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SASTM Newsflash - Crimean-Congo Hemotthagic Fever - Mpumalanga farmer


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A farmer who has been diagnosed with Crimean-Congo hemorrhagic fever [CCHF], a life-threatening disease, has been admitted to a Pretoria hospital.


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 Mpumalanga on Friday [5 Jul 2013] before the tests confirmed that he had the disease. Tests had been run while he was still in Mpumalanga because it was suspected he had CCHF. Commenting on the patient's condition, Blumberg said: "He is in a stable condition, and he is improving." Blumberg said the man had a fever, headache, muscle pain and bleeding gums.


3 other cases of CCHF have been reported in South Africa this year [2013] -- one in North West, while the other 2 patients were from the Free State. According to the

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 Bloemfontein. He had been on a farm in Pomfret, North West (about 5 km from the Botswana border), where he was bitten by a tick; 3 days later, he developed symptoms and presented with fever, rash, conjunctivitis and pharyngitis. Blumberg said: "They were all doing very well and have long been discharged."


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 Middle East and Asian countries south of the 50th parallel north, the geographical limit of the principal tick vector. Although a number of tick genera are capable of becoming infected with CCHF virus, ticks of the genus _Hyalomma_ are the principal vector.


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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The information provided in SASTM Newsflashes is collected from various news sources, health agencies and government agencies. Although the information is believed to be accurate, any express or implied warranty as to its suitability for any purpose is categorically disclaimed. In particular, this information should not be construed to serve as medical advice for any individual. The health information provided is general in nature, and may not be appropriate for all persons. Medical advice may vary because of individual differences in such factors as health risks, current medical conditions and treatment, allergies, pregnancy and breast feeding, etc. In addition, global health risks are constantly evolving and changing. International travelers should consult a qualified physician for medical advice prior to departure.

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