Crimean-Congo Fever- A Serious Threat For Public Health

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Crimean-Congo Fever- A Serious Threat For Public Health Haleema Sadia1, Riffat Mehboob2, Muhammad Idrees1, Kausar Malik3, Muhammad Ateeq4, Tariq Nadeem3, Amna Shafi5, Ahmad Nawaz6 . 1Centre for Applied Molecular Biology, University of the Punjab, Lahore, Pakistan, 2Department of Biomedical Sciences, King Edward Medical University, Lahore, Pakistan, 3National Centre of Excellence in Molecular Biology, University of the Punjab, Lahore, Pakistan,4Department of Biotechnology, University of Sargodah, Pakistan, 5Aysha Sadiqa Hospital, Lahore, Pakistan, 6Lasbela University of Agriculture, Water and Marine Sciences, Uthal, Lasbela District, Balochistan, Pakistan, INTRODUCTION SIGNS & SYMPTOMS Crimean-Congo hemorrhagic fever (CCHF) is an endemic, zoonotic, tick-borne viral disease of Bunyaviridae family having fatality rate of 80% in humans1. Its foci are spread in Middle East, Africa, South Eastern Europe, Central and Western Asia2 1 out of 5 infected humans develop clinical symptoms including vomiting, headache, muscular pain, hyperemia of face and oropharynx, hamorrhagic rash, bleeding of nasopharynx, gastrointestinal tract, etc. that can rapidly progress into a hemorrhagic syndrome, leading to multiorgan failure and death in severe cases. EPIDEMIOLOGY DIAGNOSIS Diagnosis is based on the detection of both IgM and IgG. Nucleoprotein N-based ELISA for IgM and IgG antibodies and antigen detection system assays can be used in institutes without BSL-4 laboratory. Genome amplification tests and nested RT-PCR are also used. MODE OF TRANSMISSION Virus has been reported from 31 different species of ticks from the  Hyalomma and genera Haemaphysalis3. In mammals, Multimate rats, Middle African hedgehogs and European hare are main reservoirs4. CCHF occurs mostly by bite of an infected tick frequently among medical staff, workers of agriculture and slaughterhouse5. TREATMENT CONGO FEVER IN PAKISTAN CCHF was first time reported in Pakistan in 1976. Khyber Pakhtunkhwa and Balochistan are the most affected areas. Presently more than 30 cases have been reported in Pakistan during 2016, six death has been reported from Karachi, ten from Quetta and two from Bahawalpur in 2016. On 1st Oct 2016 one more patient were diagnosed with Congo virus in Nishtar Hospital Multan reported by Dunya News 5,6,7 PRECAUTIONS AND RECOMMENDATIONS Only prevention and early identification of cases is the measure to control CCHF infection as it does not have any standard cure yet and further research is necessary to develop potential vaccines and the efficacy of different treatments like ribavirin and other antiviral drugs should be determined. Preventive measures should be taken by the hospital staff to protect others from getting infected. Those working with animals should use insect repellent on exposed skin and use proper clothing.. REFERENCES 1The PirBright Institute, 2016,16P-45; 2(Gianguglielmo, Z et al, 2013) 3(Mehravaran, A et al., 2013); 4(Dennis A. Bente et al., 2013); 5(http://dunyanews.tv/en/Pakistan/355059-One-more-patient-diagnosed-with-Congo-virus-in-Mul ) 6(http://dunyanews.tv/en/Pakistan/351910-Congo-virus-patients-toll-hits-27-in-Balochistan) 7(http://dunyanews.tv/en/Pakistan/351805-Death-toll-from-Congo-virus-climbs-to-10-in-Quetta;