[iwar] [fc:terror:.Ebola-style.killer.virus.WHAT.IF.???]

From: Fred Cohen (fc@all.net)
Date: 2001-10-04 07:27:12

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From: Fred Cohen <fc@all.net>
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Date: Thu, 4 Oct 2001 07:27:12 -0700 (PDT)
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Subject: [iwar] [fc:terror:.Ebola-style.killer.virus.WHAT.IF.???]
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A recent Weekly Report did indicate CCHF outbreak in Kosova -- not
Afghanistan (see http://www.who.int/wer/pdf/2001/wer7627.pdf)
I also found a WHO paper (on CDC site) that explains some practical
constraints with the WHO policy on timely reporting of outbreaks:

"...some argue that WHO is not timely in addressing the information
needs of the public about epidemics (4). However, WHO communicates
information as soon as it is verified. In some instances, this takes
time, but the delay prevents release of inaccurate information." (ref:
<a href="http://www.cdc.gov/ncidod/eid/vol6no2/grein.htm">http://www.cdc.gov/ncidod/eid/vol6no2/grein.htm>)

I don't know how often it usually takes for WHO to verify reports they
recieve.

A search of the WHO site for "Afghanistan and CCHF" turned up the
reports for CCHF outbreaks in 1998 and 2000.  Details follow.

"19 June 2000

Acute haemorrhagic fever syndrome in Afghanistan

An outbreak of acute haemorrhagic fever syndrome has been reported from
an isolated village in Gulran district, Afghanistan. Disease symptoms
are compatible with Crimean-Congo haemorrhagic
fever (CCHF). An international team, coordinated by WHO, arrived in the
affected area on 16 June to control and investigate this outbreak. The
team comprises experts from the WHO Collaborating
Centre at the National Institute of Virology (NIV-South Africa),
Epicentre (France) and WHO.

Preliminary findings indicate that cases began at the beginning of May
and are continuing to occur. Twenty-five suspect cases including 15
deaths were identified by the team. Samples were
collected and transported to NIV where diagnostic laboratory tests will
be performed to establish the aetiology of the outbreak.

The team has provided basic protective materials (gloves, masks),
disinfectants (chlorine bleach) and instructions for their use in caring
for patients with bleeding symptoms. An isolation area has
been identified in the hospital in Herat to deal with haemorrhagic
patients and will be equipped by WHO. Training in barrier nursing will
be provided to medical and nursing staff.
"
"8 May 1998 

     Crimean-Congo haemorrhagic fever in Afghanistan

     Crimean-Congo haemorrhagic fever has been diagnosed in cases
occurring in a village in the district of Rustaq, Province of Takar in
mid-March 1998. A total
     of 19 cases of which 12 were fatal were reported. Rustaq district,
in the north-eastern part of Afghanistan, was severely affected by the
earthquake in early
     February and access was further complicated by melting snow.
However, representatives from United Nations and non-governmental
organizations were on
     site to provide assistance and notified WHO about the outbreak. The
WHO country office organized with the International Federation of Red
Cross and Red
     Crescent Societies and Médecins Sans Frontières the investigation
and management of the cases. Blood specimens were shipped to the WHO
Collaborating
     Centre for Reference and Research on Special Pathogens at the
Centre for Applied Medical Research, Public Health Laboratory Service,
Porton Down,United
     Kingdom. Serological testing (IgG/IgM antibody) provided evidence
for Crimean-Congo haemorrhagic fever virus infection. Other virological
testing is in
     progress at Porton Down. "

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