With the Ebola virus outbreak in western African countries now admittedly both out of control and significantly underestimated in terms of its reach, cases of Crimean-Congo haemorrhagic fever (CCHF) are reported from Balochistan. At least four people are said to have been infected all from the small village of Killi Blump about 40km from Zhob city. Two of them have died. There are only a dozen houses in the village and its inhabitants are likely to be closely related, although this is not a factor in transmission or vulnerability. The means of transmission of the virus to humans is usually via ticks that have fed on the blood of livestock, though it is possible for it to pass in human-to-human contact. Animals in the area have been vaccinated as well as members of the extended family of those who have caught CCHF.
Although CCHF is not as lethal as the Ebola virus, it is a killer with up to 40 per cent of all those infected, dying. There is no vaccine against it for humans or animals, but injecting animals with acaricides that are aimed at preventing ticks is a wise precautionary measure. Why this may be a problem for Pakistan is that there is such a diversity of vectors in terms of livestock, most of which do not display any symptoms of the virus and it is only possible to be aware of its presence post-mortem. Thus livestock may harbour the carrier ticks in large numbers and across vast areas but unknown to the pastoralists, herders, shepherds and veterinarians. As with Ebola the key to the successful treatment and mitigation of an outbreak is good public health coordination, a raising of public awareness of the dangers and factors associated with the catching and spread of CCHF, and an emphasis on prevention that includes appropriate clothing in affected areas and personal hygiene. It is for the responsible agencies and authorities in the area where the outbreak has occurred to attend to all of the above and with speed if the outbreak is to be contained.
Published in The Express Tribune, August 20th, 2014.
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