KARACHI: A teenage boy suffering from Congo-Crimean Haemorrhagic Fever (CCHF) has been under treatment at the Jinnah Postgraduate Medical Centre (JMPC) for the past five days, sources told Dawn on Monday.

The 17-year-old boy, a college student living in Shah Faisal Colony, used to play in a cattle pen, they said.

It’s the second reported case of CCHF in the province this year.

Know more: Man dies from Congo virus in Karachi

Last month, 24-year-old Mohammad Kashif, a butcher working in Azizabad, died of CCHF at a private hospital. He had a history of high-grade fever, shortness of breath and internal bleeding.

“His condition has improved and we pray that it improves further,” said the JMPC’s joint executive director Dr Seemin Jamali, adding that the patient was admitted to the hospital on Thursday with internal bleeding, a history of fever and fits.

“His condition was very serious when he was brought to the hospital as he was bleeding from every orifice. But we are glad that his bleeding has stopped now,” she said.

The patient referred from a charitable hospital, she said, was being provided necessary treatment, including anti-viral drugs, and that the hospital was taking all precautions required to attend to such patients.

There was no fear at the hospital and the patient was being treated in an isolation unit, she said.

According to Dr Jamali, last year the hospital had one suspected case of CCHF that later turned out to be a case of dengue.

Ten people have died of CCHF this year in the country; one death was reported in Chakwal, three in Zhob district of Balochistan and five in Peshawar, according to media reports.

The onset of CCHF is sudden, with fever, muscle ache, dizziness, neck pain and stiffness, backache, headache, sore eyes and sensitivity to light. There may be nausea, vomiting, diarrhoea, abdominal pain and sore throat early on, followed by sharp mood swings and confusion.

‘Tick doesn’t cause disease in animals’

According to the World Health Organisation website, CCHF is a widespread disease caused by a tick-borne virus (Nairovirus) of the Bunyaviridae family. The CCHF virus causes severe viral haemorrhagic fever outbreaks, with a case fatality rate of 10pc to 40pc.

“The virus is primarily transmitted to people from ticks and livestock animals. Human-to-human transmission can occur resulting from close contact with the blood, secretions, organs or other bodily fluids of infected persons.

“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,” the website says.

The hosts of the CCHF virus include a wide range of wild and domestic animals such as cattle, sheep and goats.

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 till another tick bites the animal. Although a number of tick genera are capable of becoming infected with CCHF virus, ticks of the genus Hyalomma are the principal vector.

Hospital-acquired infections can also occur due to improper sterilisation of medical equipment, reuse of needles and contamination of medical supplies.

“The virus doesn’t cause any disease in animals but they become its carrier once they are infected. The CCHF virus is transmitted to people either by tick bites or through contact with infected animal blood or tissues. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers and veterinarians,” said Dr Nasrullah Panhwar.

Dr Panhwar, a senior vet, stressed the need for bio-security to check animal-to-human infection of CCHF virus.

“There should be mechanism at the government level to ensure that only tick-free animals are brought to Karachi. The management of this problem is easier at the farm level,” he said.

According to Dr Panhwar, cleanliness is the key to eliminating ticks at cattle pens that should be kept clean and washed with insecticides and detergents.

“The tick is not killed by chemicals and is incinerated. One should use a glove to catch a tick and then burn it,” he said.

Published in Dawn, September 9th, 2014