Consensus report: Preventive measures for Crimean-Congo Hemorrhagic Fever during Eid-al-Adha festival

Abstract

Crimean-Congo hemorrhagic fever (CCHF) is endemic in Eurasian countries such as, Turkey, Pakistan, Afghanistan and Iran. CCHF virus is spread by the Hyalomma tick, which is found mainly on cattle and sheep. Muslim countries, in which these animals are sacrificed during Eid-Al-Adha, are among the countries where CCHF is endemic, and it has been observed that CCHF is associated with practices surrounding the Eid-ad-Adha festival. The dates for Eid-Al-Adha drift 10 days earlier in each year according to Georgian calendar. In previous years Eid-al-Adha occurred in autumn-winter months however in the next 10-15 years it will be take place in the summer months when CCHF is more prevalent. This may lead to a rise in the number of cases due to increased dissemination of CCHF virus with uncontrolled animal movements in and between countries. This consensus report focuses on the variable practices regarding animal handling in different regions and possible preventative measures to reduce the incidence of CCHF. Environmental hygiene and personal protection are essential parts of prevention. There is a need for international collaborative preparedness and response plans for prevention and management of CCHF during Eid-Al-Adha in countries where the disease is prevalent.

A chronological review of experimental infection studies of the role of wild animals and livestock in the maintenance and transmission of Crimean-Congo hemorrhagic fever virus

“…These data are relevant for considering interventions like acaricide treatment and vaccination of livestock. Although acaricide treatment of animals, e.g., before or during marketing, is thought the be an effective intervention strategy and is linked to decreased seroprevalence (84,85), efficacy has not been sufficiently investigated. Ultimately, for these and other putative intervention strategies (e.g., anti-tick vaccines (86–88) or anti-CCHFV vaccines [90,91]), proper development, evaluation, and implementation would require a more detailed understanding of tick-host interactions and viral transmission.…”

Development of vaccines against Crimean-Congo haemorrhagic fever virus

“…Significantly in the next 10–20 years Eid-al-Adha will occur in the summer and spring months, when sacrificial animals are more likely to be viremic for CCHFV as a result of the transmission of the virus from infected blood-feeding ticks which are more active during these times. There is concern therefore, that the slaughter of viremic animals during these periods may facilitate the spread of CCHFV to humans which may cause secondary and tertiary human-to-human spread and subsequent outbreaks [21], [22].…”

The reasons why Pakistan might be at high risk of Crimean Congo haemorrhagic fever epidemic; a scoping review of the literature

“…Furthermore, they routinely take their cattle to other regions of the country to sell them, mainly for consumption of meat, particularly at the time of Eid-ul-Azha (a festival in which Muslims sacrifice cattle to give away to others). As a result, a greater number of CCHF cases are reported around Eid-ul-Azha [38, 39]. The festival is celebrated according to the Islamic Lunar Calendar.…”