
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: Tue 22 Jul 2014
Source: The Express Tribune [edited]
http://tribune.com.pk/story/738897/heal ... fe-at-hmc/
Last week, 3 patients from Afghanistan suspected to be suffering from Congo fever were admitted to the hospital. The National Institute of Health (NIH), Islamabad on Monday [21 Jul 2014] confirmed that one of them, age 15, tested positive for the virus, while the results of a man, age 55, and another man are still awaited.
HMC [Hayatabad Medical Complex] spokesperson on infectious diseases, Dr Wali Rehman said 12 patients suffering from the virus have been brought to HMC so far this year [2014], of whom 6 have died. He said it takes up to 15 days for the results of the blood tests to arrive from NIH.
Dr Rehman said personal protection equipment has been provided to the hospital staff, and no one is allowed to visit the isolation wards without gowns, gloves and masks. He added that 4 private rooms at HMC have been declared isolation units for [Crimean-] Congo patients and that any individual brought to the casualty department with the symptoms will be directly admitted to the isolation ward.
[byline: Asad Zia]
--
communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>
[The number of CCHF virus infections has increased from 8 on 12 Jul 2014 to 11 infections 4 days later, and now there are 12 on 22 Jul 2014.
CCHF virus is endemic in Pakistan and Afghanistan. It is not clear how many of these infections were acquired in Pakistan or in Afghanistan. It is good to see that barrier nursing and personal protective measures are being taken in the hospital.
CCHF virus is a tickborne virus in the genus _Nairovirus_, family _Bunyaviridae_. The virus can cause severe viral hemorrhagic fever outbreaks, with a case fatality rate of 10-40 per cent. The virus is transmitted by _Hyalomma_ spp. ticks or through contact with infected human blood or animal blood and tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers, and veterinarians. Exposure in health care facilities also occurs. The length of the incubation period depends on the mode of acquisition of the virus. Following infection by a tick bite, the incubation period is usually 1-3 days, with a maximum of 9 days.
Maps of Afghanistan and Pakistan can be accessed at http://www.iljournal.it/wp-content/uplo ... nistan.png and at http://healthmap.org/promed/p/140. - Mod.TY]
