Crimean haemorrhagic fever outbreak confirmed in Nakaseke, Kiboga

Health personnel manage an ebola patient the Ivory Coast. Net picture.

The Uganda Virus Research Institute has confirmed two cases of Crimean-Congo Haemorrhagic (CCHF) fever from blood samples taken off individuals in Nakaseke and Kiboga

An update from the UVRI says CCHF is one of the deadly haemorrhabgic fevers. It is transmitted through the bites of infected ticks contact with infected animals blood and tissue and through close contact with human fluids of infected persons.

“Two viral haemorrhagic fever suspect blood samples from Kiboga Hospital and Nakaseke Hospital tested positive ” the update said.

Symptoms of the disease include severe fever, muscle ache, head ache, dizziness, vomiting, diarrhea, nausea, sore eyes and photophobia (sensitivity to light) and abdominal pain.

The mortality rate is estimated at 30%, with death occurring in the second week of illness. In patients who recover, improvement generally begins on the ninth or tenth day after the onset of illness.

“In Uganda the risk of acquisition and spread is high among communities within the cattle corridor,” the UVRI update said.

Other clinical signs, according WHO, include fast heart rate, enlarged lymph nodes, and a petechial rash (a rash caused by bleeding into the skin) on internal mucosal surfaces, such as in the mouth and throat, and on the skin.

“There is usually evidence of hepatitis, and severely ill patients may experience rapid kidney deterioration, sudden liver failure or pulmonary failure after the fifth day of illness” WHO says in a media brief..

There is no known vaccine for either humans or animals for the disease, according to the World Health Organisation.

Hosts of the CCHF virus include wild and domestic animals such as cattle, sheep and goats. Many birds are resistant to infection, but ostriches are susceptible and may show a high prevalence of infection in endemic areas.

Animals become infected by the bite of infected ticks and the virus remains in their bloodstream for about one week after infection, allowing the tick-animal-tick cycle to continue when another tick bites, WHO warns further.

Incubation period
The length of the incubation period depends on the mode of acquisition of the virus.

Incubation is usually one to three days, with a maximum of nine days, when bitten by an infected tick. The incubation period following contact with infected blood or tissues is usually five to six days, with a documented maximum of 13 days.

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

Public health advice:
• Recommendations for infection control while providing care to patients with suspected or confirmed Crimean-Congo haemorrhagic fever should follow those developed by WHO for Ebola and Marburg haemorrhagic fever.
o use approved acaricides (chemicals intended to kill ticks) on clothing;
o regularly examine clothing and skin for ticks; if found, remove them safely;
o seek to eliminate or control tick infestations on animals
o avoid areas where ticks are abundant
o wear protective clothing while handling animals or their tissues in endemic areas.
o quarantine animals before they enter slaughterhouses or routinely treat animals with pesticides two weeks prior to slaughter.



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