Congo Fever: Symptoms, Causes, Diagnosis, Vaccine, Treatment, Mortality rate, Prevention And Cure

Congo fever is a tick-borne condition that originates from animals and can spread into humans. It is a highly contagious condition and one infected person may lead to an outbreak of the condition. Congo fever was initially known as Crimean- Congo hemorrhagic fever (CCHF). The CCHF virus includes a wide range of wild and domestic animals such as cattle, sheep and goats.

The virus can also be contracted through contact with viraemic animal tissues (where the virus has entered the bloodstream) during and immediately post-slaughter of animals. Congo fever is a threat to public health services as it can lead epidemics and isn't easy to treat and prevent.

The symptoms that are generally associated with Congo Fever include:

• Onset symptom of Congo fever:
  • Fever
  • Myalgia (muscle ache)
  • Neck pain
  • Dizziness
  • Backache
  • Headache
  • Stiffness
  • Photophobia (sensitivity to light)
  • Sore throat
  • Mood swings
  • Confusion
  • Abdominal Pain
  • Hepatomegaly (liver enlargement)
• Other very severe symptoms include:
  • Coma
  • Jaundice
  • Convulsions
  • Bleeding
• Clinical symptoms include:
  • Lymphadenopathy (enlarged lymph nodes)
  • Tachycardia (fast heart rate)
  • Petechial rashes (rashes caused by bleeding under the skin) on the skin's surface or inside the mouth and throat.

It is caused by the tick-borne virus (Nairovirus) of the Bunyaviridae family. The virus causes severe viral hemorrhagic fever outbreaks.

The virus is transmitted to people by tick bites or through contact with infected animal blood or tissue immediately after slaughter. The majority of cases have occurred in people involved in the livestock industry, such as agricultural workers, slaughterhouse workers and veterinarians.

A human-to-human spread can occur from close contact with the blood, secretion, organs, or other infected persons' bodily fluids. In hospitals, infections can also occur due to improper sterilization of medical equipment, contamination of medical supplies, and reuse of needles.

Congo fever is highly contagious and is associated with high mortality. It is highly contagious condition and one infected person may lead to an outbreak of the condition. Ixodid ticks transmit the virus in animals. Humans acquire the virus from direct contact with blood or infected tissues from livestock having viremia or become infected from a tick bite.

Various laboratory tests can diagnose Crimean- Congo hemorrhagic fever virus infection:

• Virus isolation by cell culture
• Serum neutralization
• Enzyme-linked immunosorbent assay (ELISA)
• Antigen detection
• Virus isolation by cell culture
• Reverse transcriptase-polymerase chain reaction (RT-PCR) assay

The person with a fatal disease or person suffering from the illness does not usually develop a measurable antibody response. The diagnosis of these patients is made by viruses or by RNA detection in blood samples. Under the maximum biological containment conditions test should be conducted.

The general care of the symptoms is the main approach to cure or treat congo fever. Ribavirin is the primary drug when it comes to treatment of Congo fever. This drug can be administered intravenously or orally as well. No other kinds of medication are recommended for patients. The only other way to treat the Congo fever is to take active precautions against the disease.

The health-workers are at significant risk of receiving infection from sharp injuries at the time of clinical procedures. Earlier, infections have been spread from the patients to surgeons while determining the reason for abdominal symptoms in the early stages or at the moment of undiagnosed infection.

Healthcare workers who have had a connection with tissue or blood from patients with suspected or confirmed CCHF Should undergo isolation and have a daily temperature check and monitor symptoms for the next 14 days after the exposure.

Ribavirin is the primary drug used for the treatment of the condition. It is mostly safe to use, but may cause side effects for some people. For instance, headache, muscle pain, weight loss, nausea and vomiting are the common side effects of the drug in question.

Serious side effects from the drug is uncommon, but may affects some people under rare conditions. For instance, the medication may lead to difficulty breathing, easy bruising or bleeding, dark urine, change in vision and mental/personality changes. Lastly, the medication is also not recommended for new mothers, who are still breastfeeding, as it can cause adverse effect on the health of the child.

The Congo fever generally lasts for a couple of weeks. If the patient starts getting better, he/she will likely survive the disease. However, around 40 per cent of people affected perish within the first two weeks of contracting the disorder. The recovery from the disease usually takes some time and during this time the patient must ensure that they get a proper diet and rest.

Recovery is slow, even though the chances of the health deteriorating post the first two weeks is quite low. The medication will have to be continued until the time that the doctor asks you to stop taking the same. If the patient’s condition improves on the ninth or tenth day, it may indicate that the person will recover from the condition.

According to the World Health Organization, the Congo fever mortality rate is 10–40 percent. Since the mortality rate is high and most deaths occur in the second week of infection, doctors need to monitor patients closely during this time.

Price of treatment depends on the dosage of the medication needed. Furthermore, the cost of hospitalization will also be factored in to the total cost, since patients cannot be kept at home with other people. In total, the cost of treatment in case of Congo fever may range between Rs. 20,000 and Rs. 75,000.

Results of the treatment are permanent in most cases. However, stopping the treatment prematurely may lead to the condition recurring. However, if the course of the treatment is followed through, there is very little risk of the disease recurring.

Treatment for Congo fever is primarily supportive. Care should include careful attention to fluid balance and correction of electrolyte abnormalities, oxygenation and hemodynamic support and appropriate treatment of secondary infections.

1. It is difficult to prevent CCHF infection in animals and ticks as the tick-animal-tick cycle usually goes unnoticed and the condition in domestic animals is generally not apparent. The tick vectors are numerous and widespread, so tick control with acaricides (Chemicals intended to kill ticks) is only a realistic option for well-managed livestock production facilities.

2.Individuals staying in endemic areas should use personal protective measures to avoid places where tick vectors are abundant. When they are active, keep a regular check on your clothes and skin ticks and their removal, use of repellents. Persons who work with livestock or other animals in the endemic areas can take practical measures to protect themselves.

3.To protect, use the repellent on the skin for example, DEET and for the clothing, you can use Permethrin and wear gloves or other protective clothing to prevent skin contact with the infected tissues or blood.

4.When the patient with the Congo fever or CCHF gets admitted to the hospital, there is a risk of nosocomial infection spread. In the past, severe outbreaks have occurred in this way and adequate infection control measures must be observed to prevent this disastrous outcome. Patients suspected of CCHF should be isolated and cared for using barrier nursing techniques.

5.Specimens of blood or tissues were taken for the diagnostic reason should be collected and handled with universal precautions. Using proper decontamination procedures, sharp needles, body wastes and other surgical instruments should be disposed off.

6.Since there are no vaccines for the disease, these precautions mainly relate to the hygiene and interaction between animals and humans. Preventative measures include wearing long sleeved clothing and other apparel that cover most parts of the body. Apart from this, people can also use approved tick repellents to ensure that the condition can be avoided.