Congo-Crimea fever

The hemorrhagic fever of the Congo-Crimea is due to a virus of the group of the Nairovirus , group constituting one of the five kinds of the family of the Bunyaviridae . The 32 members of the kind Nairovirus are transmitted without exception via Acarien S (like the ticks argasidae or ixodidae ) but only three of them are with certainty at the origin of human infections: the Dugbe virus, the virus of the disease of the sheep of Nairobi and that of the hemorrhagic fever of the Congo-Crimea, the principal disease-causing agent at the man among the three. Although it acts above all of a Zoonose, sporadic cases and epidemic blazes occur at the man. This disease is endemic in many countries of Africa, of Europe and of Asia and, in 2001, cases or blazes were notified in Kosovo, in Albania, in Iran, in Pakistan and in South Africa.

Discovered virus

The disease was described for the first time in the Crimea in 1944, which explains why it was called hemorrhagic fever of the Crimea. In 1969, it was established that the responsible disease-causing agent was identical to that of 1956 in Congo. The association of the two names gave the hemorrhagic term of fever the Congo-Crimea. The disease is serious and involves a mortality raised at the man. But it seldom occurs, one can suppose that it is more current in the animal.

Epidemics

Cases were reported in the west of the Crimea, the peninsula of Kersch, Kazakhstan and Ouzbékistan, the areas of Rostov and Astrakhan in Russia, like in Bosnia-Herzégovine, in Albania, in Bulgaria, in Iraq, in the Arab Peninsula, in Pakistan, in the west of China, in tropical Africa and South Africa.

Tank

Hares, birds, ticks, rodents, pets

Vector

Ticks

The virus

It has an extended geographical distribution, following the example vector, the tick. One established his presence in Africa, in Asia, in the Middle East and in Eastern Europe. The agents of health in the zones of endémie must be conscious of this disease and know correct measurements of fight to protect itself, like their patients, of the nosocomial risk (transmission in hospital medium).

Transmission of the virus

The puncture of an infectious adult tick or the exposure to blood or secretions contaminated already caused pushes nosocomiales, the demolition of infected animals also supports the transmission of the virus. The cases occurred in majority at those which work in contact with the animals, like the farmers, the employees of the slaughter-houses or the veterinary surgeons.

Incubation

The duration of Incubation varies according to the mode of contamination. After a puncture of tick, it is in general of one to three days, being able to go up to nine days to the maximum. After contact with contaminated blood or fabrics, it is in general from five to six days, but can be prolonged until thirteen days a documented maximum.

Clinical signs

the appearance of the symptoms is brutal: fever, myalgias (muscular pains), giddinesses, stiffness and pains of the nape of the neck, back painses, significant cephalgias, eyes and photophobia. One observes sometimes at the beginning of nauseas, the vomiting and an evil of throat, being possibly accompanied by Diarrhée S and abdominal pains. In the days which follow, the patient can have brutal confusion and sudden changes of mood sometimes and aggressiveness. After two to four days, somnolence, the depression and lassitude replace agitation and the abdominal pains come to locate in the quadrant higher right, with a hepatomegaly with palpation (increase in the volume of the liver).

Of other clinical signs appears: Tachycardia (acceleration of the cardiac rhythm), adenopathies (tumefaction of the ganglia), eruption pétéchiale (eruption caused by hemorrhages in the skin) at the same time on the mucous membranes, as in the mouth or the throat, and on the skin. The pétéchies can lead to the formation of bruises (when they cover more a large surface) and other hemorrhagic phenomena, like the méléna (hemorrhage of the small intestine involving the emission of black blood in the saddles), the hématurie (blood in the urines), of the épistaxis (nosebleed) and of the bleedings of gums. The subjects most seriously reached can develop a hepatic, renal and pulmonary insufficiency as from the fifth day of disease.

death rate is established around the 30%, death occurring during the second week of disease. For those which are restored, the general state starts to improve as from the nine or tenth day after the appearance of the symptoms.

Summary of the symptoms

Fever, Myalgia S, giddinesses, stiffness and pains of the nape of the neck, back painses, significant cephalgias, eyes and photophobia. In certain case, vomiting as well as evils of throat, being able to be accompanied by diarrheas and abdominal pains.

Treatment

An intensive follow-up is obligatory for the replacement of volume and the blood components. One used ribavirin (antiviral), with apparently of good effects, on the established cases. It seems that the oral and intravenous presentations are as effective one as the other. The utility of the therapeutic method of plasmas immunes taken on cured patients was not proven well that it was used on several occasions.

See Too

External bonds

Official site of WHO

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