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Wednesday, August 26, 2015

Swine Flu, Congo Hemorrhagic fever in Gujarat - Promed report

Published Date: 2015-08-24 17:21:41
Subject: PRO/AH/EDR> Crimean-Congo hem. fever - India (06): (GJ) 
Archive Number: 20150824.3598944
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases

Date: Sat 22 Aug 2015
Source: The Times of India [edited]

A Kutch woman succumbed to Congo fever in Rajkot, while another woman from Dwarka died of swine flu in Jamnagar on Friday.

A 50-year-old woman from Bharudiya village of Bhachau taluka of Kutch succumbed to Crimean Congo hemorrhagic fever (CCHF), commonly known as Congo fever on Friday morning [21 Aug 2015] in a private hospital in Rajkot. According to Dr Pankajkumar Pandey, chief district health officer (CDHO), Kutch, the woman was tested positive for Congo [Crimean-Congo Hemorrhagic] fever [during July 2015] and was brought to hospital in Rajkot where she died on Friday [21 Aug 2015].

[Also during July 2015], a 55-year-old woman from Rampara Vekra village in Mandvi taluka of Kutch district died of Congo fever. "We have deployed medical teams in the village to determine whether other people are having symptoms of Congo fever. A team of veterinary officials are also camping [temporarily living] in the village as well," said a health official from Kutch district.

Meanwhile, a 55-year-old woman from Dwarka succumbed to H1N1 virus -- commonly known as swine flu -- in the civil hospital of Jamnagar [Thu night 20 Aug 2015].

Communicated by:
ProMED-mail from HealthMap Alerts

[This is the 2nd report of CCHF cases from the Kutch district in 2015. There was 1 previous suspected case and 2 confirmed cases, also from the Kutch district of Gujarat state reported on 18 Feb 2015, 29 Mar 2015, and 16 July 2015. CCHF virus is endemic in Gujarat state, and human cases have occurred there as recently as last year (2014). The way in which this and previously reported CCHF virus infections were acquired is not stated. Perhaps the veterinary and public health teams investigating the situation in the village will be able to determine the source of infection. As noted in ProMED-mail archive no. 20150128.3124546, 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 CDC states, "Crimean-Congo hemorrhagic fever (CCHF) is caused by infection with a tick-borne virus (_Nairovirus_) in the family _Bunyaviridae_. The disease was initially characterized in the Crimea in 1944 and given the name Crimean hemorrhagic fever. It was then later recognized in 1969 as the cause of illness in the Congo, thus resulting in the current name of the disease.

The virus is sensitive in vitro to the antiviral drug ribavirin. It has been used in the treatment of CCHF patients, reportedly with some benefit (http://www.cdc.gov/vhf/crimean-congo/). However, since the patient died so soon after admission, effective use of the drug in the treatment of the case above would not have been possible.

A map of the states and territories of India showing the location of Gujarat in the northwest can be accessed at http://www.mapsofindia.com/maps/india/india-political-map.htm, and a HealthMap/ProMED-mail map at http://healthmap.org/promed/p/302. - Mod.TY]

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