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Published Date: 2011-11-20 20:07:11
Subject: PRO/EDR> Crimean-Congo hem. fever - Pakistan (03): (SD) human
Archive Number: 20111120.3416

CRIMEAN-CONGO HEMORRHAGIC FEVER - PAKISTAN (03): SINDH, HUMAN
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Date: Sat 19 Nov 2011
Source Dawn, Metropolitan [edited]
http://www.dawn.com/2011/11/19/young-man-dies-of-congo-fever.html

A 29-year-old man admitted to a private hospital with a history of
high-grade fever and fits for 6 days died at the private hospital on
Fri 18 Nov 2011. Sources at the Liaquat National Hospital (LNH) told
Dawn that the patient tested positive for Crimean-Congo haemorrhagic
fever (CCHF) virus infection at a private university hospital.

The patient was a resident of Gazdarabad, Ranchhore Line. Retired Brig
Syed Nasim Ahmed, director of administration at the LNH, told the Dawn
newspaper that the man was said to have lived with a friend for a week
in the cattle market during the Eid days before his illness. However,
information regarding the exact occupation and family details of the
victim could not be obtained from the LNH.

He had been brought to the LNH on 15 Nov 2011 with a high-grade fever
in a state of unconsciousness and bleeding from the mouth. He was
diagnosed as a CCHF case on Thu 17 Nov 2011. It was further learned
that the patient was being treated at the medical intensive care unit
of the LNH.

Three deaths as a result of CCHF virus infection were reported last
year [2010], one each at the Indus Hospital, Aga Khan University
Hospital and Abbasi Shaheed Hospital.

[Byline: Mukhtar Alam]

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[Crimean-Congo haemorrhagic fever (CCHF) is a tick-transmitted viral
haemorrhagic fever. Although primarily a zoonosis, sporadic cases and
outbreaks of CCHF affecting humans do occur. The disease is endemic in
many countries in Africa, Europe and Asia.

A number of tick genera are capable of becoming infected with CCHF
virus, but the most efficient and common vectors for CCHF appear to be
members of the genus _Hyalomma_. Humans who become infected with CCHF
acquire the virus from direct contact with blood or other infected
tissues from livestock, or they may become infected from a tick bite.
Transmission of infection from domestic stock generally occurs during
slaughter (and not during normal contact with domestic animals, which
are relatively unaffected by the infection).

The majority of human cases have occurred in those involved with the
livestock industry, such as agricultural workers, slaughterhouse
workers and veterinarians. It is likely that the deceased Pakistani
acquired the infection during the course of his residence in the
cattle market during the EID festival period and that he did not seek
treatment early enough to save his life. The mortality rate for human
cases is approximately 30 percent, with death occurring in the 2nd
week of illness. In those patients who recover, improvement generally
begins on the 9th or 10th day after the onset of illness. General
supportive therapy is the mainstay of patient management, although the
antiviral drug ribavirin has been used successfully in treatment of
some cases of established CCHF virus infection.

Gazdarabad is one of the neighbourhoods of Saddar Town in Karachi,
Sindh province, Pakistan. Gazdarabad was formerly known as Ranchore
Line until around the 1950s. The location of Karachi can be found in
the HealthMap interactive map at: http://healthmap.org/r/1kc-. -
Mod.CP]

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