BREAKING! Emergence of New Surge Of Crimean-Congo Haemorrhagic Fever In Iraq and Sporadic Cases Elsewhere Worries The World Health Organization
Unknown to many who are just focused on the COVID-19 pandemic or the latest Monkeypox surge that started among irresponsible gay men indulging in unprotected frivolous sex orgies that has now spread to the general population (the disease not the sex orgies please!) or the new strains of Ebola emergence in the African continent and new strains of Polio debuting in Pakistan and Afghanistan, a deadly nose-bleed fever disease called Crimean-Congo haemorrhagic fever
(CCHF) that possibility jumped from animals to humans, has emerged and is spreading fast in Iraq.
To date, Iraq had registered 19 deaths among 111 CCHF cases in humans since the first case was identified in late March 2022, according to the World Health Organization. There are hundreds more of cases being investigated and also there has been sporadic isolated cases since the Iraqi debut of the virus in other countries including UK, parts of eastern Europe, the African continent and various Middle-east countries.
Crimean-Congo haemorrhagic fever (CCHF) has a case fatality rate of between 10 to 40%!
The CCHF virus has no vaccine and onset can be swift, causing severe bleeding both internally and externally and especially from the nose.
Currently in Iraq, it is causing death in as many as two-fifths of cases, according to local medics.
Dr Haidar Hantouche, a health official in Dhi Qar province in Iraq told Thailand Medical News, "The number of cases recorded is unprecedented and worse, the disease is spreading and cases are growing. Adding to the complications, the country lacks proper testing and healthcare facilities and many cases are possibility going undetected. In the rural areas, people are dying and simply being buried without officials being notified!"
Disinfecting a cow with pesticides, local health workers target blood-sucking ticks at the heart of Iraq's worst detected outbreak of a fever that causes people to bleed to death.
The daily sight of the health workers, dressed in full protective kit, is one that has become common in the Iraqi countryside, as the Crimean-Congo haemorrhagic fever spreads, jumping from animals to humans.
Dhi Qar province, a poor farming region in southern Iraq, accounts for nearly half of Iraq's cases.
Dr Haidar Hantouche said that in previous years, cases could be counted "on the fingers of one hand.”
Typically transmitted by ticks, hosts of the virus include both wild and farmed animals such as buffalo, cattle, goats and sheep, all of which are common in Dhi Qar.
"Typically, animals become infected by the bite of infected ticks," according to the World Health Organization. It added, "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.”
Seen in the village of Al-Bujari, a health team disinfects animals in a stable next to a house where a woman was infected. Wearing masks, goggles and overalls, the workers spray a cow and her two calves with pesticides. A worker displays ticks that have fallen from the cow and been gathered into a container.
This year, the surge of cases has shocked officials, since numbers far exceed recorded cases in the 43 years since the virus was first documented in Iraq in 1979.
In Dhi Qar province alone for the month of May 2022, 43 cases of CCHF were reported including eight deaths. However as of press time, at least another 87 cases were being investigated.
Although the numbers are still tiny compared with the COVID-19 pandemic where Iraq has registered over 25,200 deaths and 2.3 million recorded cases, according to WHO figure, local health workers and the WHO are worried.
The World Health Organization’s representative in Iraq, Dr Ahmed Zouiten, said there were several "hypotheses" for the country's outbreak.
These included the spread of ticks in the absence of livestock spraying campaigns during COVID in 2020 and 2021.
He also said, "Very cautiously, we attribute part of this outbreak to global warming, which has lengthened the period of multiplication of ticks.
Iraq has of now mounted a spraying campaign countrywide.
The WHO said, “To date we are seeing in Iraq that the virus is primarily transmitted to people via ticks on livestock, most cases are among farmers, slaughterhouse workers and veterinarians.”
The WHO however warned, "Human-to-human transmission can also occur resulting from close contact with the blood, secretions, organs or other bodily fluids of infected persons.”
Besides uncontrolled bleeding, the virus causes intense fever and vomiting.
Local health authorities fear there may be an explosion of cases following the Muslim festival of Eid al-Adha in July, when families traditionally slaughter an animal to feed guests.
Dr Azhar al-Assadi, a doctor specializing in hematological diseases in a hospital in Nasiriya added, "With the increase in the slaughter of animals, and more contact with meat, there are fears of an increase in cases during Eid."
Interestingly, most of those infected were "around 33 years old", he said, although their age ranges from 12 to 75.
Iraqi health authorities have put in place disinfection campaigns and are cracking down on abattoirs that do not follow hygiene protocols. Several provinces have also banned livestock movement across their borders.
In the nearby Southern city of Najaf, slaughterhouses are being vigorously monitored by the local health authorities.
The CCHF virus has adversely hit meat consumption, according to workers and officials there.
Local butcher Hamid Mohsen told media, "I used to slaughter 15 or 16 animals a day-now it is more like seven or eight."
Director of Najaf Veterinary Hospital, Fares Mansour, which oversees the abattoirs, meanwhile noted that the number of cattle arriving for slaughter had fallen to around half normal levels. "People are afraid of red meat and think it can transmit infection," he said.
For more details about the Crimean-Congo haemorrhagic fever disease, visit the WHO site. https://www.afro.who.int/health-topics/crimean-congo-haemorrhagic-fever
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