KARACHI, Nov 29: Citizens have been advised to take necessary precautions against mosquitoes by using insect repellents, window mesh, bed nets, and of course, cleaning up gardens and neighbourhood of stagnant water or garbage dumps.

Medical professionals speaking at a seminar on viral haemorrhagic fever held at the Liaquat National Hospital urged the civic authorities and the masses to join hands to make the city clean and tidy.

An immediate and intense operation against mosquitoes must be put into action, it was stressed.

Reiterating that every private or public hospital must establish standard practices of infection control, speakers said there were set guidelines and the Infectious Disease Control and Prevention Society of Pakistan was ever willing to share its expertise and conduct workshops.

Speakers including Dr Naseem Salahuddin, head division of infectious diseases, Dr Farheen Ali, consultant infectious diseases and Dr Altaf Ahmed, head of microbiology, mentioned that viral hemorrhagic fever was a serious infection caused by several viruses around the world.

Pakistan, however, is presently reporting with only two sub-types of these, namely Congo Crimean Viral Fever (CCVF) and Dengue Hemorrhagic fever (DHF), they said adding that the CCVF was caused by the bite of a tick, found in the skin of cattle – while the DHF on the other hand was spread by the bite of a mosquito (Aedes egyptil).

The programme largely attended by physicians, trainee doctors, nurses and paramedics, was further informed that in the 1970s there was an outbreak of CCVF in Quetta that killed unsuspecting surgeons and paramedics treating patients with fever and bleeding from the stomach.

As for CCVF, it was informed that CCVF was endemic in parts of Balochistan and Afghanistan.

As for Dengue virus, they said it was in late 1990s that an outbreak of dengue fever was registered in Karachi. It was a mild form then that caused fever, muscle pain and a rash with low blood counts.

Although, it produced discomfort, the illness was completely reversible without any particular treatment.

The experts but reminded that an attack of dengue fever did not produce complete immunity and in fact, a second attack was usually severe and could result in profuse bleeding from multiple body sites, often resulting in death.

It was predictable at that time that a second attack with the same virus would cause hemorrhagic fever. And indeed, Dengue Hemorrhagic fever (DHF) is also upon us now, they said adding that clinicians were reporting this condition beginning in early August and rapidly increasing in numbers in October and November.

Our hospitals are filling up with dengue fever of mild intensity, occasionally becoming severe enough to result in haemorrhage, they added.

The experts were of the view that CCVF and DHF clinically appeared similar but could be differentiated only by specific blood tests.

Again unfortunately these tests are expensive and not always accurate, they added.

They said CCVF required antiviral treatment and isolation to protect contacts. DHF, on the other hand does not require isolation as it is spread by mosquito bite and cannot be treated with antiviral drugs, they added.

However, the doctors suggested that in the absence of accurate tests it was wise to protect all contacts.

CCVF and DHF are serious public health problems caused due to unhygienic surroundings, they added.

The speakers deplored that only a few private hospitals have had an infection control department or policies; public diagnostic labs did not offer sophisticated tests and private labs were beyond the range of a common man.

They further suggested, that it should be recognized that there was an increasing number of cases of dengue viral fever, which usually resolves without treatment, and an occasional case could become hemorrhagic, but it was not transmissible.—APP/PPI