A Case of Deadly Crimean-Congo Haemorrhagic Fever Discovered in UK I CR News

The world was finally just moving back to its normal conditions and now we have detected yet another deadly fever. Read the full article to know exactly what is Crimean-congo hemorrhagic fever, what are its symptoms, is easy to spread, most importantly how to prevent it from spreading, and much more.

What is Crimean-Congo Hemorrhagic Fever?

The UK Health Security Agency (UKHSA) can confirm that a case of Crimean-Congo haemorrhagic fever (CCHF) has been confirmed in England. The woman had recently traveled to Central Asia. The patient was diagnosed at Cambridge University Hospitals NHS Foundation Trust and is receiving specialist care in a Hospital in London.

The disease was first described in Crimea in 1944 and given the name Crimean-Congo haemorrhagic fever. In 1969 it was recognized that the pathogen causing Crimean-Congo haemorrhagic fever was the same as that responsible for an illness identified in 1956 in the Congo. The linkage of the two-place names resulted in the current name for the disease and the virus.

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A Case of Deadly Crimean-Congo Haemorrhagic Fever Discovered in UK Crimean-Congo haemorrhagic fever (CCHF) is a disease that is usually spread by ticks. It can also be contracted through contact with viraemic animal tissues (animal tissue where the virus has entered the bloodstream) during and immediately post-slaughter of animals. The current knowledge about the vector-host-CCHF interactions is very limited due to the high-level containment required for CCHF studies. Among ticks, a type of tick known as Hyalomma is the main carrier of Crimean-Congo haemorrhagic fever.

What Are its Symptoms? 

According to the WHO, the onset of CCHF symptoms is sudden and includes fever, muscle aches, dizziness, neck pain, backache, headache, sore eyes, and a sensitivity to light. Following infection by a tick bite, the WHO says the incubation period of CCHF is usually one to three days, with a maximum of nine days. Following contact with infected blood or tissues of livestock, the incubation period is usually five to six days, with a maximum of 13 days.

Those infected may also experience nausea, vomiting, diarrhea, abdominal pain, and sore throat early on, as well as sharp mood swings and confusion. Other signs of infection include increased heart rate and enlarged lymph nodes. After two to four days, an infected person may start to experience sleepiness, depression, and a lack of energy.

The Crimean-Congo haemorrhagic fever phase of the disease typically begins on day four, according to the WHO, with bleeding most commonly manifesting in the stomach, nasal cavity, and gums.  In very sick people, rapid kidney deterioration, sudden liver failure, or lung failure can happen after the 5th day of the disease. Reports say that death usually occurs in the second week of illness.

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In patients who recover, improvement generally begins on the ninth or tenth day following the onset of symptoms. The CCHF virus causes severe viral hemorrhagic fever outbreaks, with a case fatality rate of 10 to 40 percent, according to WHO.

Does it Spread Easily?

Dr. Susan Hopkins, the chief medical adviser at the UKHSA, said the virus “does not spread easily between people and the overall risk to the public is very low”. It is the third known case of fever in the UK, with prior cases reported in 2012 and 2014, both of which did not spread.

A Case of Deadly Crimean-Congo Haemorrhagic Fever Discovered in UK

The CCHF virus is transmitted to people either by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers, and veterinarians.

Human-to-human transmission can occur resulting from close contact with the blood, secretions, organs, or other bodily fluids of infected persons. Hospital-acquired infections can also occur due to improper sterilization of medical equipment, reuse of needles, and contamination of medical supplies.

A Case of Deadly Crimean-Congo Haemorrhagic Fever Discovered in UK

Crimean-Congo haemorrhagic fever is found in Eastern Europe, particularly in the former Soviet Union, throughout the Mediterranean, in northwestern China, central Asia, southern Europe, Africa, the Middle East, and the Indian subcontinent. Although, the first case of this virus/fever was reported in the UK the virus has never been detected in the UK in a tick.

Anyone visiting areas where the ticks are found should take protection, the UKHSA said. This includes avoiding areas where ticks are abundant at times when they are active, using tick repellents, and checking clothing and skin carefully for ticks. 

Diagnosis & Prevention?

Doctors can diagnose CCHF through lab tests including:

  • Antigen-capture enzyme-linked immunosorbent assay (ELISA)
  • Real-time polymerase chain reaction (RT-PCR)
  • Virus isolation attempts

Detection of antibody by ELISA (IgG and IgM)                                                          During the severe phase of the illness, doctors can use your clinical history and other testing methods to diagnose CCHF.  In survivors of CCHF, doctors can find antibodies in the blood to confirm a past case. But antigens, viral RNA, and the virus won’t be detectable anymore.

There is currently no vaccine available for CCHF for either people or animals. According to the WHO, “general supportive care with treatment of symptoms” is the main approach to managing CCHF. The WHO says the antiviral drug ribavirin has been used to treat CCHF infection to some success, and both oral and intravenous formulations have shown to be effective.

For patients without haemorrhagic complications, Health Canada says treatment with painkillers and fever-reducing medications has proved useful. With no vaccine, the WHO says the “only way” to reduce infection of CCHF in people is by raising awareness of the risk factors and providing education on measures they can take to reduce exposure.

A Case of Deadly Crimean-Congo Haemorrhagic Fever Discovered in UK

If in one of the endemic countries and in an area where ticks may be present, the WHO advises wearing light-colored protective clothing, such as long-sleeve shirts and pants, to help prevent bites and allow easy detection of ticks. It also recommends using approved chemicals intended to kill ticks — on clothing and repellent on the skin, and avoid areas that have an abundance of ticks, especially during seasons when they are most active.

To reduce CCHF risk via animal transmission, the WHO advises those handling livestock in endemic areas to wear gloves and other protective clothing, especially during slaughtering, butchering, and culling procedures. The WHO also recommends those working in the industry in endemic areas quarantine animals before they enter slaughterhouses or routinely treat them with pesticides two weeks prior to slaughter.

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