An update on crimean congo hemorrhagic fever

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Date: July-September 2011
From: Journal of Global Infectious Diseases(Vol. 3, Issue 3)
Publisher: Medknow Publications and Media Pvt. Ltd.
Document Type: Disease/Disorder overview
Length: 5,133 words
Lexile Measure: 1630L

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Byline: Suma. Appannanavar, Baijayantimala. Mishra

Crimean Congo hemorrhagic fever (CCHF) is one of the deadly hemorrhagic fevers that are endemic in Africa, Asia, Eastern Europe, and the Middle East. It is a tick-borne zoonotic viral disease caused by CCHF virus of genus Nairovirus (family Bunyaviridae). CCHF not only forms an important public health threat but has a significant effect on the healthcare personnel, especially in resource-poor countries. India was always a potentially endemic area until an outbreak hit parts of Gujarat, taking four lives including the treating medical team. The current review is an attempt to summarize the updated knowledge on the disease particularly in modern era, with special emphasis on nosocomial infections. The knowledge about the disease may help answer certain questions regarding entry of virus in India and future threat to community.

Introduction

Crimean Congo hemorrhagic fever (CCHF) is one of the severe forms of hemorrhagic fever endemic in Africa, Asia, Eastern Europe and the Middle East with a near fatal mortality rate. CCHF not only forms an important public health threat but has a significant effect on the healthcare personnel, especially in resource-poor countries. India was always under the potential threat of CCHF viral infection until an outbreak hit parts of Gujarat, taking four lives including the treating medical team in recent past. With regard to questions on the importation of virus in the region, acquisition of virus by the index case and the viral status in India are yet to be revealed. The endemic potentiality of the country poses a challenge in controlling the CCHF viral infection not only for India but also for its neighboring countries. The present review is an attempt to summarize the updated knowledge on the disease.

CCHF is a zoonotic viral disease caused by tick-borne virus Nairovirus (family Bunyaviridae). The disease has a wide distribution that correlates with the global distribution of Hyalomma tick, the vector responsible for viral transmission. The disease is generally asymptomatic in infected animals but highly fatal in humans. The disease in humans begins as non-specific febrile symptoms, which progress to hemorrhagic syndrome. Although tick is a major vector in transmission of the disease, further secondary cases are frequently seen due to human to human transmission via percutaneous or per mucosal exposure to blood and body fluids containing the virus. This uncommon transmission takes place most often among healthcare workers in hospital settings, thus posing a significant nosocomial hazard. [sup][1] Adhering to universal precautions while caring for patients, timely infection-control measures, and administration of prophylactic therapy to healthcare workers after exposure can serve as important measures in limiting the spread of infection. [sup][2],[3] However, additional community-based control measures such as use of pesticides to control tick population are necessary to decrease disease transmission and prevent further spread in the community.

History of CCHF

The first evidence of CCHF dates back to the 12 [sup]th century, where a description of a hemorrhagic syndrome in Tajikistan and the description of the arthropod that caused the disease appears similar to...

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Gale Document Number: GALE|A264340481