Crimean-Congo hemorrhagic fever (CCHF) is a viral zoonotic tick-borne disease with a high fatality rate reported in many countries. The first patient of CCHF in Oman was detected in 1995. Between 17th and 23th August 2019 (Eid Adha festival) Directorate of Disease Surveillance and Control received reports of 4 patients of CCHF from different areas in North Oman Region. Objectives: to identify CCHF patients, identify the source for each patient with mode of transmission and recommend preventive measures for future outbreaks.
Methodology
After meeting with public health team, we prepared for field visit at the same day of notification along with teams from Ministry of Agriculture, Fisheries and Municipality. A case series study was conducted to gather information using semi structured questionnaire between 17th August and 23th August 2019 in North Oman Region. The case definition was implicated according to Omani Ministry of Health guideline (communicable disease guide 2017 page 57).
Results
The results showed that all patients are males (3 are Omanis) with age ranged from 40 to 55 years. 3 patients were working in slaughterhouses while all patients had direct contact with fresh sheeps tissues. The maximum incubation period was 14 days. The most frequent symptoms were fever and gastrointestinal symptoms with case fatality rate of 25%. The patient who passed away presented late with bleeding symptoms and coagulopathy.
Conclusion
Based on the symptoms, signs, lab investigations and incubation period the causative agent was most likely CCHF Virus and the source of the outbreak was due to infected imported sheeps through direct contact with infected biological tissues. It is mandatory to test and flag all the imported sheeps on the main gate of the 3 ports in the North Region of Oman.