Tariq Ashraf, Mohammad Wasif Khan, Ahmad Khan.
Crimean Congo Hemorrhagic Fever - A hidden meance of public health importance trends in Pakistan.
Pak Armed Forces Med J Jan ;54(1):113-6.

Crimean Congo haemorrhagic fever (CCHF) is one of the most severe human viral diseases, with mortality rate of up to 50%. Apart from Pakistan; CCHF is a public health problem in many regions of the world, including Africa, Middle East, Southern and Eastern Europe, and western Asia. The causative agent for CCHF is Crimean Congo haemorrhagic Fever Virus (CCHFV) which is a type species of the genus Nairovirus in the Bunyaviridae family. Laboratory studies have shown that the virus is related to Hazara virus isolated from ticks in Pakistan, and to Nairobi sheep disease virus. CCHFV is a spherical, enveloped virion 85-100 nm in diameter, like all members of the genus, is a single-stranded RNA virus. Lipid solvents and detergents inactivate it. CCHFV has a tripartite genome consisting of a small (S), a medium (M), and a large (L) segment. The S RNA segment codes for the nucleocapsid (N) protein, and the M RNA segment codes for the glycoprotein precursor, resulting in the two envelope glycoproteins G1 and G2, while the L segment encodes the putative RNA-dependent polymerase. Humans gain infection from tick bite or from contact with infected blood/tissues coming either from human patients (Nosocomial infections - needle sticks etc), or other animals, commonly sheep and cattle. Only humans and newborn mice readily succumb to disease; other animals including nonhuman primates are either refractory or undergo mild infection. This is a review article.

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