Re: Pakistan: 2014 CCHF cases
Volume 5, Issue 27, Wednesday 9 July 2014
http://www.emro.who.int/images/stor...ekly-Epidemiological-Bulletin-27-09072014.pdf
Epidemiological week no. 27
(29 June - 5 July 2014)
? CCHF: During this week, 6 lab confirmed CCHF cases have been reported 3 from Balochistan province (2 cases belongs to Afghanistan);
2 from Khyber Pakhtunkhwa province (both the cases belongs to Afghanistan); while 1 lab confirmed CCHF death was
from Punjab province. (4 out of 6 cases belongs to Afghanistan and were brought to Pakistan for treatment).
? In this week, 76 out of 87 districts and 2,925 out of 3,590 health facilities have reported to Disease Early Warning System (DEWS),
compared to 76 districts with 2,751 health facilities shared weekly data in week 26,
2014.
? Total 987,644 patients consultations reported in week 27, 2014 as compared to 1,166,436 consultations in week 26, 2014.
? In this week, a total of 42 alerts generated and timely responded. Altogether 23 alerts were for Measles; 7 for CCHF; 5 for Leishmaniasis;
2 each for Typhoid fever and NNT; while 1 each for Acute Watery Diarrhoea,
Acute diarrhoea and Diphtheria.
...
Crimean Congo Haemorrhagic Fever
Crimean Congo Haemorrhagic Fever (CCHF) cases are reported continuously from epidemiological week 8 2014.
So far total 38
suspected cases, 22 laboratory confirmed, and 10 deaths (of these 7 laboratory confirmed) have been reported. Most of the cases are from
Balochistan province 17 suspected (9 cases belongs to Afghanistan), 9 Laboratory confirmed and 1 death. 8 Laboratory confirmed (6 from
Afghanistan) were reported from Khyber Pakhtunkhwa province. 4 suspected cases (1 from Afghanistan), 2 Laboratory confirmed and 3
deaths (due to suspected CCHF) were reported from Islamabad. 4 suspected CCHF cases (3 Laboratory confirmed), 3 deaths (2 Lab confirmed)
reported from Punjab province. While 1 suspected case was reported from district Sudhnuti (AJK) and was negative for CCHF.
The CCHF cases from Afghanistan are detected and reported from Quetta and Peshawar because the patients are referred for
treatment (mostly self referrals) to the Tertiary Care hospitals in both these cities. The list of CCHF cases with addresses shared with concerned
person at the Ministry of Public Health Afghanistan for preventive measures at community level.
...
30‐Jun CCHF Balochistan Quetta FJCH (Killi Beraw,Saryab Road)
One CCHF case was reported from FJCH. Investigations revealed that the patient
is a dairy farmer and had usual contact with cattle. As per investigations patient
had developed rigors, headache, abdominal pain from last 10 days with complaints
of nasal / gum bleeding for 3 days. The lab results showed Hb 13.5 mg/dl,
platelets 12,000/cmm and also malaria was positive. Symptomatic treatment,
supportive fluids was started. There was no travelling history. Awareness session
was taken with family regarding CCHF disease. Blood sample collected and was
found positive for CCHF.
30‐Jun CCHF Balochistan QuettaFJCH (Killi Poroon, Anjeel District, Afghanistan)
One CCHF case reported from FJCH. Patient had high grade fever, headache,
body ache and nasal / gum bleeding. Patient is an animal trader by profession
and also had animals at home. The lab investigation showed Hb 13.4 mg/dl,
platelets 129,000/cmm, urea 48 mg%, Creatinine 0.8 mg% whereas Malaria and
Dengue were negative. Patient is living in an endemic area and travel to other
districts for trading. Supportive treatment and fluids intake started. Family was
sensitized about CCHF and case condition. Blood sample collected and was found
positive for CCHF.
2‐Jul CCHF Balochistan Quetta FJCH (Killi Pethaw Kholaw, District Malghao, Afghanistan)
One CCHF case was reported from FJCH. Case is an animal trader by profession.
Symptomatic history showed high grade fever with rigors and weakness in lower
limb from last 10 days and nasal/gum bleeding for last 3 days. The lab investigations
revealed Hb 15.5 mg/dl, platelets 61,000/cmm and blood sample send to
NIH came out positive whereas malaria and Dengue were negative. Symptomatic
treatment, supportive fluids was given. There was no travelling history neither
any such case at his family. Awareness session was taken on CCHF. Family was
sensitized for being isolated with the case and inform if any contact gets similar
sign and symptoms.
2‐Jul CCHF Khyber Pakhtunkhwa Peshawar Gadi Khana, Lahori Gate, Peshawar City
Information by DMS HMC about admission of a staff member of Emergency Department
who was involved in shifting of a Positive CCHF case to the Medical
Ward. Initially he was only treated for Fever but later on it was revealed that he
was exposed to the vomitus of the CCHF case. He developed Gums & Mouth
bleeding. Ribavirin was started along with supportive therapy. Blood sample sent
to NIH came positive for CCHF. The patient could not survive and expired.
4‐Jul CCHF Khyber Pakhtunkhwa Peshawar Mohallah Naranj Bagh, Jalal Abad, Afghanistan
An 18 years old female from Jalal Abad Afghanistan was suspected as a CCHF
case at Hayat Abad Medical Complex. Patient had history of fever, body aches
and hemorrhage from nose and mouth. Patient belongs to a family that deals
with domestic animals and butchers. Patient was isolated in a separate room and
investigations revealed that platelet count was 23000; blood sample sent to NIH
found positive for CCHF. Ribavirin treatment initiated to the patient as well as to
close contacts including health care providers that examined the patient.
29‐Jun CCHF Punjab Chakwal Village Jhatla Talagang Chakwal
A death due to CCHF was reported from Holy Family Hospital (HFH) Rawalpindi.
WHO responded with DDHO Chakwal by visiting the hospital and in the community.
Patient was consulted local doctors but later come to HFH OPD and was
given out patient prescription. Later started blood in vomit and was admitted in
Emergency ward under supervision of Medical ward specialist but could not
survive and expired on 30 June 2014. The deceased was farmer by profession,
with history of cattle handling. Blood sample send to NIH during admission,
came out positive, Platelets 17000 and Hb was 4.5. Field visit was arranged and
contacts were briefed about symptoms and CCHF. No family members found ill,
LHW were instructed to remain vigilant about any case in the area. Shared the
detail Investigation report with WHO Punjab, EDO(H) Chakwal and WHO DEWS
Islamabad. Deceased was buried with proper instructions from NIH.
1‐Jul CCHF Khyber Pakhtunkhwa Peshawar Tajkungan, Mazarshrif Afghanistan
A CCHF case was reported from Isolation Room of Khyber Teaching Hospital,
Peshawar. The patient was a 32 year old male, resident of Taj Kurghan, Mazar
Sharif, Afghanistan having fever, headache, body aches for the last 5 days,
bruises on hands for the last 4 days and bleeding from gums and rectum for the
last 2 days. By profession the patient is a butcher. The laboratory investigations
show low platelets (35,000/cmm). Sample was collected and was found positive
for CCHF. The patient did not survive and died on 2nd July 2014.
...
