CDC issues travel advisory for Afghanistan due to CCHF outbreak

The Centers for Disease Control and Prevention (CDC) issued a travel notice (Level 1 - Practice Usual Precautions) this week due to an outbreak of Crimean-Congo Hemorrhagic Fever (CCHF) in most provinces in Afghanistan.

According to the World Health Organization (WHO), the total number of suspected CCHF cases and associated deaths have reached to 949 and 96, respectively (CFR 10.1%) since the beginning of the year and through August 23.

The CCHF-associated deaths were reported from 14 provinces, more than half of which were reported from 2 provinces; Kabul (46, 47.9%) and Balkh (14, 14.6%).

Crimean-Congo Hemorrhagic Fever (CCHF) is caused by infection with a tick-borne virus (a nairovirus, CCHF virus).

CCHF virus is spread by contact with infected ticks or animal (e.g., livestock) blood. CCHF virus can be spread from human to human through contact with infectious blood or bodily fluids.

The CDC says you can protect yourself by using Environmental Protection Agency (EPA)-registered insect repellants on exposed skin and clothing and wearing gloves when in contact with livestock.

In addition, avoid contact with ticks, the body fluids of infected livestock, or humans who show signs of infection.

Initial symptoms of CCHF include headache, high fever, back pain, joint pain, stomach pain, and vomiting. As the illness progresses, large areas of severe bruising, severe nosebleeds, and bleeding at injection sites can be seen.

In documented outbreaks of CCHF, fatality rates in hospitalized patients have ranged from 9% to as high as 50%.