NIH issues Congo virus advisory ahead of Eid-ul-Azha

ISLAMABAD: Health experts have issued an advisory for prevention and protection from the Crimean-Congo haemorrhagic fever (CCHF), known as Congo Virus, ahead of Eid-ul-Azha.

The National Institute of Health (NIH), Islamabad, has prepared a special advisory to provide information to health professionals and general public. The possibility of the infection’s spread increases during Eid-ul-Azha due to the transportation of cattle and increasing human contact with animals.

“In the wake of high disease transmission and risk due to anticipated increased human-animal interaction during upcoming Eid-ul-Azha, it is imperative to be vigilant about the situation and take necessary steps to interrupt the transmission of CCHF,” the advisory said.

What is CCHF?

CCHF is a widespread disease caused by a tick-borne virus. Numerous wild and domestic animals such as cattle, goats, sheep and hares, serve as amplifying hosts for the virus. The virus causes severe viral hemorrhagic fever outbreaks, with a case fatality rate of 10-40%.

Balochistan remains the most affected province yet cases have been reported from most regions of the country every year. Balochistan reported 19 suspected cases, out of which 14 were positive and five deaths occurred in 2021. During 2022 till date, a total of four confirmed cases have been reported, two cases each from Punjab and Sindh.

The CCHF virus is transmitted to people either by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. Transmission to humans occurs through contact with infected ticks or animal blood.

CCHF can be transmitted from infected person to another person by contact with infectious blood, secretions, or body fluids.

Hospital-acquired CCHF infections can also occur due to improper sterilization of medical equipment, breach in infection control practices, reuse of injection needles, and using contaminated medical supplies.

READ MORE: Congo virus suspected patient dies in RYK

Diagnosis and symptoms

Following infection by a tick bite, the incubation period is usually 1-3 days, with a maximum of 9 days. The incubation period following contact with infected blood or tissues is usually 5-6 days, with a maximum of 13 days.

Risk Groups include animal herders, livestock workers, and slaughterhouse workers in endemic areas. Healthcare workers are at risk of infection through contact with infectious blood and body fluids.

The onset of CCHF is sudden with initial signs and symptoms including headache, high-grade fever, back pain, joint pain, stomach pain, and vomiting.

Red eyes, flushed face, red throat, and petechial (red spots) on the palate with bleeding from gums are common. Symptoms may also include jaundice and in severe cases, changes in mood and altered sensorium.

As the illness progresses, large areas of severe bruising, severe nosebleeds, and uncontrolled bleeding at injection sites can be seen, beginning on about the fourth day of illness and lasting for about two weeks.

The mortality rate from CCHF is approximately 30% with death occurring in the second week of illness. In patients who recover improvement generally begins on the ninth or tenth day.

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Preventive measures

The NIH has suggest preventive measures to reduce the risk of infection in community. There is currently no safe and effective vaccine widely available for human use. The only way to reduce infection is by reducing risk factors and educating community on preventive measures.

Reducing the risk of infection transmission from tick-to-human:

• Wear protective clothing (long sleeves, long trousers);
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• Wear light colored clothing to allow easy detection of ticks on the clothes.
• Regularly examine clothing and skin for ticks; if found, remove them safely.
• Use approved acaricides on clothing.
• Use approved insect repellent on the skin.
• Avoid visiting areas where ticks are abundant and seasons when they are most active.

Reducing the risk of infection transmission from animal-to-human:

• Wear gloves and other protective clothing while handling animals notably during slaughtering, butchering and culling procedures
• Quarantine animals possibly 30 days before they enter slaughterhouses or routinely treat animals with acaricides prior to slaughter.
• Inject lvermectin to animals with ticks, 24-30 days before slaughtering.

Reducing the risk of infection transmission from human-to-human:

• Avoid close physical contact with CCHF-infected people.
• Wear gloves and protective equipment when taking care of ill people.
• Wash hands with soap regularly after caring for or visiting ill people.
• Observe safe burial practices by avoiding contact with mucus membranes and body fluids of deceased humans
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The health officials have advised general public to ensure that sacrificial animals are free from ticks. They also advised people to use germicides after consultation with the livestock department.

The health authorities have alerted people with precautionary instructions who visit cattle farms.  It has also directed concerns departments to take timely precautionary measures in cattle markets and other places for protection from the congovirus.