[iwar] [fc:Ebola-style.killer.virus.sweeps.Afghan.border]

From: Fred Cohen (fc@all.net)
Date: 2001-10-03 22:13:28


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From: Fred Cohen <fc@all.net>
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Subject: [iwar] [fc:Ebola-style.killer.virus.sweeps.Afghan.border]
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Ebola-style killer virus sweeps Afghan border
By Tim Butcher in Quetta
(Filed: 04/10/2001)

THE largest outbreak in history of a highly contagious disease that
causes patients to bleed to death from every orifice was confirmed
yesterday on Pakistan's frontier with Afghanistan. 

At least 75 people have caught the disease so far and eight have died. 
An isolation ward screened off by barbed wire has been set up in the
Pakistani city of Quetta, and an international appeal has been launched
for help. 

Evidence suggests the outbreak of Crimean-Congo Haemorrhagic Fever
emanates from within Afghanistan, raising fears of an epidemic if
millions of refugees flee across the frontier into Pakistan. 

CCHF has similar effects to the ebola virus.  Both viruses damage
arteries, veins and other blood vessels and lead to the eventual
collapse of major organs. 

As one doctor put it, a patient suffering from haemorrhagic fever
"literally melts in front of your eyes". 

At the Fatima Jinnah Chest and General Hospital in Quetta, capital of
the Pakistani province of Baluchistan, an isolation ward with eight
treatment beds and two observation bays has been set up. 

Nine-year-old Ismail Sadiq lay on one of the beds yesterday, his body
wracked with fever and a wad of cotton wool stuffed into each nostril to
stem the bleeding. 

Outside members of his family sat anxiously in the shade of a tree.  An
elderly gentleman worked a string of worry beads through his fingers,
but doctors had forbidden all visits. 

The only people Ismail now sees are doctors and nurses wearing the
complete "barrier nursing" outfit of sterilised hairnet, mask, gloves,
gown and overshoes. 

Another patient, a 65-year-old man, lay inert on his bed, with streams
of dried blood on his chin, nose and tongue.  His shirt was also stained
heavily with blood. 

Dr Akhlaq Hussain, the hospital's medical superintendent, said: "The
first cases came in June.  There were a number of deaths, but at first
we did not know what was the cause."

A number of blood samples were sent to Pakistan's national virology
testing centre in Islamabad.  They were then sent to South Africa's
National Institute of Virology in Johannesburg for confirmation. 

Dr Hussain said: "When the results came back we knew we were dealing
with Crimean-Congo Haemorrhagic Fever." He has compiled a list of all 75
cases, which involved refugees recently arrived from Afghanistan or
people living close to the border. 

The first known case of the disease was among Russian soldiers serving
in the Crimea in 1944 and then among villagers living near the Congolese
city of Kisangani in 1956.  Not until 1969 were scientists able to
isolate the single virus common to both. 

Although there have been a number of cases since, the outbreaks have
never been as large as the current one. 

The doctor said: "We had our first case in Pakistan in the 1970s.  It
would seem there is a reservoir of the virus in Afghanistan and we are
now worried about the possible effects of an influx of many new
refugees. 

"The virus is carried by domestic animals, and if they come in large
numbers with large numbers of animals we can expect many more cases."

The authorities in Pakistan have appealed to the World Health
Organisation for additional supplies to help deal with the outbreak,
including storage facilities for clean blood plasma and white blood
cells which can be used to replace those lost by patients. 

The virus is widely distributed in the blood of sheep, cattle and other
mammals across eastern Europe, Asia and Africa.  It can be passed to man
by a species of tick, Hyalomma marginatum, common in the same areas. 

If caught in time, CCHF can be treated by replacing enough of the lost
body fluids to allow the patient's own immune system to take over and
kill the virus. 

The facilities at Fatima Jinnah are basic, but the staff are dedicated
and brave, treating patients even though there is a high risk of
infection from spittle or blood. 

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