The ministry of health on We d n e s d a y c o n f i rmed th e presence of Crimean-Congo Hemorrhagic Fever (CCHF) also known as Congo Fever in the country after a male patient died on Thursday last week. 

According to the protocols of the Ministry of Health and Social Services and the World Health Organisation standards, one laboratory-confirmed case of CCHF in a jurisdiction is considered an outbreak and requires that public health measures be instituted to prevent further transmission. 

There is no treatment to cure the lethal CCHF. The treatment is primarily supportive and care should include careful attention to fluid balance, oxygenation, blood therapy, and appropriate treatment of secondary infections.The ministry revealed that the deceased patient was on Tuesday last week treated at a private health facility in Gobabis and after it was suspected that he may be infected with CCHF, he was then referred to Lady Pohamba Private Hospital in Windhoek on Wednesday and in the early hours of Thursday the patient was referred and admitted to the Windhoek Central Hospital, Isolation Unit where blood samples for CCHF investigation were taken before the patient passed away the same day. 

“On 21 May 2023, the laboratory results confirmed that the patient was positive for Crime an - C ongo Hemorrhagic Fever (CCHF) virus. From Thursday (1 8 May) a total of 27 contacts were identified of whom 24 are health workers, one co-worker of the deceased, and two household contacts,” said Ben Nangombe, the executive director in the health ministry on Tuesday. 

Background 

C r i m e a n - C o n g o Haemorrhagic Fever (CCHF) is a viral hemorrhagic fever caused by a nairovirus. It is transmitted to humans through the bites or crushing of ticks, by contact with the body fluids of a patient infected with the CCHF virus during the acute phase of infection, or by contact with blood or tissues from livestock with the CCHF virus in its blood. In documented outbreaks of CCHF, fatality rates in hospitalized patients have ranged from 9% to as high as 50%. As depicted in the table below, Namibia experienced CCHF outbreaks in the past with six confirmed cases and three deaths, (50% fatality rate). 

According to health professionals, Congo Fever is transmitted through tick bites or handling of ticks with bare hands. 

Direct contact with infected animal blood and organs of animals during the slaughtering or handling of infected meat as well as through direct physical contact with the body fluids of a person who is infected with the CCHF virus. 

Direct contact with a body of a person who has died of CCHF; and Handling of contaminated linen, beddings, and clothes of a confirmed case without protection are a risk. 

Incubation period 

This is the period between exposure to an infection and the appearance or onset of the first symptoms. For CCHF, the length of the incubation period depends on the mode of acquisition of the virus. 

“Following infection by a tick bite, the incubation period is usually one to three days, with a maximum of nine days. Following contact with infected blood or tissues, the incubation period is usually five to six days, with a documented maximum of 13 days,’’ Nangombe said. 

Signs and symptoms 

The onset of CCHF is sudden, with initial signs and symptoms including headache, high fever, back pain, joint pain, stomach pain, and vomiting. Red eyes, a flushed face, a red throat, and petechiae (red spots) on the palate are common. Symptoms may also include jaundice, and in severe cases, changes in mood and sensory perception. As the illness progresses, large areas of severe bruising, severe nosebleeds, and uncontrolled bleeding at injection sites can be seen, beginning on about the fourth day of illness and lasting for about two weeks.