Sunday, January 23, 2011

Research for Congo virus antidote on: Health expert

Further research needs to be done to come up with an antidote to the Crimean-Congo Haemorrhagic Fever (CCHF) that has claimed at least three lives in Gujarat, a senior health official has said.

'We have suggested some strong anti-viral drugs to counter the symptoms, but more research will have to be done on the blood samples collected to come up with an absolute solution,' Doctor A.C. Mishra, director of National Institute of Virology (NIV), said.

'We have also suggested isolation of patients and usage of masks for doctors and other medical staff treating the patients as well as for the relatives of patients. This is a must as the virus is highly infectious,' Mishra told IANS over phone from Pune.

'The virus that has so far killed three people in Gujarat is a category 4 virus, the most dangerous of all,' Mishra added.

Three people died in Gujarat's Sanand early January in the country's first reported attack of the Congo virus.

The three deaths are of Amina Momin, Gagan Senke, the doctor who treated her at a hospital in Ahmedabad, and a nurse in attendance.

Since then, three more patients, who include Amina's husband Rehman and a male nurse, are undergoing treatment in the isolation ward, besides another female patient, said Dr M.M. Prabhakar, superintendent of Ahmedabad's Civil Hospital.

BJ Medical College in Ahmedabad has been designated as the dedicated hospital for isolation and treatment of suspected cases. Its dean Dr Bharat Shah, when contacted, refused comment.

The Pune-based NIV is testing 132 samples received from Gujarat, of which 58 samples were found negative, reports said.

The Gujarat government is screening the Sanand area where the infection was first reported.

In its initial report, the NIV has said the Congo Virus has the potential of killing 20 to 90 percent people. The virus causes multi-organ failure and affects the brain, triggering epileptic convulsions and death.

Dr V.M. Katoch, director general of Indian Council for Medical Research (ICMR), said: 'Antibodies in animals have been seen, which show that the virus is present in the country.'

The Crimean-Congo Haemorrhagic Fever (CCHF) first came to light in 1944, when it infected over 200 Soviet military personnel who were assisting peasants in war-devastated Crimea in Ukraine.

Since then the infection has been surfacing in Africa, Europe and Asia, with outbreaks being recorded in Kosovo, Albania, Iran, Pakistan, South Africa and now for the first time in India.

CCHF is a a tick-borne viral disease. Ticks are blood-sucking parasites often found in tall grass where they wait to attach to a passing host, an animal. Although CCHF causes a mild fever in the animal briefly, the effect is severe in humans.

Examples of similar infections include rabies that infect humans through a dog or monkey bite. Anthrax infects ruminants (grass eaters) namely goats, cattle, sheep and horses and can be transmitted to humans by contact with infected specimens or their products.

According to Dr Nata Menabde, World Health Organisation's representative in India, the presence of CCHF in the country is not unexpected because cases have been reported in neighbouring Pakistan.

The Financial Daily of Pakistan has reported that the first CCHF suspected case in the country surfaced Sep 14, 2010.

Since then, 5,000 more such patients have been hospitalised, of whom 3,000 were tested positive by the NIH (National Institute of Health) in Pakistan, the report said.

Initial human symptoms of CCHF include fever, aching muscles, dizziness, stiffness, backache, headache, sore eyes and sensitivity to light. They may be followed by nausea, vomiting and sore throat, later diarrhoea and abdominal pain, according to health experts.

Over the next few days, the patient experiences mood swings, becoming confused and aggressive. Gradually, sleepiness, depression and langour may replace restlessness with localised abdominal pain and an enlarged liver. The liver, kidney and lung may fail after the fifth day of illness.

Outbreaks are usually attributable to humans handling infected animals and people. Clusters of illness typically appear after people treat, butcher or eat infected livestock, particularly ruminants and ostriches.

As a precautionary measure, US Army personnel maintain special stocks of ribavirin to protect themselves from the infection in Afghanistan and Iraq.

Significantly, CCHF is also listed as a 'potential bioterrorism agent,' classified as a Category C Disease/Agents by the National Institute of Allergy and Infectious Diseases (NIAID) in the US, according to globalsecurity.org.

'These emerging pathogens could be engineered for mass dissemination in the future because of availability, ease of production, dissemination and potential for high mortality rates and major health impact,' the website said.

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