Daily Times

Recently, Crimean-Congo hemorrhagic fever (CCHF) broke out in various parts of Pakistan causing severe apprehension among the public and the government. The death toll has gone up to 19 in the whole country with 12 in Quetta, 5 in Karachi and 2 in Bahawalpur. To add to the fright, Eid-ul-Adha being near, the situation has become more intimidating as the ticks that act as vector for the transmission of the disease causing agent to humans, reside in fur of domestic/livestock animals including those which are reared for the fulfilment of the Islamic religious ritual of qurbaani.

In order to understand the disease it is necessary to elucidate various aspects of the agent that is its cause. The disease is caused by a virus which belongs to the genus Nairovirus. Viruses belonging to this genus are generally tick-borne. The virus size ranges from 80-120 nm and has RNA as its code for proteins which act as the cause for disease. Generally, viruses require a living host in order to complete their lifecycle, and outside living organisms they exist as non-living crystals, in case of Congo virus, hard ticks (Ixodid) not only act as vector but also as a highly mobile reservoir of the virus, thus being the primary source of CCHF. The virus can enter the human body through three routes; either through direct bites of the ticks carrying the virus, by exposure to the blood or tissue of an animal earlier infected by the virus or by a human who is already infected. Slaughtering an infected animal or carrying a veterinary procedure can both be major causes of contracting the virus through animals. The ticks feeding on the domestic animals can transmit and amplify the reservoir of the virus, increasing the chances of the virus to enter the host in which they cause disease.

It is quite of a surprise that despite being one of the most feared disease causing viruses, the fatality rate of people contracting Congo virus ranges from 30-40% with a few recovering from the disease if given proper medical attention timely. As soon as a person contracts the virus, a primary symptom in the form of flu appears shortly. Within 3-5 days the symptoms of hemorrhagic fever start to develop which include swollen liver, vomiting, nose-bleeding, black stools and sometimes acute kidney failure or acute respiratory distress syndrome.

The quest for the biomedical scientists is how to find a perfect cure for the disease? There are some preventive measures which can be taken including de-ticking the animals before and after transportation from one place to the other and to ensure the environment where the animals are kept is clean. For humans it is advised to use insect-repellent lotions, and for those working with farm animals it is advised to wear clothing or, if possible, equipment to protect themselves. It is also crucial to maintain good hygiene especially after engaging with animals. To avoid human to human transfer it is necessary to physically isolate a person diagnosed positive for the virus. An anti-viral drug by the name of Ribavirin is used to cure CCHF which is also commonly used for a number of viral diseases as it avoids the synthesis of viral RNA, or its processing.

Unfortunately there had not been a major success in developing a vaccine for this virus although it is the top preference in case of viral disease management. The reason is that either the vaccines made are too toxic to cause the disease themselves or entail too low efficacy. Since 1970s, a lot of work had been conducted on developing vaccines for Congo virus. There has been a success recently in 2011 when a Turkish research group passed the clinical trials of the vaccine they developed, but they still await the approval of FDA in order to market it. Thus, there still is no available approved vaccine that could be used in this case. A couple of days ago, a senior politician advised the government and health officials to involve the use of vaccines for the management of Congo virus outbreaks in Pakistan. Him being entirely naive when it comes to medical science, though he is a political genius, is not the one to blame on this occurrence. Actually, there exists a strange trend of people commenting on things they lack the merest idea of. In fact, he cannot be blamed for the several catastrophes Pakistan faced during the five years PPP enjoyed its government because he wasn’t the one taking decisions, rather upon handing his authorities to the parliament, it is the parliament to blame, shedding burden off many shoulders.