Attachments
Introduction
1.1. Worldwide distribution and burden due to CCHF
CCHF (Crimean- Congo Haemorrhagic Fever) is a zoonotic disease that continues to be a serious public health problem in many countries. Worldwide distribution of CCHF stretches over much of Asia, extending from the XinJiang region of China to the Middle East and southern Russia, and to focal areas over much of Africa and parts of south-eastern Europe. Therefore, CCHF virus is the most widely distributed agent of severe haemorrhagic fevers known 1so far. Cases have been reported in Ukraine, Bulgaria, Albania, Serbia & Montenegro (Kosovo), Turkey, Macedonia, Russian Federation, China, Kazakhstan, Tajikistan, Pakistan, Afghanistan, Iraq, Iran, the United Arab Emirates (UAE), Saudi Arabia and Oman 2etc. Although there are no established data on CCHF outbreaks and number of cases; the following graph (1) has been developed from the figures given in “Historical cases and outbreaks of CCHF” from HPA (UK) website
Like other tick borne zoonotic agents, CCHF virus circulates in nature in an enzootic tick-vertebrate-tick cycle . This mostly infects mainly cattle, sheep and goats (reservoirs) and Humans (hosts) are being infected mainly through direct contact with blood or tissues from infected livestock or through tick bites. There for the pastoral communities are under high risk. Although the cases reported in a sporadic pattern; the case fatality rates (CFR) in hospitalized patients have ranged from 9% to as high as 50% 4 . CCHF outbreaks constitute a threat to public health services due to its epidemic potential, high CFR and potential for nosocomial outbreaks and the adversities of treatment and prevention. This might over burden the health sector of the country and bring a remarkable economical hindrance as well.