Crimean-Congo Hemorrhagic Fever Outbreak in Omaheke Region, Namibia, 2017: An Outbreak Investigation

Abstract

In March 2017, Gobabis district reported a suspected case of Crimean Congo Hemorrhagic Fever. The patient who had a history of tick bite presented with bloody vomitus, bloody stools, and Jaundice. We investigated the outbreak to determine its magnitude, and institute control measures. We conducted a descriptive, cross-sectional study to investigate the outbreak. We conducted active case search in health facilities, followed up contacts, and raised community awareness by providing health education. Data was analyzed by calculating frequencies and proportions by person, place, and time. Two confirmed cases were reported for this outbreak with a case fatality of 50%. All cases were males who were involved in livestock rearing.  A total of 64 contacts were identified and followed up for 15 days. Contacts who developed signs and symptoms of Crimean Congo Hemorrhagic Fever were tested but none tested positive for the disease. The majority of contacts were family members who lived and provided care to the cases and healthcare workers who attended to the cases in the hospital setting. Environmental assessment among affected farms was done and the application of acaricides on animals was conducted by veterinary services. This outbreak was associated with tick bite. The findings highlight the occupational risk of Crimean Congo Hemorrhagic Fever among livestock handlers and the vulnerability of healthcare workers when infection prevention and control measures are not consistently applied. Strengthening surveillance systems, improving healthcare worker training on infection prevention and control, and promoting community awareness on tick bite prevention are vital to prevent future outbreaks. The successful intersectoral collaboration demonstrates the importance of integrating a One Health approach to prevent future epidemics.