CCHF appears to be a seasonal problem in the Mid-Eastern Anatolia region of Turkey. The possible risk factors for transmission and the clinical and laboratory findings of patients with a diagnosis of CCHF were found to be similar to those reported in the literature. The mean fatality rate for Turkey is lower than the rate reported for other series from other parts of the world.
The more than 1100 human cases of Crimean-Congo Hemorrhagic Fever (CCHF) reported in a continuing series of outbreaks that started in 2003 in Turkey constitute the largest epidemic of the disease since CCHF was first recognized in 1944. The spatial distribution of CCHF case reporting rates in Turkey was studied to look for clusters of disease. We applied the spatial scan analysis to test the hypothesis of whether there were areas with a higher than expected number of CCHF cases. The analysis was conducted through windows of 10, 20, 40 and 80 km in diameter[SR1] to determine whether clustering of cases was dependent on the size of the scanning window. At the largest window size, consistent patterns of significantly higher than expected numbers of CCHF cases were found in a total of 40 administrative districts. A predictive model to map the habitat suitability for the vector tick was developed from satellite-based climate data and high-resolution features of the vegetation from Landsat images covering the whole country. It was found that areas of higher risk (higher CCHF reporting) were correlated (p<0.05) with zones of high climate suitability for the tick together with a high rate of fragmentation of agricultural land interspersed between forest and shrub-type vegetation.
Crimean-Congo haemorrhagic fever (CCHF) is an arbovirus infection, which is transmitted through ticks or via blood and secretions. Until recently, human cases of CCHF were unknown in Turkey; however, several acute disease cases were reported in 2002. We report on the investigation of a cluster of suspected CCHF cases in the middle part of the Black Sea from May 2002 to October 2003. The medical charts that we reviewed were obtained from all local physicians and our field investigations. 'Suspected case' was defined with regard to time, place, and both clinical and laboratory characteristics. A total of 108 patients were defined as suspected case. Among them 36 patients were reached and blood samples taken for examination for CCHF by using ELISA and RT-PCR. According to the laboratory analysis, 80.6% (29/36) were acute cases and 8.3% (3/36) were past CCHF infections. The overall mortality rate was 5.6%. There was no nosocomial infection; however, there were 2 family clusters. Tick exposure was the most prevalent risk factor (74.2%). A multidisciplinary collaboration should be developed in order to understand the magnitude of the disease and also to keep it under control.
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