CCHF Outbreak in Pakistan

From 1 January to 9 June 2013, a total of 16 suspected cases of Crimean-Congo haemorrhagic fever (CCHF), including six deaths (case–fatality rate 37.5%) were reported from Pakistan. So far, 7 of these reported cases have been laboratory-confirmed. In 2012, the country faced a similar outbreak of CCHF with 61 suspected cases, including 17 deaths (case–fatality rate 27.8%) reported from the disease. The majority of the cases were reported from the province of Balochistan, Sindh, Khyber Pakhtunkhwa and Punjab. 

Etiology

Crimean-Congo Hemorrhagic fever is a viral haemorrhagic fever transmitted by ticks. It can be responsible for severe outbreaks in humans, but it is not pathogenic for ruminants, their amplifying host. The disease was first described in the Crimea in 1944 and given the name Crimean haemorrhagic fever. In 1969 it was recognized that the pathogen causing Crimean haemorrhagic fever was the same as that responsible for an illness identified in 1956 in the Congo, and linkage of the two place names resulted in the current name for the disease and the virus.

Transmission

CCHF spreads to humans either by tick-bites, or through contact with viraemic animal tissues during and immediately post-slaughter. CCHF outbreaks constitute a threat to public health services because of its epidemic potential, its high case fatality ratio (10-40%), its potential for nosocomial outbreaks and the difficulties in treatment and prevention. CCHF is endemic in all of Africa, the Balkans, the Middle East and in Asia south of the 50° parallel north, the geographic limit of the genus Hyalomma, the principal tick vector.