Disease outbreaks at Afghan border

Refugees on the border between Afghanistan and Pakistan are becoming victims of a highly contagious disease that causes patients to bleed to death.The outbreak of Crimean-Congo Haemorrhagic Fever (CCHF) is centred around the Pakistani city of Quetta. At least 75 people have become infected so far and eight have died. CCHF is a viral fever caused by the Nairovirus group. The virus is carried by domestic animals. The length of the incubation period for this illness depends on the mode of infection of the virus. Following infection via tick bite, the incubation period is usually one to three days, with a maximum of nine days. The incubation period following contact with infected blood or tissues is usually five to six days. The onset of symptoms is sudden, with fever, dizziness, neck pain, backache, headache, sore eyes and photophobia (sensitivity to light). There may be nausea, vomiting and sore throat, which may be accompanied by diarrhoea and abdominal pain. The virus damages the arteries, veins and other blood vessels and causes the collapse of major organs. The mortality rate from CCHF is approximately 30%, with death occurring in the second week of illness. In those patients who recover, improvement generally begins on the ninth or tenth day after onset of illness.These patients have been isolated at the refugee camps, but the evidence suggesting the disease originated from within Afghanistan has raised fears of an epidemic as millions of refugees flock to the Pakistani border. If these refugees come in large numbers with large numbers of animals, more cases of this disease are expected to be reported. Healthcare workers in endemic areas should be aware of the illness and the correct infection control procedures to protect themselves and their patients from the risk of the infection.