NIH issues Congo Fever advisory

Islamabad: The Field Epidemiology and Disease Surveillance Division (FEDSD) of the National Institute of Health (NIH) has issued, ahead of Eid, an advisory for prevention and control of Crimean-Congo Hemorrhagic Fever (CCHF), which is transmitted to people either by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter.

The objective of this advisory is to sensitize human and animal health care authorities to further strengthen and improve the level of preparedness in prevention and control of CCHF. According to the advisory, CCHF is a widespread disease caused by a tick-borne virus (Nairovirus) of the Bunyaviridae family with a case fatality rate of 100-40%. Ticks, especially of the Hyalomma genus, are both reservoir and vector for the CCHF virus. Numerous wild and domestic animals such as cattle, buffaloes, goats, sheep are silent carriers of this virus and the adult ticks feed on these animals.

Although Balochistan remains the most affected province, yet cases have been reported from almost all geographical regions of Pakistan. Of the 101 confirmed CCHF cases during 2016, as many as 33 deaths were reported. During 2017 till date, 41 confirmed cases have been reported (16 cases from Balochistan, 15 from Punjab, 7 from KPK and 3 from FATA). The latest fatal case was reported from Khyber Agency, FATA, on August 16, 2017.

Public health workers along with animal herders, veterinarians, para-veterinary staff, livestock workers, animal merchants, butchers and slaughterhouse workers are at risk of the disease. Apart from them, close contacts caring the suspected case and persons involved in burial practices are also at risk of getting infection.

There is currently no vaccine available for humans, and the only way to reduce infection is by raising awareness. Public health advice should focus on several aspects: Wear protective clothing (long sleeves, long trousers).

Wear light coloured clothing during visit to animal market to allow easy detection of ticks on clothes and regularly examine clothing and skin for ticks; if found, remove them safely; and use approved repellents on clothing and skin.

Don’t crush the ticks.

Wear gloves and other protective clothing while handling animals or their tissues, notably during slaughtering, butchering, and culling procedures in slaughterhouses or at home.

Avoid close physical contact with CCHF-infected people, wear gloves and protective equipment when taking care of ill people, wash hands frequently after caring or visiting ill people and insect repellents to ward off ticks in human populations.

Safe burial practices include spraying the dead body with 1:10 liquid bleach solution and then wrapping it in a winding sheet sprayed with bleach solution. The body should then be placed in a plastic bag, which should be sealed with adhesive tape. Disinfect the transport vehicle and burn all clothing of the deceased.