key: cord-0762087-tw84h06q authors: Greene, Leah; UWISHEMA, Olivier; Nicholas, Aderinto; Kapoor, Arushi; Berjaoui, Christin; Adamolekun, Emmanuel; Khoury, Carlo; Yagoub, Fatima Elbasri Abuelgasim Mohammed; Onyeaka, Helen title: Crimean-Congo Haemorrhagic Fever During the COVID-19 Pandemic in Africa: Efforts, Recommendations and Challenges at Hand date: 2022-02-21 journal: Afr J Emerg Med DOI: 10.1016/j.afjem.2022.02.004 sha: 6784b6a78f75ee34ee4cb70ec53248c51990a4eb doc_id: 762087 cord_uid: tw84h06q Since the beginning of the COVID-19 pandemic, millions have suffered globally and as a result, attention and resources for other diseases, such as Crimean-Congo Haemorrhagic Fever (CCHF), has declined. Despite a significantly lower incidence rate compared to COVID-19, CCHF has a considerably higher mortality rate at approximately 30%. Both diseases share symptoms such as headache, fever, nausea and vomiting, fatigue, sore throat, however they have different modes of transmission, mortality rates, and incubation periods. Public health professionals have faced several challenges when attempting to prevent and control the spread of both diseases and despite their differences, many of the prevention methods remain the same. These include increasing public awareness regarding avoiding contact with infected individuals and animals, training healthcare professionals in emergency and preparedness for disease outbreaks and increasing the investment in medical supplies and treatment to control the spread of both diseases. In December 2019, the severe acute respiratory syndrome coronavirus 2, SARS-CoV-2 infection, later known as COVID-19, was discovered in Wuhan, China. Symptoms of this virus include fever, dry cough, and lung involvement1. The global pandemic that followed has posed a severe threat to public health worldwide. COVID-19 continues to jeopardise many health programs, especially in low and middle-income countries. Over 1.3 million people missed their first measles vaccinations, and 362,000 women in Nigeria missed antenatal treatment, resulting in a 50% increase in maternal deaths in health facilities from 2019, according to the World Health Organization (WHO) 2 . Crimean-Congo Haemorrhagic Fever (CCHF) was first described following World War II during an outbreak among 200 Soviet military recruits in the Crimean Peninsula 3 CCHF has many unique symptoms that can help clinically differentiate between a COVID-19 infection. Employment history plays a major factor as well with people working in the cattle sector, such as agricultural laborers, slaughterhouse employees, and veterinarians, at a higher risk of contracting CCHF 9 . A week after initial symptoms, the clinical difference becomes much clearer with the increased risk of bleeding in patients with CCHF infections which does not occur in COVID-19 infections 10 . Disease characteristics of COVID-19 and CCHF are listed in Table 1 . Given the challenges involved with controlling CCHF, several actions should be implemented to minimise its effects and eventually prevent the spread of the disease. The public should be informed on ways to protect themselves from human-to-animal transmission such as wearing gloves and light-coloured, longsleeved clothes covered in acaricides and tick repellents. They should also avoid unpasteurised milk, cook food at an appropriate temperature, and disinfect materials used in both kitchens and butchery. Healthcare professionals need proper training to differentiate between symptoms of CCHF and COVID-19. Furthermore, medical facilities need more protective equipment (PPE), hygiene products, disposable isolative curtains, properly equipped medical laboratories with advanced diagnostic equipment such as CT scanners and PCR tests, and medical supplies such as disposable needles and syringes. Mobile field hospitals should also be set up exclusively for treating CCHF and COVID-19 separately and promoting safe burial practices and proper guidelines for disposing of medical waste. Since the start of the Authors contributed as follow to the conception or design of the work; the acquisition, analysis, or interpretation of data for the work; and drafting the work or revising it critically for important intellectual content: • Leah contributed 50%, Olivier 25%, Helen and Fatima 10%, Aderinto, Arushi , Christin, Emmanuel and Carlo 15 %. • All authors approved the version to be published and agreed to be accountable for all aspects of the work. No conflict of interest declared and have not received any financial support for this manuscript. An overview of COVID-19 Opening statement Nature focus of zone infections in the Crimea Congo virus: a hitherto undescribed virus occurring in Africa. I. Human isolations--clinical notes Crimean-Congo haemorrhagic fever Crimean-Congo haemorrhagic fever Crimean Congo hemorrhagic fever case reported in Mauritania Crimean-Congo hemorraghic fever (CCHF) Symptoms of COVID-19. Center for Disease Control Crimean-Congo hemorrhagic fever (CCHF): signs and symptoms Mortality risk of COVID-19. 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