Pakistan: CCHF 2011

[Shiloh]

Source: http://www.geo.tv/9-16-2011/86288.htm

Three Congo Virus cases reported in Quetta
Updated at: 1631 PST, Friday, September 16, 2011

Three Congo Virus cases reported in Quetta QUETTA: Three Congo Virus cases were reported in Quetta on Friday, Geo News reported. A senior surgeon and medical technician are amongst those who have contracted the virus.

Dr. Adam Khan the head of the isolation ward at Fatima Jinnah TB hospital said the surgeon and technician were infected with the virus while they were treating a patient. Dr. Khan added that the blood samples of the patients had been sent to Islamabad for testing.

[Shiloh]

Re: Pakistan: Four Congo Virus cases reported in Quetta

Source: http://nation.com.pk/pakistan-news-n...th-Congo-virus

Surgeon among four infected with Congo virus
By: Bari Baloch | Published: September 17, 2011

QUETTA-Four people, including a senior surgeon and a medical technician have contracted the Congo virus in Quetta on Friday.

Senior surgeon, Dr. Ayaz Mandokhail, Imran medical technician, five year old Afghan national Izatullah and a resident of Kuchlak are suspicious of contracting Congo virus. Sources said, surgeon Ayaz who is also a government employee was operating a Congo infected patient at a private hospital when he and Imran contracted the virus.

Dr. Ayaz was immediately shifted to Karachi owing to his serious condition while Imran was admitted in an isolation ward of Fatima Jinnah Hospital (FJH) Quetta.

Hospital sources said two more patients including 5-year-old Afghan boy Izatullah and another person belonging to Kuchlak area, some 20 kilometers away from the provincial capital were admitted in isolation ward of FJH...

[alert]

Re: Pakistan: Four Congo Virus cases reported in Quetta

http://www.promedmail.org/pls/apex/f?p=2400:1001:5948057342066210::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,90304

Archive Number 20110917.2833
Published Date 17-SEP-2011
Subject PRO/AH/EDR> Crimean-Congo hem. fever - Pakistan ex Afghanistan, nosocomial

CRIMEAN-CONGO HEMORRHAGIC FEVER - PAKISTAN ex AFGHANISTAN, NOSOCOMIAL
************************************************** *******************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Sat 17 Sep 2011
Source: Pakistan today [abbreviated, edited]
<http://www.pakistantoday.com.pk/2011/09/surgeon-among-four-down-with-congo-virus-in-quetta/>


Surgeon among 4 down with CCHF virus in Quetta
----------------------------------------------
A total of 4 people, including a surgeon and a medical technician,
have fallen victim to haemorrhagic fever in Quetta. Reports said a
patient suffering from Congo virus [Crimean-Congo haemorrhagic fever
virus (CCHF) infection] was brought to Quetta from Afghanistan for
surgery. He was being operated on by senior surgeon Dr Mohammad Ayaz
at a private hospital when he [Dr Ayaz] got infected with the virus as
well. A medical technician who was assisting the surgeon also got
infected.

Dr Ayaz was immediately moved to Karachi for treatment, despite the
fact that isolation wards have been established for such patients at
Fatima Jinnah Hospital in Quetta. The technician, however, was being
treated in an isolation ward at the hospital. Reports further said
that another 2 patients [with CCHF virus infection had been] admitted
to Fatima Jinnah Hospital.

Dr Aadam, the [physician] in charge of the isolation ward, said that
another 2 patients, including an Afghan refugee and a youth from
Kuchlak, were also suffering from [CCHF virus infection]. He said
there was a possibility that more attendants and medical staff [would
become infected] with CCHF virus while treating these patients. The
doctor said [CCHF] was a dangerous disease and doctors in the hospital
lacked proper equipment to protect themselves from it.

He said over the past 4 years, members of the staff had not been
vaccinated. [No vaccine is currently approved for human use. -
Mod.CP]

[Byline: Shahzada Zulfiqar]

--
Communicated by:
Shamsudeen Fagbo, DVM
National Coordinator
Zoonotic Diseases Unit
Directorate of Communicable Diseases
Ministry of Health
Riyadh 11176
Saudi Arabia
<oloungbo@yahoo.com>

[At least 2 of the patients admitted to the hospital in Quetta had
come to Pakistan from Afghanistan, and the surgeon, a technician and
possibly others contracted infection during treatment of the index
case. No information is provided regarding the condition of those
affected, other than that the surgeon operating on the index case was
evacuated to a hospital in Karachi. Serious nosocomial infection in a
Pakistan hospital was reported previously in 2010 (see ProMED-mail
reference below).

CCHF is found throughout the Mediterranean region, in northwestern
China, central Asia, Africa, the Middle East, and the Indian
subcontinent. Ixodid ticks, especially those of the genus, _Hyalomma_,
are both a reservoir and a vector for CCHF virus. Numerous wild and
domestic animals, such as cattle, goats, sheep and hares, serve as
amplifying hosts for the virus. Transmission to humans occurs through
contact with infected animal blood or ticks. CCHF can be transmitted
from one infected human to another by contact with infectious blood or
body fluids. CCHF has also occurred in hospitals due to improper
sterilization of medical equipment, reuse of injection needles, and
contamination of medical supplies.

