CCHF deaths in Khyber-Pakhtunkhwa Province, September 2013

Four butchers in Haripur have died after being infected with Crimean-Congo Hemorrhagic Fever virus (CCHF) in September 2013. The butchers lost their lives after they slaughtered and handled the meat of an infected sheep that was bought from a local animal market, although it is believed that the sheep had come from Afghanistan. An immediate ban on the slaughtering of animals was imposed for 7 days to help prevent further infection and to raise awareness about CCHF in the local area.

Disease notes

CCHF virus was initially identified in Pakistan in 2006 near Loralai, after some butchers and livestock buyers died because of the disease.

Crimean-Congo Hemorrhagic fever is a viral haemorrhagic fever that can be transmitted by ticks. It can cause outbreaks of severe disease in human populations, but it does not cause clinical disease in ruminants, which act as amplifying hosts for this virus.

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 that had been identified in 1956 in the Congo, and linkage of the two place names resulted in the current name for the disease and the virus.

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 an endemic disease across Africa, the Balkans, the Middle East and Asian countries that are south of the 50° parallel north, which is the geographic limit of the genus Hyalomma, the principal tick vector.