Crimean Congo haemorrhagic fever
Crimean Congo haemorrhagic fever (CCHF) is a viral zoonotic disease with a ruminants reservoir. Infections in cattle, sheep and goats are not accompanied by clinical signs, and the majority of human infections are also subclinical. However, on rare occasions, the disease manifests in humans as a severe haemorrhagic fever with a case fatality rate of up to 50%.
The first human case was reported in Pakistan in 1976, and the disease is now endemic in Pakistan with sporadic outbreaks occurring throughout Pakistan.
Brucellosis is a globally important zoonotic disease. Although very few human cases of brucellosis are reported in Pakistan, serosurveys of community members report sero-positivity prevalences of between 10–20%. Reported seroprevalences for cattle, buffalo, sheep and equids range between 1% to 33% positive.
The problem being addressed
Although both of these diseases are endemic in Pakistan, a lack of reliable information about the occurrence and distribution of these zoonoses is preventing the development of surveillance, prevention and control programs.
This project will involve two districts within each of two provinces in Pakistan — Baluchistan and Khyber Pakhtunkhwa.
It comprises two studies:
Cross-sectional seroprevalence survey of CCHF and brucellosis
- It is aimed to collect blood samples from 1,500 humans, 3,000 small ruminants and 640 cattle from 480 households.
- All sera will be tested with the brucellosis Rose Bengal Plate Agglutination test (RBT). RBT-positive samples will be further tested using a competitive ELISA.
- An IgG based ELISA will be used for CCHF testing.
- Questionnaires will be used to collect human demographic data and CCHF and brucellosis exposure data.
- Data will also be collected regarding the peoples' knowledge, attitudes and practices (KAP) related to these diseases.
Spatio-temporal analysis of primary CCHF cases
- The residential location and date of onset of clinical symptoms for primary CCHF cases will be identified from healthcare reports.
- Analysis of spatio-temporal patterns will enable an evaluation to be made of the trends of CCHF in geographical space and over time.
Reliable information on the prevalence of serological evidence of CCHF and brucellosis in animals and humans in selected villages and households which will be useful for:
- Understanding the level of exposure of people to both CCHF and brucellosis in these districts.
- Understanding the disease burden imposed by exposure to these diseases.
- Designing appropriate interventions for control programs.
- Providing baseline information, which will be useful for evaluating the efficacy of control programs.
- Providing public health information regarding the most effective measures for reducing the risks of exposure to these diseases.
- Identifying the emerging nature of CCHF and facilitating the identification of possible risk factors for the spread.
In addition, a serum bank will be established that may be useful for providing insight into other diseases in people and livestock in these districts.
Key organisations and people
Ministry of Health
- The National Institute of Health
- The Cabinet Secretariat
- The Cabinet Division
- The Public Health Laboratories
- The Epidemic Investigation Cell
Ministry of Food, Agriculture and Livestock
- The Pakistan Research Council
- The National Agricultural Research Centre
- The Animal Sciences Institute
Livestock and Dairy Department
- The Directorate General (Extension) Livestock and Dairy Development Services
- The Directorate General (Research) Livestock and Dairy Development Services
- The Veterinary Research Institute
|Dr Khalid Naeem||Chief Scientist||Animal Sciences Institute, National Agricultural Research Centre|
|Dr Muhammad Safdar||Principal Scientific Officer||National Institute of Health, Islamabad|
|Dr Fazal Manan Salarzai||Deputy Medical Superintendent||Ayub Medical Complex, KPK|
|Dr Muhammad Tariq Shah||Veterinary Officer||Livestock and Dairy Development Department, KPK|
|Dr Mohammad Younas||Veterinary Officer||Livestock and Dairy Development Department, BAL|
|Dr Essa Khan Jogezai||Director||Health Services, Department of Health, BAL|
|Dr Aman Ullah||Scientific Officer||National Agricultural Research Centre (NARC)|
|Dr Jaleel Kamran||Head||Epidemic Investigation Cell, National Institute of Health|
|Dr Najamullah Baig||Scientific Officer||National Institute of Health, Islamabad|
|Dr Zahida Fatima||Senior Scientific Officer||National Agricultural Research Centre (NARC)|
|Dr Sher Muhammad||Director General||Livestock and Dairy Development Department, KPK|
|Dr Nisar Ahmed||Director General||Livestock and Dairy Development Department, BAL|
|Dr Zaibullah Khan||Veterinary Officer||Livestock and Dairy Development Department, KPK|
|Dr Imtiaz Ali Shah||Research Officer||Veterinary Research Institute, KPK|
|Dr Mirza Ali Khan||Principal Research Officer||Veterinary Research Institute, KPK|
|Dr M Naeem Riaz||Senior Scientific Officer||
|Dr Asad Ali Shah||District Livestock Officer||Livestock and Dairy Development Department, KPK|
|Dr Uzma Amir||Senior Virologist||National Institute of Health, Islamabad|
|Dr Rana Asghar||Resident Advisor||National Institute of Health, Islamabad|
|Dr Amir Baig||Visiting Faculty||National Institute of Health, Islamabad|
|Dr Inaam Haq||Senior Health Specialist||The World Bank, Islamabad|
|Dr Sharif Khan||Director General||Health Services, KPK, Peshawar|
|Dr Fahad Lodhi||Assistant Professor||International Medical College, Abbottabad|
|Dr Maqsood Nousherwani||Director General||Health Services, Quetta, Balochistan|
|Dr Mehmood Paracha||Epidemiologist||Department of Health, Quetta, Balochistan|
|Dr Muhammad Salman||Consultant Microbiologist||National Institute of Health, Islamabad|
|Mr Syed Zaidi||Head of Department||Provincial Health Directorate|
|Dr Ron Jackson||Consultant Epidemiologist||EpiCentre, Massey University|
|Dr Toby Leslie||Research Fellow||London School of Hygiene and Tropical Medicine|
Project Activity Coordinator
|Dr Joanna McKenzie||Consultant Epidemiologist||EpiCentre, Massey University|