Since the dawn of humanity, man has always toiled to combat the horrors of disease, with the view of maintaining human society as physically healthy and economically vibrant. In the present age, outbreaks of viral hemorrhagic fevers in different parts of the globe have pummelled humanity with maledictions of pessimism despite using huge resources for its control. Crimean Congo Hemorrhagic Fever Virus (CCHFV) is considered a euphemism for holocaust and inferno in the affected area of East and West Africa.
Physician Ghislaine Courtois spearheaded research to find out about this virus in the Belgian Congo in 1956. CCHFV is genetically the most diverse of the arboviruses. So far, seven genotypes of CCHFV have been ferreted out throughout the world inter-alia Senegal, the Democratic Republic of Congo and South Africa, Southern and Western Africa, Albania, Bulgaria, Kosovo, Russia and Turkey, Greece, The Middle East, Iran and Pakistan, China, Kazakhstan, Tajikistan and Uzbekistan.
The ticks of genus Hyalomma are the principal vectors of CCHFV. They are transmitted to the human body by other ticks and domestic animals. Human to human transmission occurs from close contact with blood, secretions, organs and the bodily fluids of infected people. Fever, myalgia, dizziness, headache, nausea, vomiting, abdominal pain, neck pain and stiffness are the initial symptoms of this debilitating disease, which are followed by mood instability, mental confusion, epistaxis, petechia, ecchymoses, rainbow urine and detectable hepatomegaly. Laboratory tests for timely detection of infection include Enzyme-Linked Immunosorbent Assay (ELISA), antigen detection, serum neutralisation, RT-PCR assay and virus isolation by cell culture.
The deathly scenes produced by this awful virus can be seen throughout the globe. In Pakistan, many cases of this viral fever have already occurred i.e. 16 in Karachi, three in Zhob, two in Quetta and eight in Peshawar in 2014 alone. Some cases were also registered in Kazakhstan in June 2014. Currently, there is no licensed vaccine to beat the danger in the affected regions, despite the fact that sufficient breakthrough has been made by the Refik Saydam Health Institute (Turkey) by developing a treatment serum that is 90 percent effective for infected patients. Hence, uniform efforts are required by the comity of nations around the world to invent and certify a standard preventive vaccine in this regard.
Elimination of this virus demands both long-term and short-term plans. An equitable system of health management like that of isolation wards and separate intensive care units for vector borne diseases is necessitated in the tertiary level hospitals. Minimising the risk and scale of infection, a special stock of Ribavirin must be maintained in primary healthcare centres besides procuring medicines to the armed forces deployed in the endemic regions.
Achieving the target of better comprehension, documentation cells are needed to be established in healthcare centers. Various research institutes and pharmaceutical companies should sponsor and patronise the quicker invention of a safe vaccine. Research is to be initiated to develop a therapeutic tool that can interfere with the CCHFV Receptor Binding Domain (RBD) and its binding partner. Interference with the binding of envelope glycoproteins of CCHFV to the nucleolin receptor would be a therapeutic breakthrough. Practical invention or discovery of a nucleolin blocker would also minimise the invasion of this virus inside the body cells.
Evidently, a vibrant institutional arrangement for producing the luminaries of vector borne diseases must be evolved for catapulting the health management system to new heights. In order to remove the fears of constant damnation, the ineffable provisos of better healthcare should be implemented in full swing so that the tomorrow of today is free of such horrid occurences. Tracking down future imminent threats of the spread of this disease, it is also added that the government and people of Pakistan urgently need to develop a robust system with steady nerves to beat the danger of imbalance between population and resources, and environmental pollution with special focus on safeguarding drinking water and taking measures for an equitable drainage system. Apparently intractable, it is claimed that several easy mechanisms will ensure the needful infrastructure on a low cost basis.
The writer is the medical graduate of Xi’An Jiaotong UniversityChina and is based in Abbottabad