By Azizullah Sharif
Renowned microbiologist and Rector/ Vice Chancellor of Dadabhoy Institute of Higher Education (DIHE) Prof Dr Shahana Urooj Kazmi said that the recent death of a nurse and a surgeon speaks volumes about absence of the Biosafety and Biosecurity practices in healthcare institutions of Pakistan.
Deploring that most of the country’s hospitals, laboratories and blood banks have been openly flouting biosafety protocols, she demanded of the government to immediately set up a centre for surveillance and research on vector-borne diseases in each major city of the country.
She also advocated the need for making it mandatory for all labs to have trained microbiolists.
Prof Kazmi expressed these views in an exclusive interview with the Medical News.
Having more than 39 years of rich experience as an academician, researcher and administrator, Prof Kazmi did her Ph.D in 1984 in Microbiology and Immunology from University of Maryland, USA. She had earlier served Karachi University as Pro-Vice Chancellor (Academics and International Linkages), Acting Vice Chancellor and Dean Faculty of Science and Chairperson of Microbiology Department.
She is also the founder Rector of National University of Agricultural Sciences (now PIAS) – Islamabad , Project Director – National Institute of Genomics and Advanced Biotechnology , Member – Animal Sciences – Pakistan Agricultural Research Council- Islamabad.
To her credit, Prof Kazmi has, so far, supervised research projects of 51 graduate students i.e. 34 MSc. 10 M.Phil and 30 Ph.D students (completed) while seven M. Phil and six Ph.D students are currently working. She has, so far, published more than 100 research papers in international journals of repute.
Her research group at KU and DIHE has been able to identify a number of natural plant products with immune-stimulating properties and activity against the Multiple Drug Resistant clinical isolates of Sal.typhi and the compound has been Patented.
In recognition of her services to education and research in the area of Microbiology, American Society for Microbiology (ASM) honored her with Country Liaison of the year Award in 2011 and ASM Ambassador of the year Award for Pakistan (2012-2017).
She is also a member of National Task Force on Vaccine Development and Technical Committee (TAC) and of Federal Ministry of Environment’s National Biosafety Centre.
Prof Kazmi has founded Pakistan Society for Microbiology in 1974 and Bio-Safety Association of Pakistan in 2007 in collaboration with ASM / ABSA / BEP – USA, PMRC, PARC, COMSTEC, Pakistan.
Talking about emerging threat of Congo fever during Eidul Azha, Prof Kazmi said that diseases carried by ticks include Anaplasmosis, Ehrlichiosis, Lyme Disease, Rickettsiosis, Rocky Mountain Spotted Fever, Southern Tick-Associated Rash Illness, Tickborne relapsing fever, Tularemia, African Tick Bite Fever, Meningoencephalitis, Colorado tick fever, CCHF, Babesiosis and Cytauxziinosis.
Tracing the history of CCHF in Pakistan, she said that first such case was reported at the NIH, Islamabad, in 1976, 187 cases were reported from 1976 to 2002, 403 cases between 2003 and 2004 and 922 cases from 2005-2011.
SMART TICK: She said that CCHF tick is so smart that that when it bites an animal or human being, it secretes a cementing substance into skin that closes the hole with glue, then produces anti-inflammatory chemical so that host may not feel prick as it allows blood to go where it needs to go in the body and hence the tick goes unnoticed by the host though the entire process help the pathogen to establish foothold in the host.
Referring to CCHF’s threat, she said that viral disease transmitted through bite of ticks are found on hairy small ruminants / food animals.
Agreeing that there is a threat of spread of CCHF during Eidul Azha due to influx of animals from endemic areas as well as due to setting up of cattle markets in the thickly populated urban centres of the country, she said infection is transmitted when individuals come in contact with blood, tissues/organs of infected animals and human to human contact is also possible. “By now 19 people had expired, 100 are suspected, most of them in Quetta,”
she said, adding the fatality rate in the case of humans is: 30-50 per cent whereas the mortality rate is: 10-80pc.
SYPTOMS: Apprising about the CCHF symptoms, she said these include fever, myalgia (aching muscles), dizziness, neck pain and vomiting, backache, headache, sore eyes and photophobia, besides there may be nausea, vomiting and sore throat earlier which may lead to diarrhea and generalized abdominal pain.
The other symptom are: Hepatomegaly (liver enlargement) may also result while other clinical signs may include tachycardia (fast heart rate), lymphadenopathy (enlarged lymph nodes) and a petechial rash (a rash caused by bleeding into the skin).
RISK FACTORS: She said that exposure to livestock, infected blood, other secretions etc., are known risk factors.
Talking about the strategies which the authorities concerned should adopt for bringing a halt to spread of CCHF virus, Prof Kazmi said that there has to be spray in animal markets, ban on entry of diseased animals in cities, safe and proper disposal of animals’ waste, besides special wards and lab facilities should be available in hospitals with trained doctors, paramedics and laboratory staff.
Moreover, there has to be designated areas for sample receipt, processing and testing, waste management must be done through Autoclaving and incineration, she suggested.
Asked who are at risk, she said those travelling to endemic area, working in animal facility, laboratory, slaughter house that handles infected animals or virus infected samples as well as those having direct contact with blood, other body fluids , secretions , excretions of a person or animal with CCHF.
She also advised nurses, paramedics and lab staff to be extra cautious while collecting samples, avoid contact with infected blood, body fluids – urine, vomit, feces and never use contaminated needles and syringes.
In case of death due to CCHF, she suggested that family of the deceased person should be informed to follow safe burial protocol which include washing of the body by wearing long rubber gloves or double surgical gloves, spraying of dead body with 1:10 diluted liquid bleach and, thereafter, wrapping of the body in sheet which should be sprayed with bleach solution and finally body be placed in a big plastic bag, sealed with adhesive tape, disinfect the transport vehicle, burn all apparels of the dead person, wear protective clothing in the isolation area, in laundry and in laboratory, clean and disinfect spills, waste, and reusable, etc.
ZIKA VIRUS: Regretting that Zika virus screening facility was not available in the country, Prof Kazmi said that a pregnant woman must be screened for Zika virus before blood transfusion, or else the unborn baby might become victim of Zika, resulting into microcephaly (abnormal smallness of the head, a congenital condition associated with incomplete brain development) and other complications.
She emphasised the need for active surveillance of CCHF and other viruses throughout the year, especially before Eidul Azha and urged Sindh chief minister to set up a task force comprising veterinarians, microbiologists, entomologists for monitoring of livestock as well as for providing proper biosafety training to all the persons concerned.
At the outset, she underscored the need for educating public about the CCHF by conducting seminars and by launching media campaign.