CRIMEAN-CONGO HEMORRHAGIC FEVER
A farmer who has been diagnosed with Crimean-Congo hemorrhagic fever [CCHF], a life-threatening disease, has been admitted to a
On Sunday [7 Jul 2013], Dr Lucille Blumberg, from the National Institute for Communicable Diseases (NICD), confirmed that the man, who is in his 40s, was diagnosed with CCHF. She said the man was transferred from a hospital in
3 other cases of CCHF have been reported in
1 Jan 2013 communique on the NICD website, a 31-year-old man working as a game warden on a private game ranch near Jagersfontein in the Free State presented with clinical symptoms suggestive CCHF. A 2nd case of CCHF was confirmed on 12 Jan 2013, after a 44-year-old man was taken to hospital in
Communicated by: ProMED-mail
[Crimean-Congo haemorrhagic fever (CCHF) is a widespread disease caused by a tick-borne virus (genus _Nairovirus_, family _Bunyaviridae_). CCHF virus causes severe viral haemorrhagic fever outbreaks, with a case fatality rate of 10-40 percent.
CCHF is endemic in Africa, the Balkans, 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. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers and veterinarians. The length of the incubation period depends on the mode of acquisition of the virus. 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 documented maximum of 13 days.
Onset of symptoms is sudden, with fever, myalgia, (muscle ache), dizziness, neck pain and stiffness, backache, headache, sore eyes and photophobia (sensitivity to light). There may be nausea, vomiting, diarrhoea, abdominal pain and sore throat early on, After 2-4 days, the agitation may be replaced by sleepiness, depression and lassitude, and the abdominal pain may localize to the upper right quadrant, with detectable hepatomegaly.
Mortality rate from CCHF is approximately 30 percent, with death occurring in the 2nd week of illness. In patients who recover, improvement generally begins on the 9th or 10th day after the onset of illness. General supportive care with treatment of symptoms is the main approach to managing CCHF in people. The antiviral drug ribavirin has been used to treat CCHF infection with apparent benefit. Both oral and intravenous formulations seem to be effective.
All 4 South African patients appear to be responding well to treatment in hospital, and it would be generally useful if the treatment protocols could be publicised.
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