August 18, 2013

Crimean-Congo Fever Outbreak: MOH Issues National Alert

The ministry of health has issued a nationwide alert following the confirmed outbreak of the Crimean-Congo hemorrhagic fever-CCHF in Agago district.

The Crimean-Congo hemorrhagic fever is caused by a tick-borne virus identified as Nairovirus. CCHF virus causes severe viral hemorrhagic fever outbreaks, with an approximately 30% death rate occurring in the second week of illness.

Dr Makumbi and Dr Elioda
Doctors Makumbi and Elioda

It is endemic in Africa, the Balkans, the Middle East and Asian countries, which have the predominant tick vector. It is transmitted to people either by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. Dr. Issa Makumbi, the Head of Surveillance and Epidemiology at National Disease Control-NDC unit says in severe occurrences 40 in 100 people may die in an outbreak.

He says that investigations are ongoing to ascertain if four cases reported in Kalongo Hospital are linked to the CCHF virus. He explained that NDC has moved to strengthen surveillance in Agago and its neighboring districts saying the disease is highly infectious.

Dr. Issa Makumbi advises the public to cook meat thoroughly before eating. He also advises members of the public to be careful while visiting pork and roast meat eateries, as the preparation of the meat may not meet the required levels of sterilization.

According to the World Health Organization (WHO) in patients who recover, improvement generally begins on the ninth or tenth day after the onset of illness.  The hosts of the CCHF virus include a wide range of wild and domestic animals such as cattle, sheep and goats.

Dr. Wondimagegnehu Alemu the WHO Representative in Uganda notes that when animals are bitten by ticks, they become infected and the virus remains in their bloodstream for about one week after infection, allowing the completion of virus transfer from tick to animal and vice versa when another tick bites.

Dr. Alemu says that WHO is part of the mitigation to prevent the spread of the disease including; providing surveillance, diagnosis and outbreak response activities.

Dr. Makumbi explains further that once a person is bitten by a tick it takes three incubation days, there after the patient will start experiencing a sudden onset of symptoms including fever, muscle ache, dizziness, neck pain and stiffness, backache, headache, sore eyes and sensitive to light. He says the patient may also suffer from nausea, vomiting, diarrhea, abdominal pain and sore throat, followed by sharp mood swings and confusion.
After two to four days, the patient may experience sleepiness, depression and abdominal pain and detectable liver enlargement.

Virus causing agents of Ebola hemorrhagic fever, Marburg hemorrhagic fever, CCHF, Rift Valley fever, and yellow fever are all endemic in East and Central Africa. In 2000, 224 people were killed following an Ebola outbreak in Gulu district, while in 2012; the Uganda Virus Research Institute (UVRI) reported a total of 18 cases and 9 deaths related to Marburg hemorrhagic fever, in 5 districts: Kabale, Kampala, Ibanda, Mbarara and Kabarole.

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