JOHANNESBURG, 7 October 2008 (IRIN): At least three people have been confirmed dead in Johannesburg, South Africa, in an outbreak of what officials believe to be contagious hemorrhagic fever.
Almost one month ago, Zambian tourism operator Cecilia van Deventer was airlifted to a private hospital in Johannesburg, where she died of what health officials say is likely to be Crimean-Congo fever.
Since then, the unconfirmed illness has claimed at least two more lives, that of a paramedic who accompanied van Deventer from Zambia, and a nurse who attended to her during her stay at the hospital. Health officials are on high alert.
Crimean-Congo hemorrhagic fever was first reported in South Africa in 1981, and since then the country has usually experienced up to 10 cases annually, not all of which resulted in death, according to Dr Lucille Blumberg of South Africa’s National Institute for Communicable Diseases (NICD).
More on Congo Fever
Crimean-Congo hemorrhagic fever, or Congo fever, was first discovered in 1944 in Crimea, a peninsula in the Black Sea on the southern coast of Ukraine, and recognised in 1969 as the same virus causing an outbreak of illness in the Democratic Republic of Congo.
Transmission to humans occurs through tick bites or contact with infected animal blood, putting those in slaughter houses or the agricultural industry at greater risk.
Health workers in areas where the disease is endemic can also be at risk, as human-to-human transmission has been known to occur in health care settings due to improper sterilisation of medical equipment.
Fatality rates in hospitalised patients have ranged from 9 percent to as high as 50 percent.
Symptoms include:
• headache
• uncontrolled bleeding
• high fever
• joint pain
• stomach pain
Source: Centres for Disease Control and Prevention (CDC)
Confirmation as to whether Congo fever is the cause of the recent deaths is expected late next week when the NICD delivers the findings of laboratory tests, according to Gauteng provincial health department spokesperson, Zanele Mngadi.
– It may be something else, although there are not a lot of diseases that present like this – transmission in a health care setting, high mortality and a clinical picture that would contain some bleeding, Blumberg said.
Uncontrolled bleeding from the mouth, nose or genitals is among the symptoms of Congo fever. It has a mortality rate of 30 per cent, with death usually occurring in the second week of illness, according to the World Health Organisation.
Hospital spokesperson Melinda Pelser said the recent death of a cleaner was unrelated to the virus, but the provincial health department has not ruled out the possibility of hemorrhagic fever.
Congo-Crimea, like Ebola, is a viral hemorrhagic fever that resides in an animal host, but is less virulent than its headline-grabbing relation. Treatment is primarily supportive, and recovery is slow.
