When Amina Momin, 30, took to bed with a cold and fever late in December, her family dismissed it as a bout of flu. When the fever persisted and bruises started appearing on her body, her husband, cab driver Rehman Husain, rushed her to Shalby Hospital in Ahmedabad, 40 km away. Momin died three days, on January 3.
But her illness got attention after two people who treated her at Shalby — Dr Gagan Sharma and nurse Asha John — developed similar symptoms. Their blood samples were sent to Pune’s National Institute Virology (NIV) for testing. Both tested positive for Crimean-Congo Haemorrhagic Fever (CCHF), which killed them on the day the results were announced. With the confirmation, Momin became India’s first recorded case of CCHF, a flu-like illness that jumps from animals to humans through tick-bite. Outbreaks in humans occur in Africa, eastern Europe and parts of Asia, including Iran and Pakistan.
Soon after Momin’s death, her husband Husain was hospitalised with symptoms of high fever with chills, bodyache, headache, abdominal pain and vomiting. Treatment using the anti-viral drug Ribavirin, however, worked and he recovered rapidly.
Husain became first person to be cured of the disease. He still has no idea how he or his wife got infected. “We don’t own or live in proximity to animals, from where the infection is said to be originating,” says Husain.
With the Husain pulling through and new cases reported for two weeks, the Gujarat government thought they had things under control until Dr Shabbir Ali, a medical intern of the Ahmedabad Civil Hospital, died of CCHF on Monday last week. He had no connection with the three earlier deaths. “We have traced Dr Ali’s travel history over the past two months and suspect that he got infected from cattle on a visit to his relative’s farm in a village in North Gujarat,” a said health department official, who did not want to be named.
“We’ve done all we could. We’ve taken blood samples of cattle from the village for testing and his family and friends are under observation. So far, no one has shown any symptoms of the disease,” he says. Dr Ali died on Monday, January 31.
Since early this week, baffled health officials have swung into action as hundreds of villagers in Kolat and six neighbouring villages have been screened and tested for CCHF. Cattle in Kolat and nearby villages in the Ahmedabad district have been found to carry ticks with a high load of the Congo virus, which puts the people at high risk of infection. “We have found virus in the samples collected from the six villages in Ahmedabad,” says Dr A C Mishra, director of NIV, Pune.
Help at hand Gujarat health minister Jaynarayan Vyas has sought help from the Centre in procuring drugs and vaccines to begin vaccinating health workers. “We have asked the Union ministry to procure injectable Ribavirin from the international market on an emergency basis so that we can combat the CCHF outbreak, which is threatening to assume the epidemic proportion in Gujarat,” says Vyas."Given that the infection appears to be already thriving among cattle, it’s only a matter of time before it reaches the critical mass to cause a large outbreak in humans," he says.
With an effective anti-viral drug and a vaccine — developed in Bulgaria in 1974, it contained outbreaks to less than 20 cases a year with the exception of 2002, when there were 54 cases — already available, all that’s needed is some planning to prevent the virus from taking over hospital wards.
“If diagnosed and treated at an early stage with antiviral therapy and supportive care, CCHF is curable,” says Dr Atul Patel, who treated Momin. Considering he’s got results to back his claim, there’s still hope of stopping CCHF before it goes the way of H1N1, or swine flu, which is in India to stay.