Congo hemorrhagic fever is a severe viral infection caused by Nairovirus of Bunyaviridae family. It is primarily spread by number of ticks which commonly live in the domestic animals such as cattle, sheep and goats�����. Although disease is quite common in Africa and middle east but number of cases has been reported in many Asian countries as well.   

TRANSMISSION:
Congo virus is transmitted to human beings by the bite of infected ticks after contact with blood of infected animals .Alarmingly, transmission from human to human also occurs because of contact with blood and other secretions of infected persons. Hospital acquired infections have also been reported due to improper sterilization of medical equipment and reuse of syringes.

CLINICAL FEATURES:
 It takes 3-7 days to develop signs & symptoms of Congo Hemorrhagic Fever  after entry of virus in a healthy person. Characteristically fever, generalized pains especially headache and backache are the presenting features. Abdominal pain, nausea, vomiting followed by agitation/confusion also accompany these patient. In complicated cases, these features are followed by appearance of petechie, ecchymosis & hemorrhage from skin & different mucous membranes. One third of the patient ultimately have fatal outcome. Death in most cases is reported in 2^nd week of illness. Recovery in remaining patients start after 10^th day of illness.

DIAGNOSIS:
Diagnosis of Congo hemorrhagic fever needs confirmation for which number of specialized tests for the detection of antigen or virus are available which includes  ELISA, PCR and cell culture.

MANAGEMENT:
Most of the patients are managed by supported care which include relief of fever bodyaches and pains, adequate hydration and blood transfusion  as and when required. Use of anti-viral drugs/Ribavirin has also been found effective in this infection.

PREVENTION:
Health education of the masses regarding the care of domestic animals in general and at the time of slaughtering is the main preventive measures.

 Use of acaricides for the killing of ticks over infested animals, use of gloves by poultry workers and appropriate disposal of the secretions of infected patients are the major preventive measures until the availability of an effective vaccine which is not currently available. Thus, it is the duty of the health authorities to educate people about these preventive measures and by using electronic and print media.

Dr. Rizwan Gohar                                                    Prof Agha Shabbir Ali
MBBS, FCPS                                                             MBBS, FCPS
S.R Pediatrics Department                                      Head of Pediatrics Department
LGH, Lahore.                                                          PGMI/AMC/LGH, Lahore.    

Postgraduate Medical Institute

Ameer-ud-Din Medical College

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