Gujarat - CCHF 2014

[Ronan Kelly]

From week 30 IDSP Report; http://idsp.nic.in/idsp/IDSP/30th_wk14.pdf

Gujarat Kutch CCHF 1 case 1 fatality 22/07/14 22/07/14
Investigation Open
Cases reported from Village Gajod, Sub centre Gajaod, PHC
Kera, Taluk Bhuj, District Kutch. One case reported from
Village Gajod. 1 serum sample of CCHF sent to NIV Pune,
CCHF positive. House to house survey. Antilarval measures
taken. Daily monitoring of suspected contacts of deceased.
Patient kept under surveillance. Rivavarin given. De-ticking
of animals done. Dusting near animal is done with lindane

Previous CCHF in India;
2011: Gujarat: CCHF claims 4 lives including 2 doctors, nurse
India: 2011/2012 Congo fever cases; 7 fatalities
2013: Gujarat - Up to 9 deaths from CCHF in Amreli, 6 others under treatment; 3 fatalities in suspected outbreak in Ahmedabad

[Ronan Kelly]

Re: Gujarat - CCHF death reported in Kutch

Published Date: 2014-11-24 06:22:06
Subject: PRO> Crimean-Congo hem. fever - India: (GJ)
Archive Number: 20141124.2960918
CRIMEAN-CONGO HEMORRHAGIC FEVER - INDIA: (GUJARAT)
**************************************************
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: Fri 14 Nov 2014 [ProMED regrets the delay in posting. We have not found an update since then.]
Source: Daily Mail [edited]
http://www.dailymail.co.uk/indiahome...taken-ill.html


A doctor and a labourer of Bayad taluka [administrative division] in north Gujarat have tested positive for [Crimean-Congo hemorrhagic] fever [CCHF virus], sending the health department into panic mode in the state.

Acting swiftly, the Gujarat government has pressed 4 teams from the animal vaccination, health, animal husbandry, and agriculture departments into service to check the spread of the virus. The doctor has been lodged at a private hospital in Ahmedabad for treatment.

The labourer was first moved to the Ahmedabad civil hospital but is now admitted to a hospital in Patan.

The 4 teams have been deployed in Bayad and surrounding areas from where the 2 cases have been reported, Dr Manish Fancy, Chief District Health Officer of Sabarkantha district under which the area was before it was included in the newly carved out Aravalli district, said.

He said the vaccination team had administered anti-virus vaccinations to around 300 domestic animals in the region, while a group of health officials was engaged in a survey of the villages there. On the other hand, an animal husbandry team has been tasked to carry out a health survey of domestic animals.

[Byline: Darshan Desai]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[CCHF has been an ongoing public health problem in Gujarat state over the past 3 years. Studies have shown that there is relatively high antibody prevalence in domestic animals in this area. A published study cited in ProMED-mail archive no. 20140920.2790245 stated, "this disease is asymptomatic in animals. CCHF was first confirmed in a nosocomial outbreak in 2011 in Gujarat State. Another notifiable outbreak occurred in July 2013, in Karyana Village, Amreli district, Gujarat State. Anti-CCHF virus (CCHFV) immunoglobulin G (IgG) antibodies were detected in domestic animals from the adjoining villages of the affected area, indicating a considerable amount of positivity in domestic animals. Antibodies were detected in all the 15 districts surveyed; with positivity of 12 per cent, 41 per cent, and 34 per cent in bovines, sheep, and goats, respectively."

As Mod.CP noted (see ProMED-mail archive no. 20100810.2732), CCHF virus is tick-borne, and in the genus _Nairovirus_, family _Bunyaviridae_. The virus can cause severe viral hemorrhagic fever outbreaks, with a case fatality rate of 10-40 per cent. The virus is transmitted by _Hyalomma_ spp. ticks or through contact with infected human blood or animal blood and 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. Exposure in health care facilities also occurs. The length of the incubation period depends on the mode of acquisition of the virus. Following infection by a tick bite, the incubation period is usually 1-3 days, with a maximum of 9 days.


[The source of the CCHF virus infection in the laborer was presumably a bite from a livestock tick, leading to infection of the doctor who treated him. It is sad that 3 years after the 1st reported cases in Gujarat there was still a doctor there who did not take adequate precautions around a hemorrhagic fever patient. There is no licensed human vaccine. - Mod.JW

http://promedmail.org/direct.php?id=20141124.2960918

[Ronan Kelly]

Re: Gujarat - CCHF 2014

Congo virus rears its head again
TNN | Dec 14, 2014, 02.00AM IST

AHMEDABAD: After the city reported the first Crimean Congo Hemorrhagic Fever (CCHF) virus death, of a Bhuj resident at a Paldi hosiptal, local health authorities have put 33 individuals at Aarna Hospital under medical surveillance. They are being administered chemoprophylaxis ? medication to prevent disease or infection. Just like Ebola virus, CCHF affects people who come in immediate contact with a patient ? relatives and medical staff attending to them.

Since December 2010, there have been six CCHF clusters in the state. "The disease is now endemic to the state. It has been reported in Amreli, Sanand, Bhuj and Patan districts," said infectious diseases specialist Dr Atul Patel, who recently presented a research paper on the CCHF scenario in the state.

"We came across 8 patients diagnosed with CCHF during 18 months, from December 2010 to July 2012, including 2 isolated cases and 2 clusters of cases. In July 2013, the CCHF outbreak in Amreli district affected six patients of a community of which two died and four were stable. That very month there was an isolated case from Patan district where the patient succumbed," says Patel. There was also a death reported from Bhuj earlier.
...

http://timesofindia.indiatimes.com/city/ahmedabad/Congo-virus-rears-its-head-again/articleshow/45508677.cms

Congo fever kills one
TNN | Dec 13, 2014, 05.51AM IST


AHMEDABAD: The deadly Crimean Congo Haemorrhagic Fever (CCHF) has claimed its first victim in the state this season.

Suresh Moriya, 34, a resident of Madhapar village near Bhuj, died at a private hospital in Paldi on Thursday night. He was shifted to Ahmedabad on December 7 after a local hospital in Bhuj suspected that he was suffering from dengue. Moriya's health deteriorated two days later and he died on Thursday night.

"Moriya was referred to a urological hospital in Paldi area. It was here that doctors confirmed his symptoms to be that of CCHF," says medical officer of health, Ahmedabad Municipal Corporation, Bhavin Solanki.
...

http://timesofindia.indiatimes.com/city/ahmedabad/Congo-fever-kills-one/articleshow/45500691.cms

[Ronan Kelly]

From Week 46 IDSP Report;

http://idsp.nic.in/idsp/IDSP/46th_wk14.pdf

Gujarat
Sabarkantha CCHF 1 0 1/11/14 11/11/14 Under
Surveillance
Case of High Grade fever, vomiting, Diarrhoea, hematuria
and bleeding from gums reported from Village Bayad, PHC
Choila, Block Bayad, District Sabarkantha. RRT visited the
affected area. House to house surveillance done. 1 serum
sample tested positive by RT PCR at NIV pune for CCHF.
Anti tick control measures taken

[Ronan Kelly]

From Week 51 IDSP Report http://idsp.nic.in/

Gujarat
Kutch
Crimean Congo Hemorrhagic Fever
1 case 1 fatality 07/12/14 Under Surveillance
Case reported from PHC Madhapur, Taluka Bhuj, District Kutch.District
RRT investigated the outbreak. The case presented with high grade fever
headache followed by cough, diarrhea and sputum with blood. Sample tested
from patient tested positive for CCHF at NIV Pune. The patient condition
deteriorated and expired. Anti tick control measures taken.Health education
given.