Crimean-Congo haemorrhagic fever is a particularly nasty viral infection commonly transmitted to man by ticks.
It has a sudden onset with high fever, chills, malaise, diffuse aches, photophobia, irritability and vertigo. Fever can last between 5 and 12 days. Other frequent symptoms include abdominal pain, anorexia, nausea and vomiting, diarrhoea, a dangerously slow heart rate, hyperaemia and oedema of the face and neck, and conjunctival congestion.
The haemorrhagic phase of the disease usually begins on day 4, with the most common manifestations being blood spots in the skin, nosebleeds, haemorrhaging of the gums, blood in urine, bleeding from the vagina, and from the stomach lining. When death occurs, it is usually due to shock brought on by the loss of blood, or by neurological complications, lung haemorrhages, or secondary infections. The case fatality rate is estimated to be between 30 and 50%. You do not want to get Crimean-Congo haemorrhagic fever.
An outbreak is taking place Ahmedabad, in the Gujarat region of India, and an isolation ward in being set up in every major hospital in the city. The Crimean-Congo Haemorrhagic Fever (CCHF) virus has so far claimed four lives. The government has asked medical and para-medical staff to take utmost care while treating CCHF-positive cases. This is because the virus has claimed two doctors and a nurse, who were attending to patients with Congo fever.
Amina Momin from Kolat village in Sanand taluka was the first victim of the virus. She died on January 3. After that, Dr Gagan Sharma and nurse Asha John, who attended to Momin, also died of Congo fever.
I oonder if teh same precautions apply to those who handle waste from these cases. This is a high risk virus and would demand the most strict of isolation facilities with space suit type isolation of cases.
The virus is reasonably susceptible to heat (56°C for 30 minutes, or 60°C for 15 minutes), to UV light (1,200 to 3,000 μW/cm2), and is inactivated in 40% ethanol within 2 minutes.
It is stable in wet conditions for 7 hours at 37 °C, 11 days at 20 °C, and 15 days at 4 °C . Under dry conditions, the virus is stable for at least 90 minutes, but less than 24 hours. Infection can occur from exposure to virus, via contamination of broken skin, sharps injury and inhalation of contaminated aerosols.
Waste handlers will obviously be at risk, though thankfully CCHF is almost unknown in the UK.
The risks of infection acquired from contact with waste – irrespective of some notional classification as infectious or non-infectious – should never be underestimated.
- What are you handling today?
- What is in that waste, and what is on the outside of the waste containers?
- Are you working safely, for the protection of yourself and others?
In all likelihood the answers are negative and standards of safety could, and should, be improved.