Afghanistan: Elevated levels of Crimean-Congo hemorrhagic fever were reported nationwide through July

Event

Afghan health officials report elevated Crimean-Congo hemorrhagic fever (CCHF) activity, with 119 cases reported between Jan. 1-July 9. This caseload is compared to roughly 40 cases reported over a similar period in 2021. Disease activity is reported from 22 provinces, with Herat reporting the highest number of cases followed by Kabul, Balkh, and Nangarhar. As of July 9, eight deaths are associated with the outbreak. This report is the most complete information available as of July 20.

Context

Crimean-Congo hemorrhagic fever (CCHF) is considered a nationwide threat in Afghanistan, and disease activity is typically highest between April and September.

CCHF is caused by a virus that commonly infects wild and domestic animals (cattle, sheep, and goats), but may also infect humans. The disease is transmitted through the bite of a tick, or through contaminated tissue or blood from infected humans or animals. Once a human is infected, the disease can spread among people through close personal contact. CCHF can also infect healthcare workers who fail to diagnose the disease and institute proper precautions. CCHF fatality rates for patients requiring hospitalization can range from 9-50 percent. Early treatment with the antiviral agent ribavirin can reduce fatality rates.

Advice

After being in areas where ticks may be present, bathe or shower as soon as possible and conduct a full-body tick check using a hand-held or full-length mirror to view all parts of the body. As weather permits, wear clothing that covers arms and legs. Wear socks and avoid wearing sandals. Use an insect repellent containing DEET (around 35 percent) on clothing and exposed skin when outdoors. These precautions are especially important during the daytime. Contact a healthcare provider if a fever develops during or after being in Iraq, especially if you remember being bitten by a tick.