Risk Communication and Community Engagement | By Dr. Asif Maqsood Butt

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Risk communication and community engagement

IN Pakistan, we probably only attribute diseases to seasons, but in fact diseases live with us until we are able to recognize them and take corrective action before they cause greater losses to the community.

With the approach of the 2nd Islamic festival and to fulfill the obligation of sacrifice, Muslims rush to the cattle markets, thus running the risk of attracting Crimean-Congo hemorrhagic fever, the cases of which are multiplying from day by day.

Congo is a viral hemorrhagic fever usually transmitted by ticks. It can also be contracted through contact with viraemic animal tissue (animal tissue where the virus has entered the bloodstream) during and immediately after animal slaughter.

CCHF outbreaks pose a threat to public health services because the virus can lead to outbreaks, has a high mortality rate (10-40%), can lead to outbreaks in hospitals and healthcare facilities, and is difficult to control. prevent and treat.

CCHF is endemic throughout Africa, the Balkans, the Middle East and Asia. The disease was first diagnosed in Crimea in 1944 and given the name Crimean hemorrhagic fever.

In 1969, it was recognized that the pathogen responsible for Crimean haemorrhagic fever was the same as that responsible for a disease identified in 1956 in the Congo.

The link between the two place names gave the current name of the disease and the virus.

The one and only way to stay safe is to take protective measures, including: wearing protective clothing (long sleeves, long pants); light colored clothing to allow easy detection of ticks on clothing; using approved acaricides (chemicals intended to kill ticks) on clothing; use an approved repellent on skin and clothing; regularly examine clothes and skin for ticks; if found, remove them safely; seek to eliminate or control tick infestations on animals or in stables and barns; Avoid areas where ticks are abundant and seasons when they are most active.

Wear gloves and other protective clothing when handling animals or their tissues in endemic areas, especially during slaughter, butchering and culling procedures in slaughterhouses or at home; Quarantine animals before they enter slaughterhouses or regularly treat animals with pesticides two weeks before slaughter.

avoid close physical contact with people infected with CCHF; wear gloves and protective equipment when caring for sick people; Wash hands regularly after caring for or visiting sick people.

In case of contracting the disease; The onset of symptoms is sudden, with fever, myalgia (muscle pain), dizziness, neck pain and stiffness, back pain, headache, irritated eyes and photophobia (sensitivity to light).

There may be nausea, vomiting, diarrhea, abdominal pain and sore throat at first, followed by sudden mood swings and confusion.

After two to four days, restlessness may be replaced by drowsiness, depression, and lassitude, and abdominal pain may localize to the right upper quadrant, with detectable hepatomegaly (enlarged liver).

Other clinical signs include tachycardia (rapid heartbeat), lymphadenopathy (enlarged lymph nodes), and petechial rash (a rash caused by bleeding into the skin) on internal mucosal surfaces, such as the mouth and throat. and on the skin.

Petechiae can give way to larger rashes called bruising and other bleeding phenomena.

There are usually signs of hepatitis, and critically ill patients may experience rapid kidney deterioration, sudden liver failure, or lung failure after the fifth day of illness.

The mortality rate of CCHF is about 30%, with death occurring in the second week of illness.

In recovering patients, improvement usually begins on the ninth or tenth day after illness onset.

Healthcare workers caring for patients with suspected or confirmed CCHF, or handling specimens from them, should apply standard infection control precautions.

These include basic hand hygiene, use of personal protective equipment, safe injection practices and safe burial practices.

As a precautionary measure, healthcare workers caring for patients immediately outside the CCHF outbreak area should also implement standard infection control precautions.

—The author is a contributing columnist, based in Rawalpindi.


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