Skopje, 8 August 2023 (MIA) — Ten family members and one health worker who had been in close contact with the Infectious Diseases Clinic staff member currently hospitalized with Crimean–Congo hemorrhagic fever have been surveyed and will be kept under symptom monitoring by telephonic interviews with epidemiologists in an attempt to stop the virus from spreading, State Sanitary and Health Inspectorate director Renata Mladenovska said Tuesday.

According to Mladenovska, the contact tracing was undertaken on Aug. 5, immediately after the Public Health Institute informed the Center for Public Health in Skopje about the second confirmed case of Crimean–Congo hemorrhagic fever reported in the past two weeks.

"The female patient, that is, her contacts, will have to call and be in constant contact with an epidemiologist on duty in the Skopje Center for Public Health. This is not classical isolation, but they should not have any contact with others, even if it is their immediate family," Mladenovska said.

"They simply need to make it through these 14 days so this infection does not spread. I hope that this will be the last case," she added.

According to Mladenovska, out of the 29 identified contacts of the first case of Crimean–Congo hemorrhagic fever reported in late July, the currently hospitalized health worker was the only one who had developed a secondary infection so far.

The first reported case of Crimean–Congo hemorrhagic fever was a 27-year-old woman from the village of Kuchica in the Shtip municipality of Karbinci. Her initial symptoms started on July 21, after she had been bitten by a tick two days earlier. She was hospitalized on July 23 and died on July 30.

Earlier on Tuesday, Commission for Infectious Diseases chair Zlate Mehmedovikj told MIA that there was no need for panic as more cases of Crimean–Congo hemorrhagic fever were not expected in the near future.

The first case was a case of direct infection and the secondary case was probably caused by handling contaminated blood, Mehmedovikj said.

According to papers published by the National Library of Medicine at the US National Institutes of Health, Crimean–Congo hemorrhagic fever is a zoonotic viral disease caused by tick-borne virus Nairovirus (family Bunyaviridae). It is one of the severe forms of hemorrhagic fever endemic in Africa, Asia, Eastern Europe and the Middle East. The viral infection has a fatality rate of up to 50% during outbreaks.

Ticks of the genus Hyalomma act as the reservoir and the vector responsible for viral transmision. The disease is generally asymptomatic in infected animals but highly fatal in humans. The disease in humans begins as non-specific flu-like symptoms (fever, muscle aches, headache), which can lead to organ failure and internal bleeding.

Secondary human-to-human transmission occurs through direct contact with the blood, secretions, organs, or other body fluids of infected persons. It has also been shown that the virus has the potential to be transmitted by aerosols. mr/