ISLAMABAD: Eight out of 59 suspected cases of Crimean Congo Hemorrhagic Fever (CCHF) submitted to the National Institute of Health (NIH) for testing since the beginning of the year were found to be positive and resulted in three deaths, an NIH advisory revealed.

The advisory was issued by the institute’s Field Epidemiology and Disease Surveillance Division (FEDSH) regarding the prevention and control of CCHF, commonly known as the Congo virus.

It aims to sensitise human and animal healthcare authorities to strengthen and improve preparedness for the prevention and control of CCHF ahead of Eidul Azha.

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 10 to 40pc. Ticks are both reservoirs and vectors for the virus, and numerous wild and domestic animals – including cattle, buffaloes, goats and sheep – are silent carriers of the virus that adult ticks feed on.

Institute suggests measures to prevent CCHF ahead of Eidul Azha

Areas with very high domestication of animals can be affected by the disease. Last year, Pakistan saw a total of 51 positive cases of CCHF; 59 suspected cases were submitted for testing since the begging of this year, of which eight were found to be positive.

The advisory states: “Healthcare 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 the close contacts caring [for] the suspected case and person involved in burial practices are also at risk of getting infection.”

There is no vaccine available for humans, and the only way to reduce infection is by raising public awareness.

Public health advice focuses on several aspects, such as wearing protective clothing, such as long sleeves and trousers in light colours, while visiting animal markets to easily detect ticks on clothing. If found, ticks should be removed safely, and the approved acaricides or repellents should be used on clothes and skin.

People are advised not to crush ticks, to wear gloves and other protective clothing when handling animal or animal tissue – notably during slaughtering, butchering and culling procedures at slaughterhouses or at home.

Close physical contact with people infected with CCHF should be avoided, people should wear gloves and protective equipment when taking care of unwell people and wash their hands frequently after caring for or visiting unwell people. Insect repellents are the most effective in warding off ticks in human populations, and the advisory also suggests ensuring safe burial practices.

The Pakistan Medical Association (PMA) has expressed concerns about rising cases of CCHF across the country due to contact with sacrificial animals around Eid.

PMA Secretary General Dr Qaisar Sajjad said in a statement that people should immediately visit a physician in case of high fever, muscle ache, backache, headache, vomiting, severe bruising and nosebleeds.

Typhoid fever advisory

In light of the high number of typhoid fever cases in the country, the NIH has said that typhoid fever spreads mostly in the summer and rainy seasons. Typhoid is caused by a bacteria known as Salmonella Typhi, which occur occur through the feco-oral route and spread through contaminated food, milk, frozen fruit and water or through close contact with an already infected person. Contamination is mainly caused by poor sanitation and the mixing of sewerage and drinking water.

The newly emerged for of typhoid fever, extensively drug resistant (XDR) typhoid, is being reported in parts of Sindh – particularly Hyderabad and Karachi. More than 2,000 positive cases of XDR typhoid have been reported so far.

The advisory suggests properly washing hands and restoring hand hygiene conditions in routine life, avoiding eating raw food and vegetables and drinking boiled drinking water. The typhoid vaccine is available in Pakistan and people should be vaccinated after consulting a doctor.

Published in Dawn, August 16th, 2018