Congo virus outbreak requires careful handling

By Lahja Nashuuta

Recently, the health authorities in Namibia announced the outbreak of Crimean-Congo haemorrhagic fever (CCHF) that was detected at a farm in the Omaheke region, which borders Botswana, and it has already claimed its first victim. 

Health minister Dr Bernard Haufiku on Tuesday announced that a new case was detected in the //Karas region, in addition to people who are currently on quarantine at the Gobabis State Hospital, in Omaheke region. The virus causes severe viral haemorrhagic fever outbreaks.

The victim, a 26-year-old, was treated at Gobabis for fever, diarrhoea and coughing a few days earlier but later died after vomiting blood.

Family members said he was bitten by a tick, and the health authorities later confirmed that he indeed died of CCHF or Congo Fever.

The ministry was swift in dispatching health personnel from Windhoek to Gobabis to contain the outbreak. And the good news was that people that were placed on quarantine, including health personnel who treated the deceased, as a proactive measure, were cleared of the fever.

CCHF is one of the deadliest haemorrhagic fevers that are endemic in Africa, Asia, Eastern Europe, and the Middle East.

Of course, this is not the first Congo fever outbreak in Namibia. History tells us that Congo fever outbreak was reported for the first time in 1986, when three cases were recorded in the eastern part of the country in Grootfontein (Otjozondjupa region) and two cases in Windhoek (Khomas region). The next outbreak was reported in 1998 and two cases were recorded in 2001.

According to the World Health Organisation (WHO), the virus is primarily transmitted to people from ticks and livestock and the outbreaks have a fatality rate of up to 40 percent.

The world health body said the hosts of the CCHF virus include a wide range of 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.

For example, a former outbreak occurred at an ostrich abattoir in South Africa. There is no apparent disease in these animals.

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. Although a number of ticks are capable of becoming infected with CCHF virus, ticks of the genus Hyalomma are the principal vectors, according to WHO.

WHO stressed that there is no vaccine available for either people or animals.

However, it said the antiviral drug, Ribavirin, has been successfully used to treat CCHF infection. Both oral and intravenous formulations seem to be effective, it said.

But in the absence of a vaccine, the only way to reduce infection in people is by raising awareness of the risk factors and educating people about the measures they can take to reduce exposure to the virus.

WHO advised people to wear protective clothing (long sleeves, long trousers); use approved acaricides (chemicals intended to kill ticks) on clothing; use approved repellent on the skin and clothing; and avoid areas where ticks are abundant and seasons when they are most active in order to reduce tick-to-human transmission.

And to reduce the risk of animal-to-human transmission WHO urged people to wear gloves and other protective clothing while handling animals or their tissues in endemic areas, notably during slaughtering, butchering and culling procedures in slaughterhouses or at home.

As for healthcare workers caring for patients with suspected or confirmed CCHF, or handling specimens from them, they should implement standard infection control precautions. These include basic hand hygiene, use of personal protective equipment, safe injection practices and safe burial practices, WHO advised.

It further advised that as a precautionary measure, healthcare workers caring for patients immediately outside the CCHF outbreak area should also implement standard infection control precautions.

WHO further cautioned that samples taken from people with suspected CCHF should be handled by trained staff working in suitably equipped laboratories.

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