Kerala has reported its first case of Crimean-Congo Haemorrhagic Fever (CCHF). A UAE-returned man, who arrived in Kerala last week, presented with the pre-existing conditions of the fever, which is caused by a tick-borne virus. Confirming this, Additional Chief Secretary (Health) Rajeev Sadanandan said the man is currently undergoing treatment at a private medical institution in Thrissur.
Speaking to TNM, Rajeev said, “The man was diagnosed with the disease in the UAE, where he was undergoing treatment. He reached Kerala three days ago to continue the treatment. The fever is managed in the hospital and we have put all precautionary measures in place.”
Crimean-Congo Haemorrhagic Fever is caused by nairovirus, which is transmitted to people either by tick bites or through contact with infected animal blood or tissues during and immediately after slaughter. People working or involved in the livestock industry, such as agricultural workers, slaughterhouse workers and veterinarians, have often presented with the fever. According to the World Health Organisation (WHO), CCHF is endemic in Africa, the Balkans, the Middle East and Asian countries.
Dr KJ Reena, the District Health Officer, Thrissur, told TNM that the 30-year-old man, who is a native of Malappuram, worked at an abattoir in the UAE.
“This disease is the result of an occupational hazard. Along with this man, three others, including a veterinary surgeon, contracted the disease in the UAE,” she said.
Following fever, headache, nausea, vomiting and dizziness, the man went to a nearby hospital in the UAE, on November 15. He was diagnosed with CCHF and was administered the antiviral drug, ribavirin. On completing the course, he was discharged on November 27, although he tested positive for CCHF, said Dr Reena.
“He reached Cochin International Airport on November 29. On his way to Malappuram, he experienced a severe headache and reached the private hospital, where he is currently undergoing treatment. After he informed the hospital authorities that he was diagnosed with the fever, we immediately isolated him the same day and advised all staff members to do barrier nursing,” said the Thrissur DMO, who also convened a Rapid Response Team.
The patient is being administered ribavirin and samples of his blood have been sent to Pune and Manipal. “If tested positive, we will continue to place the patient in isolation until he is completely treated,” says Dr Reena.
Also, 20 other persons, who came into contact with the man, including the cab driver and some hospital authorities, have been enlisted and are being monitored twice a day. “In case they present with any symptoms, we will make arrangement to take their blood samples,” she added.
Dr Reena said that being an arboviral or an arthropod-borne, CCHF is an animal disease, which is transmitted from one animal to another through a tick. And human-to-human transmission can happen due to close contact with the blood, secretions, organs or other bodily fluids of infected persons.
“To eliminate the possibility of any human-to-human infection, we have advised the nursing staff and doctors treating the patient to wear all supportive gear and dispose of the body fluid, such as saliva, blood and urine in the proper manner,” said the DMO.
Some of the symptoms, as stated by WHO, include fever, myalgia (muscle ache), dizziness, neck pain and stiffness, backache, headache, sore eyes, photophobia (sensitivity to light), nausea, vomiting, diarrhoea, abdominal pain and sore throat early on, followed by sharp mood swings and confusion.
On November 29, the Kerala Health and Family Welfare Department issued a notice asking people to take necessary precautions ahead of the Nipah Virus transmission season beginning from December till about June. The Kerala government has warned the public not to eat fruits bitten by bats and to consume fruits and vegetables only after properly washing them.