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Outbreak of Crimean Congo Hemorrhagic Fever (CCHF) (01 Jan to 08 Jul 2023)
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During week 27-2023, a total of 54 new cases of CCHF (30 cases were confirmed positive by PCR) and 9 new deaths were reported (Table 1). This brings the total number of CCHF cases to 494 from 32 provinces since the beginning of 2023 (Figure 2).
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3 additional CCHF associated deaths were added to cumulative deaths which were reported sporadically from 2 provinces. This brings the total number of CCHF associated deaths to 47 (CFR=9.5%) from the beginning of 2023.
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The CCHF associated deaths were reported from 16 prov-inces (Kabul (19), Balkh (6), Takhar (5), Parwan (3), Jawzjan (2), Kandahar (2), and 1 from each of the following provinces: Badakhshan, Baghlan, Faryab, Ghazni, Kapisa, Khost, Kunduz, Paktya, Sar-e-pul and Wardak provinces).
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Out of total cases (494), 493 (99.8%) were above 5 years of age and 141 (28.5%) were females.
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Main case load over the past 2 months is from South (Kandahar and Helmand), North (Balkh) and Central (Kabul) regions.
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Since the beginning of 2023, a total of 156 samples of suspected CCHF cases were tested in CPHL, of which 63 sam-ples were positive (40.4% positivity). In addition, 270 samples were tested in Kabul infectious disease hospital (IDH) and 5 Regional Reference Labs (RRLs), of which 83 were positive (30.7% positivity rate). Cumulatively, a total of 426 samples were tested from suspected CCHF cases in different laboratories, out of which 146 were positive (positivity rate 34.3%).
Response to CCHF outbreak
Coordination and leadership
- National zoonosis committee meeting has been held and chaired by CDC-MoPH where relevant departments from the Ministry of Agriculture, Kabul Municipality, Ministry of Information and Technology, national and international partners attended the meeting; coordinating the prepar-edness and response to zoonotic diseases outbreak (including CCHF); public awareness and case management of infected cases were discussed and decided among the committee members.
Surveillance
- Surveillance support teams (SSTs) are actively participat-ing in outbreak investigation and response activities in 34 provinces.
Laboratory and supplies
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A total of 13 CCHF PCR kits have been distributed to IDH, Nangarhar, Herat, Balkh, and Kandahar RRLs since the be-ginning of 2023.
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On-the-job training has been conducted to Nangarhar, He-rat and Balkh RRLs’ staff; and the capacities have been built to utilize the PCR and ELISA technologies for labora-tory confirmation of CCHF.
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Lab training has been conducted for 6 days on PCR and ELISA for 6 Regional NDSR lab focal points at CPHL.
Case management
- Case management guideline for CCHF has been revised and being reviewed by the MoPH for their endorsement; a one-day workshop was also held with participation of rep-resentatives from specialty hospitals and guideline proto-col department of MoPH to present and finalize the guide-line.