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Is this upsurge caused by a recent terrorist release? If not, is it an unlikely coincidence in its timing? If so, is it a "foreshock" or "warning shot" of what may be in store in the United States and/or elsewhere?

Hyperlink: http://www.portal.telegraph.co.uk/news/main.jhtml?xml=/news/2001/10/04/wref04.xml&sSheet=/news/2001/10/04/ixhome.html

Copyright of Telegraph Group Limited, Fair Use for Educational and Research Purposes Only

Ebola-style killer virus sweeps Afghan border

By Tim Butcher in Quetta (Filed: 2001/10/04)

The largest outbreak in history of a highly contagious disease that causes patients to bleed to death from every orifice was confirmed yesterday on Pakistan's frontier with Afghanistan. At least 75 people have caught the disease so far and eight have died. An isolation ward screened off by barbed wire has been set up in the Pakistani city of Quetta, and an international appeal has been launched for help.

Evidence suggests the outbreak of Crimean-Congo Haemorrhagic Fever emanates from within Afghanistan, raising fears of an epidemic if millions of refugees flee across the frontier into Pakistan. CCHF has similar effects to the Ebola virus. Both viruses damage arteries, veins and other blood vessels and lead to the eventual collapse of major organs. As one doctor put it, a patient suffering from haemorrhagic fever "literally melts in front of your eyes".

At the Fatima Jinnah Chest and General Hospital in Quetta, capital of the Pakistani province of Baluchistan, an isolation ward with eight treatment beds and two observation bays has been set up. Nine-year-old Ismail Sadiq lay on one of the beds yesterday, his body wracked with fever and a wad of cotton wool stuffed into each nostril to stem the bleeding. Outside members of his family sat anxiously in the shade of a tree. An elderly gentleman worked a string of worry beads through his fingers, but doctors had forbidden all visits. The only people Ismail now sees are doctors and nurses wearing the complete "barrier nursing" outfit of sterilised hairnet, mask, gloves, gown and overshoes. Another patient, a 65-year-old man, lay inert on his bed, with streams of dried blood on his chin, nose and tongue. His shirt was also stained heavily with blood.

Dr Akhlaq Hussain, the hospital's medical superintendent, said: "The first cases came in June. There were a number of deaths, but at first we did not know what was the cause." A number of blood samples were sent to Pakistan's national virology testing centre in Islamabad. They were then sent to South Africa's National Institute of Virology in Johannesburg for confirmation. Dr Hussain said: "When the results came back we knew we were dealing with Crimean-Congo Haemorrhagic Fever." He has compiled a list of all 75 cases, which involved refugees recently arrived from Afghanistan or people living close to the border. The first known case of the disease was among Russian soldiers serving in the Crimea in 1944 and then among villagers living near the Congolese city of Kisangani in 1956. Not until 1969 were scientists able to isolate the single virus common to both.

Although there have been a number of cases since, the outbreaks have never been as large as the current one. The doctor said: "We had our first case in Pakistan in the 1970s. It would seem there is a reservoir of the virus in Afghanistan and we are now worried about the possible effects of an influx of many new refugees. "The virus is carried by domestic animals, and if they come in large numbers with large numbers of animals we can expect many more cases." The authorities in Pakistan have appealed to the World Health Organisation for additional supplies to help deal with the outbreak, including storage facilities for clean blood plasma and white blood cells which can be used to replace those lost by patients.

The virus is widely distributed in the blood of sheep, cattle and other mammals across eastern Europe, Asia and Africa. It can be passed to man by a species of tick, Hyalomma marginatum, common in the same areas. If caught in time, CCHF can be treated by replacing enough of the lost body fluids to allow the patient's own immune system to take over and kill the virus. The facilities at Fatima Jinnah are basic, but the staff are dedicated and brave, treating patients even though there is a high risk of infection from spittle or blood.

-- Robert Riggs (rxr.999@worldnet.att.net), October 04, 2001


That's pretty big news, thanks for the post Robert.

-- Guy Daley (guydaley1@netzero.net), October 04, 2001.

This is where we start to realize what a hornet's nest we've gotten ourselves into, and we really really start to question why we're meddling in that part of the world. Now we'll have to face the ugly truth of our terminal condition, our fatal addiction, our utterly insane dependance on fossil fuels. Hopefully we'll understand that even if we could wipe out the entire Arab population, the oilwells are just a few years away from going into decline. Hopefully we'll back off and accept a humbler rank in the world, and give up our gas- guzzling planes and SUV's before it's too late. But of course our politicians are pushing us in exactly the opposite direction. Absolute unconscionable scumbags. They understand nothing. Last month's watchword: "Stay out of tall buildings and stay away from crowds." This month's watchword: "Don't drink water and don't breathe air."

-- Hugh Johnson (spammy@semplicesoft.com), October 04, 2001.

Fatal malaria epidemic spreads in Afghanistan

By Naveed Ahmad

ISLAMABAD: Impoverished Afghans struggling against drought, war and poverty are on the verge of fatal falciparum malaria epidemics caused by Anopheles mosquitoes.

UNOCHA Spokesperson Stephanie Bunker Wednesday told a crowded news briefing that the newfound enemy of the poor Afghans could be extremely fatal. Dr Sohail Sadiq told this correspondent that falciparum malaria organism enters liver through blood and damages liver cells before coming out and further damaging blood.

Dr Sohail said initially the virus causes fever and jaundice. Due to lack of proper treatment and nutrition, a child, obvious victims and most vulnerable prey, may die within 5 days. Stephanie Bunker termed the epidemic as the most dangerous kind of malaria in Afghanistan.

She said the health group for the humanitarian crisis facilitated by the World Health Organisation along with many UN and NGO partners is now worried about the potential malaria epidemic in the very near future.

