Weekly Epidemiological Monitor ISSN 2224-4220 Volume 10; Issue no 51; 17 December 2017 Current major event Crimean-Congo Hemorrhagic Fever reported in Afghanistan, 2017 Crimean-Congo hemorrhagic Cases Deaths CFR (%) fever in Afghanistan 50 60 The Ministry of Public Health in Afghan- 50 istan recently reported an increase in the 40 40 number of Crimean-Congo haemorrhagic 30 fever (CCHF) cases in the country. In 30 20 2017, a total of 237 cases of CCHF in- 20 cluding 41 deaths (CFR: 17.2%) have 10 10 been reported throughout 27 provinces. 0 0 Majority of these cases-71 cases including Case Fatality Rate (% ) 13 associated deaths (CFR: 18.3%), were Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec Month reported from the capital city, Kabul. Num bandCases Deaths erof Editorial note Geographical distribution of CCHF cases and deaths in Afghanistan, 2017 Update on outbreaks Crimean-Congo haemorrhagic fever is a in the Eastern Mediterranean Region widespread tick-borne viral disease that results in severe viral haemorrhagic fever MERS in Saudi Arabia; cholera in Soma- outbreaks, with a high CFR of 10–40%. lia; cholera in Yemen; dengue in Hosts of CCHF virus include a wide Pakistan. range of wild and domestic animals such as cattle, sheep and goats. The CCHF Current public health events of virus is transmitted to people either by international concern tick bites or through contact with infected [cumulative No of cases (deaths), CFR %] animal blood or tissues during and imme- diately after slaughter. Human-to-human Avian influenza: 2006-2017 transmission can occur resulting from Egypt (A/H5N1) [359 (122), 34%] close contact with the blood, secretions, Egypt (A/H9N2) [4 (0)] organs or other bodily fluids of infected The increase in the slaughtering of ani- persons. mals during this time period might have Avian influenza A (H7N9): 2013-2017 CCHF is endemic in some countries of significantly increased the risk of CCHF the Eastern Mediterranean Region of virus transmission. This trend is con- China [1,564 (612), 39.1%] WHO and particularly in Afghanistan. sistent with the last outbreaks in the Chikungunya: 2016-2017 An average of 5 to 50 human cases are country. reported every year in the country. The The high risk groups for contracting Pakistan [8,363 (0)] last most severe outbreak of the disease CCHF include animal herders, livestock Cholera: 2016-2017 occurred in 2016, when 156 cases includ- workers, butchers, slaughterhouse work- ing 18 deaths (CFR: 11.5%) were report- ers and veterinarians. Health care work- Somalia [78,784 (1,159), 1.5%] ed. ers are also at risk of infection through Yemen [983,484 (2,225), 0.23%] In 2017, the total number of cases report- unprotected contact with infectious ed is 237 including 41 deaths (CFR: blood and body fluids while caring for Plague: 2017 17.2%). The male to female ratio of cases patients. Madagascar [2,417 (209), 9%] in 27 out of 34 provinces is 2:1. Out of Prevention and control interventions for the total reported cases, 26 were labora- CCHF need to be strengthened. This Dengue fever: 2017 tory confirmed. The highest number of should include effective coordination Pakistan [125,316 (69), 0.1%] cases was reported in Kabul and Herat between human and animal health sec- provinces. Herat province has an endem- tors and other relevant stakeholders. As MERS: 2012-2017 ic foci for CCHF. A total of 67 cases in- there is no vaccine available either for cluding 10 deaths (CFR: 14.9%) were humans or animals, prevention measures Saudi Arabia [1,751 (682), 38.9%] reported from this province. These two are crucial. Protective gear should be Wild poliovirus: 2014-2017 provinces border Pakistan and Iran (see utilised by animal handlers while dealing figure) where livestock transboundary with infected animals and healthcare Pakistan [7 (0)] movement is not controlled. workers while dealing with suspected Afghanistan [12 (0)] Majority of CCHF cases and deaths in cases. Community awareness and risk Afghanistan were recorded from June to communication through sessions, elec- Zika virus infection: 2015-2017 September (see graph) around the time of tronic and print media, is the key to pre- vent the virus/infection spread. 84 countries and territories have reported Eid Al-Adha (sacrifice feast in Islam). transmission so far. Published by World Health Organization, Regional Office for Eastern Mediterranean, Cairo, Egypt Tel: +20 2 22765273 Fax: +20 2 2765456 Email: [email protected] Previous issues are available at http://www.emro.who.int/surveillance-forecasting-response/weekly-epidemiological-monitor/ 51 .