The Senegalese Ministry of Health and Social Welfare reported two imported cases of Crimean-Congo hemorrhagic fever (CCHF) last week, prompting a outbreak declaration.
A summary of the situation is as follows: The index case was a 16 year old female patient from Nouakchott in Mauritania, developed intense pain in the left ear and diffuse headache on Apr. 16. She presented to Nouakchott Friendship hospital in Mauritania from where a tick was extracted from the left ear.
Several days later she developed fever, followed by multiple bleeding tendencies and was admitted at the Nouakchott Friendship hospital.
A week later she was aerovaced to Dakar for treatment.
The second case was the mother to the first case. The 48 year old mother developed fever, headache, muscle and joint pains, weakness, vomiting and insomnia on Apr. 19 (from Mauritania).
Fifteen close contacts have been listed (including the four relatives, two patients who shared the same room, two intern doctors, four nurses and three students) and are being followed up. Epidemiological investigation established the presence of sheep with many ticks in the family environment. The national authorities in Mauritania have been notified and are conducting detailed investigations.
Both cases tested positive for Crimean-Congo hemorrhagic fever virus.
According to the WHO, Crimean-Congo hemorrhagic fever is a widespread disease caused by a tick-borne virus (Nairovirus) of the Bunyaviridae family. The CCHF virus causes severe viral hemorrhagic fever outbreaks, with a case fatality rate of 10–40%.
CCHF is endemic in Africa, the Balkans, the Middle East and Asian countries south of the 50th parallel north – the geographical limit of the principal tick vector. The hosts of the CCHF virus include a wide range of wild and domestic animals such as cattle, sheep and goats.
Animals become infected by the bite of infected ticks and the virus remains in their bloodstream for about one week after infection, allowing the tick-animal-tick cycle to continue when another tick bites. Although a number of tick genera are capable of becoming infected with CCHF virus, ticks of the genus Hyalomma are the principal vector.
The CCHF virus is transmitted to people either by tick bites or through contact with infected animal blood or 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. Human-to-human transmission is possible.
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