Published Date: 1998-09-02 23:50:00
Subject: PRO> Crimean-Congo hemorrhagic fever - Pakistan: not?
Archive Number: 19980902.1764

CRIMEAN-CONGO HEMORRHAGIC FEVER - PAKISTAN: NOT?
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See Also

Crimean-Congo hemorrhagic fever - Pakistan 980509061024
Crimean-Congo hemorrhagic fever - Afghanistan 980509061151
Date: Mon, 31 Aug 1998 15:19:10 PDT
From: Aamir Khan <aamirjkhan@hotmail.com>
Source: Green Monkeys Pakistan Public Health Forum Volume 1 : Number 82,
Tue, 1 Sep 1998

- visit our website at <http://www.greenmonkeys.net/>
- post all contributions to greenmonkeys@maillists.com.

PCR results on 1998 hemorrhagic fever outbreaks
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The results of the PCR testing on the samples from the hemorrhagic fever
outbreaks in Pakistan and Afghanistan earlier this year are negative. In
light of the positive results previously reported on ELISA [IgM/IgG(?)
for Crimean Congo Hemorrhagic Fever, it looks like Bob Swanepoel`s
suggestion that there`s more going on here than CCHF is more plausible.
Incidentally, Joe McCormick and Sue Fisher-Hoch had suggested in 1996 that
there may be cross-reactivity with a related virus on the ELISA test,
though which one was anyone`s guess. Humayun Asghar at NIH, Islamabad also
agrees we`re dealing with another hemorrhagic virus. That makes it a whole
lot of people who know what it isn`t.
I now count 6 reported outbreaks of CCHF/hemorrhagic fevers other than
dengue occurring in Pakistan between 1976, the first reported one and 1998.
[visit <http://www.greenmonkeys.net/ahistory.htm> for details.
Mr. Zaidi at the NIH Virology Dept. mentions one in 1983-4 in Lyari,
Karachi that I`m trying to learn more about. Whether or not the Karachi
event actually occurred, it seems that these outbreaks are more frequent
than we earlier supposed and that they primarily affect health care
professionals in areas already deprived of basic health facilities.
The NIH has pulled together a national response team to investigate the
next hemorrhagic fever outbreak within Pakistan. The team is not adequately
funded, protective equipment to handle level 4 pathogens are currently
unavailable and there is bound to be red-tapism once the need for a
response arises. But it at least has some pretty determined people on
board. If you hear of anything suggestive of a hemorrhagic fever case or
outbreak -- Quetta/Dera Ghazi Khan/Multan/Rawalpindi/Karachi(?) are likely
canditate cities - please share your information as soon as possible, both
on this forum and with Humayun Asghar <asgharh@nihpak.sdnpk.undp.org > or
myself < ajkhan@jhsph.edu / aamirjkhan@hotmail.com >
--
Aamir Khan
e-mail: ajkhan@jhsph.edu / aamirjkhan@hotmail.com
........................................jw/es
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