"There are malaria epidemic region of Afghanistan in eastern region near Jalalabad, north-eastern in Qandoos," warned the UNOCHA official. The most threatening aspect of the disease that a mosquito carrying infected blood can transmit the disease to another person.

Stephanie said, "preventive measures are being taken. Bed nets and insecticides are being distributed amongst the people." She also mentioned of training being conducted for medical personnel to diagnose and treat the disease quickly. She said 10,000 bed nets are being distributed in the northeastern region alone to control the epidemic.

Stephanie said all of the WHO sub-offices in Afghanistan have pre- positioned anti-malaria drugs in health centres as people inevitably come in with this disease despite these precautions.

The health NGOs and UN agencies are also stating that eastern and central regions are having considerable pressure from population moving from urban areas to rural areas, she explained. Witnesses say the rural clinics are now seeing double the number of the patients than before in eastern regions "which is one indication of pace of population movement".

Stephanie believes a combination of poverty, hunger, war, displacement and abuse of civilians combine to make this country probably the most difficult place in the world to try to survive.

Updating on the communications aspect of the UN agencies in Taliban- controlled Afghanistan, she said the impasse remains unresolved with still one radio operating in Herat and monitored by the Taliban inside a UN office.

She said more radios are being set up in the ministry of public health in Kabul and a public health director's office in Herat for UN staff to use. She regretted that so for the request by Oshima for restoration of UN communications network has failed to get any response.

Meanwhile, in southern Afghanistan, the United Nations deputy regional coordinator met with the governor of Kandahar. The local authorities reassured the United Nations in Kandahar that the staff would be safe and secure.

Generally the report from Southern Afghanistan continue to suggest that the humanitarian conditions are continuing to deteriorate due to drought, loss of income due to ban on poppy production and a conflict because in this area people are being recruited for military.

In another recent development, a large influx of families from Kabul into the Panjsher valley is being reported. About 30 to 40 families, on the average each comprising six people, were coming in by the day and over the weekends 50 to 70 families were arriving in the Panjsher everyday, Stephanie told the media. She said, so far the NGOs in the Panjsher are working normally.

http://www.jang.com.pk/thenews/oct2001-daily/04-10- 2001/main/main11.htm

-- Martin Thompson (mthom1927@aol.com), October 04, 2001.

Media reports of Crimean-Congo haemorrhagic fever in Pakistan 4 October 2001 Media reports have claimed that 75 people, including 8 who have died, have been infected with Crimean-Congo haemorrhagic fever (CCHF) virus in Pakistan, on the border with Afghanistan. The WHO Country Office in Pakistan and its team in Quetta, and the WHO Office for the Eastern Mediterranean Region have investigated this report. Their findings follow: This week, a hospital in Quetta opened a new ward specifically for managing CCHF patients since cases occur each year in the region. As soon as the ward was open, 4 suspected cases were transferred or referred by other health care providers to the new ward. All the cases were from Pakistan, had disease onset within the past week and were not linked. As per the usual procedure, samples have been collected and sent to the National Institute of Health in Islamabad.The total number of suspected CCHF cases reported in Pakistan in 2001 is 41 cases with 12 deaths (onset March to October). An additional 6 cases with 2 deaths (onset May to August) were persons infected in Afghanistan who were treated in Pakistan. In summary, these recent cases exhibit the typical pattern for this endemic disease. CCHF is a viral haemorrhagic fever, primarily a zoonosis, although sporadic cases and small outbreaks of CCHF affecting humans do occur. It is endemic in the area (see Disease Outbreak News Report: 8 May 1998 - Afghanistan; Pakistan). The virus is transmitted by argasid or ixodid ticks. With cooler weather approaching, virus transmission is expected to end within several weeks.

http://www.who.int/disease-outbreak-news/n2001/october/CCHF_Pakistan.h tml

-- Jayne Barnd (jaynbarn@telusplanet.net), October 04, 2001.

Like the Greyhound criminal hijacking that induced every bus in the U.S. to shut down for a time, the world is jittery indeed. The bioterrorism scare was 'nonsense' only in retrospect, like Y2K; but it was mistaken.

Hyperlink: http://news.bbc.co.uk/hi/english/world/south_asia/newsid_1582000/15822 31.stm

WHO dismisses Afghan virus 'scare' Crimean Congo fever resembles the Ebola virus

Reports warning of an outbreak of a deadly viral disease similar to Ebola on the frontier between Afghanistan and Pakistan are "incorrect and misleading," the World Health Organisation (WHO) says. It says reports of a potential epidemic of Crimean Congo Haemorrhagic Fever (CCHF) have been exaggerated.

Nothing suggests it will get worse Ian Simpson, World Health Organisation (WHO) says there have been only 35 reported cases of the virus in the Afghanistan-Pakistan border region this year and only four people are currently being treated. It had been suggested that Afghan refugees were particularly at risk.

Hungry for stories

There were fears that they might spread the virus in Pakistan as they flee from their own country. But WHO says the reports caught the attention of the international media because there are many journalists in the area looking for stories.

Thousands of Afghans have fled to Pakistan The symptoms of CCHF are similar to those of the deadly Ebola virus but Ian Simpson of the WHO Centre for Communicable Diseases in Geneva said there were important differences: "It doesn't spread as quickly, and there is a significantly higher recovery rate."

Mr Simpson told Reuters news agency that the disease would decline with the onset of winter. The ticks that transmit the disease will be wiped out by cold weather, he said. The WHO says that rumours of CCHF being spread as biological warfare are nonsense.

-- Robert Riggs (rxr.999@worldnet.att.net), October 07, 2001.

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