Crimean-‐Congo haemorrhagic fever: An outbreak in India

Crimean--Congo hemorrhagic fever (CCHF) is a zoonotic viral disease that is asymptomatic in infected animals, but a serious threat to the health of humans.Human infections begin with non--specific febrile symptoms, but progresses to a serious haemorrhagic syndrome with a high case fatality rate. 1,2CCHF is caused by the CCHF virus (CCHFV), a member of the genus Nairovirus in the family Bunyaviridae.The virus is stable for up to 10 days in blood kept at 40°C.Although the causative virus is often transmitted by ticks, animal--to--human and human--to--human transmission also occurs.CCHF affects mostly adults (no case has been reported in children under 15 in South Africa since 1993) 3 and is endemic in many countries in Africa, Europe and Asia.During 2001, cases or outbreaks were recorded in Iran, Pakistan, South Africa with the latest being in India. 4It has also been found in parts of Europe including southern portions of the former USSR (Crimea, Astrakhan, Rostov, Uzbekistan, Kazakhstan, and Tajikistan), Turkey, Bulgaria, Greece, Albania and Kosovo (a province of the former Yugoslavia). 5--10Limited serological evidence suggests that CCHFV might also occur in parts of Hungary, France and Portugal.The most recent CCHF outbreak occurred in January 2011 in the state of Ahmedabad (India).In this outbreak this rare deadly virus killed three people.The three victims included an adult female, a nurse, and the doctor who treated the adult female at a private hospital in Ahmedabad (India). 11The patients died due to multiple organ failure, specifically failure of the liver and kidney.The National Institute of Virology (NIV), (Pune, India) confirmed that all three patients were infected with the CCHF virus.11 The NIV is testing some 50 samples from the area, and the Gujarat government, warning of a possible outbreak, has begun a screening exercise covering approximately 16,000 villagers.No CCHF case has ever been reported in India before.