Under pressure because of the Hemorrhagic Fever - Iraq

Outbreak-at-a-glance 

212 instances of Crimean-Congo Hemorrhagic Fever were recorded by Iraqi health officials between January 1 and May 22 of this year (CCHF). Thirteen lab-confirmed deaths and 14 suspected deaths were reported. In the first five months of the year 2021, 33 cases had been confirmed in the lab as having occurred. Several Iraqi provinces have reported incidents that could put a strain on the health care system.

Describe the epidemic

Between 1 January and 22 May 2022, Iraqi health officials recorded 212 instances of CCHF, with 169 (or 80 percent) occurring in April and May. A total of 115 cases that had been suspected were found to be true. There were 27 deaths, 13 of which were confirmed by the laboratory.

At Iraq's Central Public Health Laboratory, PCR verified cases (PCR).

Farmers and slaughterhouse workers were the most likely suspects. Males accounted for 62% of confirmed cases, while those aged 15-44 comprised 54% of the total.

Iraq's Thiqar governorate is home to nearly half of the confirmed cases (n=47; 48 percent). In addition to these, reports came in from the following 12 governorates: Missan (13), Muthanna (7), Wastit (6), Dwania (4), Karkh (4), Kirkuk (3), Basrah (3), Najaf (3), Nineveh (3), Bagdad-Rusafa (2), Babylon (1), and Karbala (unreported) (1). 1.

n=97 cases of Crimean-Congo Hemorrhagic Fever in Iraq between January 1 and May 22, 2022.

Epidemiology

Infected blood or tissue can spread CCHF to humans through tick bites. Every continent except Antarctica and Antarctica has CCHF as an endemic disease.

Iraq has the CCHF. In 1979, ten Iraqis were diagnosed with CCHF. More than a dozen occurrences have been documented between 1989 and 2009, with six occurring during that period, 11 in 2010, three fatal cases in 2018, and 33 (CFR 39 percent) in 2021.

Sheep and cattle are widely farmed in Iraq. Hylomma ticks, the primary CCHF vector, frequently infect these animals.

Human CCHF has been endorsed by the FDA. CCHF is treated with ribavirin, which can be given orally or intravenously. Ribavirin has not been proven to treat CCHF in clinical trials. There is no immunization for either animals or humans.

Governmental response to the outbreak:

Thiqar is home to epidemiological investigators. There were teams from the Ministry of Health, as well as IFETP fellows (MoH). Cases' residences were visited by the epidemiology team, and contacts were traced. Ticks from outbreak locations were collected and categorized.

The veterinary clinic cared for pets while the Department of Health and Human Services' vector control team sprayed acaricides inside and outside buildings.

IEC paperwork was printed by the Ministry of Health and Agencies. Case contacts and the surrounding community received the products, which were primarily sent to butchers and farmers.

The World Health Organization and the Ministry of Health produce diagnostics and sequence genomes. Regular teleconferences between WHO and Iraqi health professionals are held to analyze epidemics.

WHO threat

More than half of Thiqar governorate's population lives in rural areas, while the other half lives in urban areas. All members of the family are involved in caring for livestock in rural communities with neighboring barns. CCHF can be transmitted by domestic animals in specific circumstances.

More camels, cows, and sheep will be slaughtered in celebration of Eid al-Adha in July, which will help spread CCHF throughout Iraq. The movement of people and animals across borders makes it possible for diseases to spread internationally. There was an increase in 2022 instances of CCHF during Ramadan.

The World Health Organization (WHO) recommends that member governments maintain CCHF surveillance, diagnostic competence, and outbreak response.

I enforcing relevant prevention measures during slaughtering, butchering, and culling; (ii) quarantining animals before they enter slaughterhouses or routinely treating animals with pesticides two weeks before slaughtering them; and (iv) ensuring health care workers implement infection prevention control measures when caring for CCHF cases or ocular tick bites. CCHF is transmitted by ticks to humans, animals, and humans.

A ban on travel to Iraq is not recommended by the World Health Organization (WHO).