The onset of CCHF is sudden, with initial signs and symptoms including
headache, high fever, back pain, joint pain, stomach pain, and
vomiting. Red eyes, a flushed face, a red throat, and petechiae (red
spots) on the palate are common. Symptoms may also include jaundice,
and in severe cases, changes in mood and sensory perception. As the
illness progresses, large areas of severe bruising, severe nosebleeds,
and uncontrolled bleeding at injection sites can be seen, beginning on
about the 4th day of illness and lasting for about 2 weeks. In
documented outbreaks of CCHF, fatality rates in hospitalized patients
have ranged from 9 percent to 50 percent. Animal herders, livestock
workers, and slaughter houses in endemic areas are at risk of CCHF.
Health care workers in endemic areas are at risk of infection through
unprotected contact with infectious blood and body fluids.

Treatment for CCHF is primarily supportive. The virus is sensitive in
vitro to the antiviral drug ribavirin and it has been used in the
treatment of CCHF patients reportedly with some benefit. An
inactivated, mouse-brain derived vaccine against CCHF has been
developed and is used on a small scale in Eastern Europe. However,
there is no safe and effective vaccine widely available for human use.
For more information, see:
<http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/cchf.htm>.

The city of Quetta is located near the Durand Line border with
Afghanistan and is an important trade and communications centre
between the 2 countries. The city lies on the Bolan Pass route which
was once the only land route to and from South Asia. The
HealthMap/ProMED-mail interactive map of Pakistan can be accessed at:
<http://healthmap.org/r/00tj>. - Mod.CP]

[Shiloh]

Re: Pakistan: Four Congo Virus cases reported in Quetta

Source: http://www.pakistantoday.com.pk/2011...-dies-at-akuh/

Congo scare looms after surgeon dies at AKUH
AAMIR MAJEED 45 mins ago

* Dr Ayaz Mandokhel Khan was infected by Congo virus in Quetta while operating on another CCHF patient

KARACHI - A surgeon at a public hospital in Quetta, Balochistan suffering from the Congo Crimean Hemorrhagic Fever (CCHF) died on Tuesday at the Aga Khan University Hospital (AKUH). Senior surgeon and assistant professor at the Bolan Medical College Hospital, 44-year-old Dr Ayaz Mandokhel Khan was brought to Karachi on September 14 on suspicion of being infected with the Congo virus after performing a surgical operation of an afghan refugee woman at a private hospital two days earlier.

Besides Ayaz, his assistant Imran was also diagnosed to be infected with the deadly virus and is under treatment at Fatima Jinnah Hospital Quetta (FJHQ). Initially, Ayaz was also admitted to the same hospital but when doctors failed to identify the disease he was suffering from, he was shifted to Karachi and admitted at the AKUH.An AKUH official, on condition of anonymity, told Pakistan Today that the surgeon had been unconscious since he was brought to the hospital...

[Ronan Kelly]

Re: Pakistan: Four Congo Virus cases reported in Quetta

ISLAMABAD, Oct 25: If you thought dengue was the final blow that nature could inflict on Pakistanis for this year, you were wrong. In a cruel twist of fate, the country is now expected to be plagued by a wave of the high-fatality tick-bite disease, the Crimean Congo Haemorrhagic Fever (CCHF).

The National Institute of Health`s (NIH) warning on the latest infectious disease comes a week after its first victim succumbed to it at the Pakistan Institute of Medical Sciences (Pims). Dawn

?An adult patient Hamza from Haripur district of Khyber Pakhtunkhwa has died due to CCHF. The patient came with massive bleeding and was admitted at the isolation ward. We immediately sent his samples to NIH but he died during the course of his treatment due to massive bleeding,? Prof Mehmood Jamal, executive-director of Pims, told .

...

http://www.dawn.com/2011/10/26/with-dengue-now-comes-congo-fever.html

[Ronan Kelly]

Re: Pakistan: CCHF 2011

Young man dies of Congo feverMukhtar Alam | Metropolitan > Karachi | From the Newspaper
(13 hours ago) TodayKARACHI, Nov 18: A 29-year-old man admitted to a private hospital with a history of high-grade fever and fits for six days died at a private hospital on Friday.

Sources at the Liaquat National Hospital (LNH) told Dawn that the patient tested positive for the Congo Crimean haemorrhagic fever virus by a private university hospital.

The patient was a resident of Gazdarabad, Ranchhore Line.

...

He was brought to the LNH with a high-grade fever in a state of unconsciou-sness, bleeding at the mouth, on Nov 15. He was diagnosed as a CCHF case on Nov 17, he added.

It was further learnt that the patient was being treated at the medical intensive care unit of the LNH.

...

http://www.dawn.com/2011/11/19/young-man-dies-of-congo-fever.html

[Ronan Kelly]

Re: Pakistan: CCHF 2011

Family of Congo victim not yet screened
Mukhtar Alam | Metropolitan > Karachi | From the Newspaper (15 hours ago) Today

KARACHI, Nov 19: Health officials have yet to contact the family of a young man who died of Congo Crimean haemorrhagic fever in a private hospital on Friday, it emerged on Saturday.

However, the Liaquat National Hospital, where the patient died, has started administering preventive medicines to a number of its employees, including doctors, believed to have come into contact with the dead. The man had been admitted to the LNH with a history of high-grade fever, body aches, fits and bleeding for six days before he died.

The 29-year-old-man living in Gazdarabad, Ranchhore Line, left behind a wife and a one-and-a-half-year-old boy besides parents and siblings.

According to medical and infectious disease experts, the doctors and paramedics known to have come into contact with the patient during treatment and relatives of the patient needed to be kept under observation as a preventive measure for some time.

...

http://www.dawn.com/2011/11/20/family-of-congo-victim-not-yet-screened.html