Pathfinder
Editor, Senior Moderator
Source: Outbreaks and other emergencies updates
Week 19: 06 ? 12 May 2017
http://www.afro.who.int/en/clusters-a-programmes/whe/outbreaks-and-other-emergencies-updates.html
WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 19: 06 ? 12 May 2017
Data as reported by 17:00 12 May 2017
Excerpt:
Crimean-Congo haemorrhagic fever Senegal
Event description
2
Cases
0
Deaths
0%
CFR
On 08 May 2017, the Senegalese Ministry of Health and Social Welfare
notified WHO of two imported cases of Crimean-Congo haemorrhagic
fever (CCHF) at the National University Hospital Center Le
Dantec in Dakar. The index case, a 16 year old female patient from
Nouakchott in Mauritania, developed intense pain in the left ear and
diffuse headache on 16 April 2017. She presented to Nouakchott
Friendship hospital in Mauritania from where a tick was extracted
from the left ear. On 21 April 2017, the case-patient developed fever,
followed by multiple bleeding tendencies (epistaxis, bleeding from the
gum, melena, metrorrhagia, and vomiting blood), and was admitted
at the Nouakchott Friendship hospital. Slow clinical improvement was
however observed. On 29 April 2017, the case-patient was evacuated
by air to Dakar (accompanied by four relatives) and was admitted at
the Dantec University Hospital. The hospital carried out clinical investigations
with inconclusive findings. On 04 May 2017, blood sample
was obtained and shipped to the Pasteur Institute in Dakar. Laboratory
result released on 05 May 2017 was positive for Crimean-Congo
hemorrhagic fever virus.
The second case, a 48 year old mother to the index case, developed
fever, headache, muscle and joint pains, weakness, ecchymosis,
vomiting and insomnia on 19 April 2017 (from Mauritania). Blood sample
obtained from the case-patient on 06 May 2017 tested positive for
Crimean-Congo hemorrhagic fever virus.
As of 08 May 2017, 2 cases with zero death have been reported. Fifteen
close contacts have been listed (including the four relatives, two
patients who shared the same room, two intern doctors, four nurses
and three students) and are being followed up. Epidemiological investigation
established the presence of sheep with many ticks in the
family environment. The national authorities in Mauritania have been
notified and are conducting detailed investigations.
Public health actions
? The Ministry of Health made formal declaration and notification of the outbreak, in line with the International Health Regulations (IHR
2005) requirements.
? The Ministry of Health activated the Emergency Operations Center to coordinate response to the outbreak.
? Health care workers in the hospital have been sensitized on infection prevention and control (IPC) practices including the use of personal
protective materials. Personal protective equipment and IPC materials have been provided.
? Health workers in the hospital have been trained on arboviruses and viral haemorrhagic fevers in order to enhance surveillance including
identification of suspected cases and contacts, and sampling procedures. Active case search for suspected cases and contacts is
ongoing.
? Further epidemiological investigations are ongoing.
Situation interpretation
Crimean-Congo haemorrhagic fever is a tick-borne viral disease that is endemic in Africa, the Balkans, the Middle East and Asian countries.
The hosts of the CCHF virus include a wide range of wild and domestic animals such as cattle, sheep and goats. 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.
The index case in this outbreak reported close interactions with sheep as the potential risk factor for infection.
More epidemiological and entomological investigations are required, especially in Mauritania, to establish the full picture of the outbreak in
the country. The Senegalese authorities also need to monitor the situation very closely to avoid further escalation.
Week 19: 06 ? 12 May 2017http://www.afro.who.int/en/clusters-a-programmes/whe/outbreaks-and-other-emergencies-updates.html
WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 19: 06 ? 12 May 2017
Data as reported by 17:00 12 May 2017
Excerpt:
Crimean-Congo haemorrhagic fever Senegal
Event description
2
Cases
0
Deaths
0%
CFR
On 08 May 2017, the Senegalese Ministry of Health and Social Welfare
notified WHO of two imported cases of Crimean-Congo haemorrhagic
fever (CCHF) at the National University Hospital Center Le
Dantec in Dakar. The index case, a 16 year old female patient from
Nouakchott in Mauritania, developed intense pain in the left ear and
diffuse headache on 16 April 2017. She presented to Nouakchott
Friendship hospital in Mauritania from where a tick was extracted
from the left ear. On 21 April 2017, the case-patient developed fever,
followed by multiple bleeding tendencies (epistaxis, bleeding from the
gum, melena, metrorrhagia, and vomiting blood), and was admitted
at the Nouakchott Friendship hospital. Slow clinical improvement was
however observed. On 29 April 2017, the case-patient was evacuated
by air to Dakar (accompanied by four relatives) and was admitted at
the Dantec University Hospital. The hospital carried out clinical investigations
with inconclusive findings. On 04 May 2017, blood sample
was obtained and shipped to the Pasteur Institute in Dakar. Laboratory
result released on 05 May 2017 was positive for Crimean-Congo
hemorrhagic fever virus.
The second case, a 48 year old mother to the index case, developed
fever, headache, muscle and joint pains, weakness, ecchymosis,
vomiting and insomnia on 19 April 2017 (from Mauritania). Blood sample
obtained from the case-patient on 06 May 2017 tested positive for
Crimean-Congo hemorrhagic fever virus.
As of 08 May 2017, 2 cases with zero death have been reported. Fifteen
close contacts have been listed (including the four relatives, two
patients who shared the same room, two intern doctors, four nurses
and three students) and are being followed up. Epidemiological investigation
established the presence of sheep with many ticks in the
family environment. The national authorities in Mauritania have been
notified and are conducting detailed investigations.
Public health actions
? The Ministry of Health made formal declaration and notification of the outbreak, in line with the International Health Regulations (IHR
2005) requirements.
? The Ministry of Health activated the Emergency Operations Center to coordinate response to the outbreak.
? Health care workers in the hospital have been sensitized on infection prevention and control (IPC) practices including the use of personal
protective materials. Personal protective equipment and IPC materials have been provided.
? Health workers in the hospital have been trained on arboviruses and viral haemorrhagic fevers in order to enhance surveillance including
identification of suspected cases and contacts, and sampling procedures. Active case search for suspected cases and contacts is
ongoing.
? Further epidemiological investigations are ongoing.
Situation interpretation
Crimean-Congo haemorrhagic fever is a tick-borne viral disease that is endemic in Africa, the Balkans, the Middle East and Asian countries.
The hosts of the CCHF virus include a wide range of wild and domestic animals such as cattle, sheep and goats. 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.
The index case in this outbreak reported close interactions with sheep as the potential risk factor for infection.
More epidemiological and entomological investigations are required, especially in Mauritania, to establish the full picture of the outbreak in
the country. The Senegalese authorities also need to monitor the situation very closely to avoid further escalation.