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      Crimean-Congo Hemorrhagic Fever Virus in High-Risk Population, Turkey

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          Abstract

          In the Tokat and Sivas provinces of Turkey, the overall Crimean-Congo hemorrhagic fever virus (CCHFV) seroprevalence was 12.8% among 782 members of a high-risk population. CCHFV seroprevalence was associated with history of tick bite or tick removal from animals, employment in animal husbandry or farming, and being >40 years of age.

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          Crimean-Congo haemorrhagic fever

          Önder Ergönül (2006)
          Summary Crimean-Congo haemorrhagic fever (CCHF) is an often fatal viral infection described in about 30 countries, and it has the most extensive geographic distribution of the medically important tickborne viral diseases, closely approximating the known global distribution of Hyalomma spp ticks. Human beings become infected through tick bites, by crushing infected ticks, after contact with a patient with CCHF during the acute phase of infection, or by contact with blood or tissues from viraemic livestock. Clinical features commonly show a dramatic progression characterised by haemorrhage, myalgia, and fever. The levels of liver enzymes, creatinine phosphokinase, and lactate dehydrogenase are raised, and bleeding markers are prolonged. Infection of the endothelium has a major pathogenic role. Besides direct infection of the endothelium, indirect damage by viral factors or virus-mediated host-derived soluble factors that cause endothelial activations and dysfunction are thought to occur. In diagnosis, enzyme-linked immunoassay and real-time reverse transcriptase PCR are used. Early diagnosis is critical for patient therapy and prevention of potential nosocomial infections. Supportive therapy is the most essential part of case management. Recent studies suggest that ribavirin is effective against CCHF, although definitive studies are not available. Health-care workers have a serious risk of infection, particularly during care of patients with haemorrhages from the nose, mouth, gums, vagina, and injection sites. Simple barrier precautions have been reported to be effective.
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            Characteristics of patients with Crimean-Congo hemorrhagic fever in a recent outbreak in Turkey and impact of oral ribavirin therapy.

            Önder Ergönül, Harika Esener, Sebnem Cevik … (2004)
            We describe the epidemiological, clinical, and laboratory findings and the role of ribavirin therapy for 35 patients who received a diagnosis of Crimean-Congo hemorrhagic fever (CCHF). All patients had immunoglobulin M antibodies and/or PCR results positive for CCHF virus in blood or tissue specimens. Eighty-six percent of the patients were considered to have severe cases of CCHF. The overall case-fatality rate was 2.8%. Eight patients were given ribavirin, and all 8 survived. We suggest using ribavirin to treat patients with CCHF, particularly those with severe cases.
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              Crimean-Congo haemorrhagic fever outbreak in Middle Anatolia: a multicentre study of clinical features and outcome measures.

              Mehmet Tasyaran, Mehmet Bakir, Haluk Vahaboglu … (2005)
              A Crimean-Congo haemorrhagic fever (CCHF) outbreak emerged from 2001 to 2003 in the Middle Anatolia region of Turkey. This study describes the clinical characteristics and outcome features of CCHF patients admitted to four tertiary care hospitals in Turkey. Definitive diagnosis was based on the detection of CCHF virus-specific IgM by ELISA or of genomic segments of the CCHF virus by RT-PCR. Related data were collected by a retrospective chart review. Hospital costs were extracted from the final discharge bills. Univariate and multivariate analyses were conducted to determine the independent predictors of mortality. CCHF virus-specific antibodies or genomic segments were detected in the sera of 99 cases. Seven cases that were treated with ribavirin were excluded from the study. Cases were mostly farmers (83 cases, 90 %), and 60 % had a tick-bite history before the onset of fever. Impaired consciousness and splenomegaly were independent predictors of a fatal outcome.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Emerg Infect Dis
                Journal ID (publisher-id): EID
                Title: Emerging Infectious Diseases
                Publisher: Centers for Disease Control and Prevention
                ISSN (Print): 1080-6040
                ISSN (Electronic): 1080-6059
                Publication date (Print): March 2009
                Volume: 15
                Issue: 3
                Pages: 461-464
                Affiliations
                [1]Cumhuriyet University, Sivas, Turkey
                Author notes
                Address for correspondence: Nazif Elaldi, Cumhuriyet University, Medical Faculty, Department of Infectious Diseases and Clinical Bacteriology, 58140, Sivas, Turkey; email: nelaldi@ 123456cumhuriyet.edu.tr
                Article
                Publisher ID: 08-0687
                DOI: 10.3201/eid1503.080687
                PMC ID: 2681111
                PubMed ID: 19239765
                SO-VID: 41cf35b1-d0dc-4d40-bb24-e72b2f92adf3
                History
                Categories
                Subject: Dispatch

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: epicenter,turkey,seroprevalence,crimean-congo hemorrhagic fever,dispatch
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: epicenter, turkey, seroprevalence, crimean-congo hemorrhagic fever, dispatch

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