Download Crimean-Congo Hemorrhagic Fever ICD

Crimean-Congo Hemorrhagic Fever
ICD-10 A98
Identification 1.4.1
A viral disease with sudden onset of fever, malaise, weakness, irritability, headache, pain in
limbs and bleeding tendency manifested at fourth day of illness, which may include
epistaxis, bleeding gum, G.I.T or urogenital tract bleeding, echymosis and purpura (spots
.with bruising patches on skin), and bleeding from the site of injection
Case definitions
Suspected case: Fever with acute hemorrhagic symptoms with history of contact with
.animal
.Probable case: Suspected case plus history of contact with confirmed human case
Confirmed case: Suspected case with laboratory confirmatory tests. Diagnosis confirmed by
.C.F.T, IFAT, ELISA
Infectious agent
)The Crimean-Congo hemorrhagic fever virus (Bunyaviridae Nairovirus
Occurrence
In 2010, an outbreak in Ninawa province occurred. No. of confirmed cases were 10 and one
.case occurred in Duhok province. 3 of these cases died. Death rate is 10 – 30% in Iraq
Reservoir
Tick (Hyalomma marginatum) are both a reservoir and a vector, domestic animals (sheep,
.goats and cattle) may act as amplifying transmission host during epizootics
Mode of transmission 1.4.1
.By bite of infective Hyalomma marginatum
.Nosocomial infection
.1
.2
Butchering infected animal: spread by infected fluid especially blood through direct
.contact with injured or scratch human skin
.3
Incubation period 1.4.1
days. Depends on the mode of acquisition of the virus. With tick bite: 1 to 3 days, up to 12-3
.9 days. Following contact with infected blood or tissues: 5 to 6 days, upto12 days
Period of communicability 1.4.1
Domestic animals, such as cattle, sheep and goats, are viremic (virus circulating in the
.bloodstream) for around one week after becoming infected with ticks
Susceptibility and resistance 1.4.1
Recovery is slow, begins on the ninth or tenth day after the onset of illness. Case fatality
.rates in hospitalized patients have ranged from 9% to as high as 50%
Methods of control 1.4.1
.1
Case detection and report to Health Department in the province within 24 hours by
.telephone or E-mail and also to CDC
Isolate suspected human cases and confirmed cases in the hospitals with control
.measures to protect medical and paramedical contacts
Tics control measures
.2
.3
Check for the close contacts in patient’s house under medical supervision by nearby
.4
PHC. Contacts with tissue or blood exposure from patients with suspected or confirmed
cases should be followed up with daily temperature and symptom monitoring for at least 14
.days after the exposure
Rapid information to veterinary department to take action by using tick insecticides
.on the infested animal at the patient’s house
Management of the disease 1.4.11
General supportive therapy is the mainstay of patient management in CCHF.
.Intensive monitoring to guide volume and blood component replacement is required
The antiviral drug ribavirin has been used in treatment of established CCHF infection
.with apparent benefit. Both oral and intravenous formulations seem to be effective
The value of immune plasma from recovered patients for therapeutic purposes has
.not been demonstrated, although it has been employed on several occasions
Ref: WHO Initiative for Vaccine Research (IVR): updated 2009.
http://www.who.int/csr/disease/crimean_congoHF/en/index.html
.1