Friday, January 21, 2011

Crimean-Congo Haemorrhagic Fever: CCHF has high mortality rate, is highly infectious

By Syed Akbar
Hyderabad, Jan 20: City hospitals are ill-equipped to tackle cases of the highly infectious Crimean-Congo Haemorrhagic Fever if the disease breaks out here. Worse, most doctors are unaware of the clinical manifestation of CCHF and it is unlikely that they have had direct interaction with a CCHF patient.

"We studied about CCHF in one of our microbiology lessons. But I have never come across a CCHF patient in my career so far," confessed an expert in internal medicine attached to a corporate hospital.
Infectious diseases specialist Dr Suneetha Narreddy said since CCHF was not a common disease, it would be difficult for a doctor to diagnose it. "Doctors first look for common diseases and then go for uncommon diseases. But chances are that no doctor here will look for CCHF since it has not been reported here earlier," she said. CCHF, the first cases of which have just been diagnosed in India, spreads fast through body fluids from person to person. Its transmission from animal to humans is through tick bites.
It is such a dangerous disease that the National Institute of Virology has warned that any serum samples from an infected person should be sent through a three-level isolation box to NIV, Pune, for confirmatory diagnostic tests.
CCHF was first diagnosed in 1944 in the Ukraine.
Though it has been causing havoc regularly in different parts of the world, it was not reported in India till recently. Early this month, the disease was diagnosed in Ahmedabad and so far it has caused the death of three people.

Given its highly infectious nature and the regular movement of large numbers of people between Gujarat and AP, doctors and health experts fear that any outbreak of CCHF in Hyderabad will precipitate a medical emergency. Most hospitals do not have special isolation wards fulfilling the WHO standards for Congo fever patients.
Senior physician, Dr Aftab Ahmed, said, "Since it is a viral disease, antibiotics do not work and the treatment has to be supportive. What matters is early diagnosis of the disease. It has one of the highest mortality rates with 40 per cent of patients succumbing to it."
Doctors at the government-owned Sir Ronald Ross Institute of Tropical and Communicable Diseases (Fever Hospital) also admit that they do not have a WHO-standard isolation ward to deal with Congo fever cases.
According to the National Institute of Virology, an individual is said to be suffering from CCHF if he manifests an acute febrile (fever) illness, with bleeding/haemorrhagic manifestations or acute unexplained death, plus at least one of the following: (a) tick bite in the previous three weeks (b) contact with livestock in the previous three weeks and or (c) direct physical contact, or contact with body fluids, of someone with a similar illness in the previous three wee

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