An outbreak of a highly contagious Ebola-style disease that causes patients to bleed to death from every orifice was confirmed yesterday on Pakistan?s frontier with Afghanistan. It?s the largest outbreak of this type of disease in history.

At least 75 people have caught the disease so far and eight have died. An isolation ward that is screened off by barbed wire has been set up in the Pakistani city of Quetta.

Evidence suggests the disease originated within Afghanistan, raising Pakistani fears of an epidemic if refugees continue to flee across the frontier into Pakistan. Crimean-Congo Hemorrhagic Fever (CCHF) has symptoms that are similar to Ebola. 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 it ?literally melts in front of your eyes.?

At the Fatima Jinnah Chest and General Hospital in Quetta, an isolation ward with eight beds has been set up. Nine-year-old Ismail Sadiq is one of the patients there. He has a high fever and wads of cotton are stuffed into his nostrils to stem the bleeding. Members of his family wait anxiously outside, in the shade of a tree. Doctors have forbidden all visits, so the only people Ismail sees are doctors and nurses wearing masks, gloves, gowns and shoes coverings.

Another patient, who is a 65-year-old man, lies on his bed with streams of blood drying on his chin, nose and tongue. His shirt is stained with blood.

Dr. Akhlaq Hussain, the hospital?s medical superintendent, says, ?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 center in Islamabad. They were then sent to South Africa?s National Institute of Virology in Johannesburg for confirmation. Dr. Hussain says, ?When the results came back we knew we were dealing with Crimean-Congo Haemorrhagic Fever.? The 75 cases that have since been discovered all involve refugees recently arrived from Afghanistan or people living close to the border.

The first known case of the disease occurred among Russian soldiers serving in the Crimea in 1944 and then among villagers living near the Congolese city of Kisangani in 1956. Scientists were not able to isolate the single virus common to both outbreaks until 1969. Although there have been a number of cases since, the outbreaks have never been as large as the current one.

Dr. Hussain says, ?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 [the refugees] come in large numbers with large numbers of animals we can expect many more cases.? The virus is found in the blood of sheep, cattle and other mammals in Europe, Asia and Africa. It can be passed to man by a species of tick that is common to these areas.

The authorities in Pakistan have appealed to the World Health Organization for additional supplies to help deal with the outbreak, including storage facilities for clean blood plasma and white blood cells. If caught in time, CCHF can be treated by replacing enough lost body fluids to allow the patient?s own immune system to take over and kill the virus.

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