Update: CCHF Patient In Scotland Dies

 

Global Distribution of CCHF – Credit WHO

 

# 6612

 

News this morning from the UK press that the 38-year old man who flew into Glasgow, Scotland earlier this week from the Middle East infected with CCHF (see Crimean-Congo Hemorrhagic Fever Patient Isolated In Glasgow) has died overnight.

 

This report from the Independent, after which, I’ll have more.

 

Patient with rare fever dies in UK hospital

Lucinda Cameron  - Saturday 06 October 2012

A man being treated for Crimean-Congo haemorrhagic fever after returning to the UK from Afghanistan has died.

 

It is the first laboratory-confirmed case of CCHF in the UK, according to the Health Protection Agency (HPA).

 

Other passengers who sat close to him on an aircraft are undergoing daily health checks.

(Continue . . . )

 

 

Although originally hospitalized at Gartnavel General Hospital's Brownlee Centre, the unidentified patient was transferred yesterday to a high bio-security unit at London's Royal Free Hospital yesterday.

 

The following statement from the HPA was released yesterday, before the patient’s death.

 

Confirmed case of Crimean Congo Haemorrhagic Fever in the UK

5 October 2012

The Health Protection Agency (HPA) is aware of a laboratory confirmed case of Crimean-Congo Haemorrhagic Fever (CCHF) in a UK traveller who has recently returned from Afghanistan. The patient has been transferred from Glasgow, Scotland to the high security infectious diseases unit at the Royal Free hospital in London using specialist air transport.

CCHF is a serious viral disease which infects a range of domestic and wild animals. Humans are usually infected directly from the blood or body fluids of infected animals or via tick bites. The disease is endemic in many countries in Africa, parts of Europe, the Middle East and Asia.

CCHF can be acquired from an infected patient, but this requires direct contact with their blood or body fluids Therefore, there is no risk to the general population. As a precautionary measure, close contacts of the patient including hospital staff involved in the patient’s care have been contacted and will be monitored.

The HPA is providing public health, diagnostic and other support to the teams currently handling this incident.

This is the first laboratory-confirmed case of CCHF in the United Kingdom.

Information about the Crimean-Congo Haemorrhagic Fever is available on the HPA website. 

Information about the geographical distribution of CCHF is available on the HPA website.

Further information about the transmission of CCHF is available on the HPA website.

Information on CCHF is available from the World Health Organization (WHO) website [external link].

Visit the Royal Free Hospital website [external link].

 

While the risk that this virus has been spread to others is considered low, the HPA will monitor close contacts of this patient for the next two weeks looking for any signs of infection.

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WHO On Cholera/CCHF/Dengue Outbreaks In Pakistan

 

 

# 5010

 

 

Two updates today from the World Health Organization on the ongoing outbreaks of several infectious diseases in Pakistan.

 

First, Cholera – which like in Africa and now Haiti, has also been sporadically reported in the flood affected provinces of Sindh, Punjab and Khyber Pakhtunkhwa.

 

Cholera in Pakistan

25 October 2010 -- On 12 October 2010, the Ministry of Health in Pakistan reported laboratory confirmation of 99 cases of Vibrio cholera 01 in the country. These cases were laboratory-confirmed by the National Institute of Health since the beginning of the flood until 30 September 2010. These cases have been reported sporadically from a wide geographical area in the flood-affected provinces of Sindh, Punjab and Khyber Pakhtunkhwa.

 

The Ministry of Health in Pakistan supported by the World Health Organization and other local and international partners are collaborating closely to prevent outbreaks of any disease, including cholera, and treat people affected by such illnesses. More than 60 diarrhoeal treatment centres are either operating or are soon to start functioning in the 46 most affected districts of the country.

 

Diarrhoeal diseases including cholera are among the most reported health conditions in many locations affected by the recent floods disaster in the country.

FOR MORE INFORMATION

WHO cholera Fact sheet
WHO Pakistan web site

 

 

Next, since the end of September we’ve been watching reports of heightened transmission of CCHF – normally a tick-borne illness – being reported in several areas of Pakistan. 

 

As you can see from this WHO map, CCHF is not uncommon in this part of the world.

 

 

While I’ve been tempted to blog on this outbreak for a couple of weeks, quite frankly the reports I’ve seen have been inconsistent and confusing.

 

Over the past month we’ve suggestions of nosocomial transmission among health care workers, denials, retractions, and revisions of numbers as these ProMed Mail dispatches demonstrate.

 

PRO/AH/EDR> Crimean-Congo hem. fever - Pakistan (09): (NW)

PRO/AH/EDR> Crimean-Congo hem. fever - Pakistan (08): (PB), not

PRO/AH/EDR> Crimean-Congo hem. fever - Pakistan (07): revised data, WHO

PRO/AH/EDR> Crimean-Congo hem. fever - Pakistan (06): (PB)

PRO/AH/EDR> Crimean-Congo hem. fever - Pakistan (05): (NW)

PRO/AH/EDR> Crimean-Congo hem. fever - Pakistan (04): (PB)

PRO/AH/EDR> Crimean-Congo hem. fever - Pakistan (03): (PB) nosocomial

 

 

Today, a rather generic update from the WHO that suffers from a lack of detail. 

 

Nothing is said about exactly where these cases occurred, or about the mode of transmission, leaving much uncertainty.

 

Things are, however, still in a state of flux in the wake of the unprecedented flooding disaster last month in that nation, and so some of this ambiguity may be understandable. 

 

 

Crimean-Congo haemorrhagic fever (CCHF) and Dengue in Pakistan

25 October 2010 -- As of 15 October, the IHR National Focal Point, Ministry of Health (MoH), Pakistan, has notified WHO of 26 cases, including 3 deaths, of Crimean-Congo haemorrhagic fever (CCHF). In addition, over 1500 laboratory-confirmed cases of dengue fever including 15 deaths have also been reported from Pakistan so far.

 

Both CCHF and dengue fever are endemic in Pakistan with seasonal rise in cases. However, recently, the transmission of both CCHF and dengue fever has intensified in the country with increased incidence and geographic expansion. The recent Pakistan floods may have contributed to this upsurge as a result of changes in risk factors for these diseases.

Operational response

The MoH has scaled up response activities to prevent and mitigate CCHF and dengue fever, including awareness-raising campaigns on exposure risks and preventive measures for the general public, strengthening clinical and case management of patients with haemorrhagic fevers, stockpiling appropriate drugs and personal protective equipment, and implementing targeted vector control activities.

 

Upon request from the MoH in Pakistan, WHO is mobilizing experts in the clinical management of severe dengue fever and in infection control in health care settings through the Global Outbreak Alert and Response Network (GOARN). WHO is also assisting the country with resource mobilization, strengthening disease surveillance, laboratory diagnostics, and training of health care providers.

FOR MORE INFORMATION

WHO dengue website
WHO CCHF website

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