Emergency Report: Crimean-Congo Hemorrhagic Fever in Mauritania

March 18, 2003

Translation of information received on 10 March 2003 from Dr Mokhtar Fall, deputy director, Department of Animal Production and Agriculture, Ministry of Rural Development and Environment, Nouakchott: report date: 10 March 2003.

One outbreak in Nouakchott, first infection estimated to have occurred on 6 Feb 2003. Animal health incident first detected 18 Feb 2003. Laboratory diagnosed.

To date the epidemic mostly affects human beings (30 people have been diagnosed with the disease, 6 of whom have died, and 235 people are considered at risk). With respect to animals, the whole animal population of Nouakchott is under suspicion, but only one animal case has been confirmed (presence of IgG in serum from one goat).

Diagnosis made at the Pasteur Institute, Dakar, Senegal, using serology (Crimean-Congo haemorrhagic fever, IgG, IgM); reverse transcriptase polymerase chain reaction (RT-PCR); virus isolation.

Epidemiology: Source of agent / origin of infection: unknown. Mode of spread: ticks. Most of the 30 persons affected were infected following contact with sick people (secretions, etc.). Other epidemiological details: contact with domestic animals was suspected as the source of infection for the first human victim. Samples (whole blood, ticks) from the animals reared on the victim's plot were submitted for testing. Results showed evidence of IgG in one goat. Other samples (whole blood, ticks) have been taken from the wilaya of Brakna (250-300 km to the southwest of Nouakchott) -- the area from which the animals were introduced onto the plot before the Aid-El-Kebir feast (mutton festival) are thought to have come -- as well as from Nouakchott's abattoir and cattle market.

Control measures: Public health measures: disinfection, confinement, etc. Animal health measures: - supervision of slaughter; - control of ticks; - protection of populations at high risk of exposure (farmers, abattoir workers, etc.); - epidemiological surveillance.

-- ProMED-mail <promed@promedmail.org>

[Crimean-Congo haemorrhagic fever (CCHF) is a viral haemorrhagic fever, the agent of which belongs to the Nairovirus group. It is a zoonotic disease but does not appear on either the OIE List A or B groups of diseases. CCHF is severe but uncommon in humans with a 30 per cent case fatality rate. In animals, CCHF is a more common but milder disease unless tick exposure occurs late in life. Agricultural, slaughterhouse and livestock workers are at increased risk of the disease. Reservoirs include rodents, hares, birds and domestic animals. Domestic animal hosts, commonly ruminants, suffer only a transient viremia. Birds are resistant but Ostriches can show a high prevalence of infection. Most infections in humans are due to exposure to ticks of the _Hyalomma spp._ but the disease can be transmitted by contact with infected animal blood or tissues. The reservior for CCHF is widely distributed ranging from Asia, Eastern Europe, the Middle East and Africa. - Mod.PC]

http://www.oie.int/eng/info/hebdo/AIS_28.HTM#Sec2