Clinical and laboratory features of Crimean-Congo hemorrhagic fever: predictors of fatality

Çevik, Mustafa Aydın; Erbay, Ayşe; Bodur, Hürrem; Gülderen, Evrim; Baştuğ, Aliye; Kubar, Ayhan; Akıncı, Esragül

doi:10.1016/j.ijid.2007.09.010

Cited by 169 publications

(180 citation statements)

References 20 publications

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“…Experience over the past decade in Turkey has shown that gingival bleeding, ecchymoses, hematemesis, diarrhea, melena, confusion and somnolence are significantly more common in fatal cases (Ergonul et al, 2006a;Cevik et al, 2008;Hatipoglu et al, 2010). Lethal illness was associated with more severe thrombocytopenia, more prolonged PT and aPTT, lower fibrinogen levels and increased serum AST and ALT (Ergonul et al, 2006a;Ozkurt et al, 2006;Onguru et al, 2010).…”

Section: Predictors Of Survival or Deathmentioning

confidence: 99%

Crimean-Congo hemorrhagic fever: History, epidemiology, pathogenesis, clinical syndrome and genetic diversity

et al. 2013

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Bente, Dennis A.; Forrester, Naomi L.; Watts, Douglas M.; McAuley, Alexander J.; Whitehouse, Chris A.; and Bray, Mike, "CrimeanCongo hemorrhagic fever: History, epidemiology, pathogenesis, clinical syndrome and genetic diversity" (2013 b s t r a c tCrimean-Congo hemorrhagic fever (CCHF) is the most important tick-borne viral disease of humans, causing sporadic cases or outbreaks of severe illness across a huge geographic area, from western China to the Middle East and southeastern Europe and throughout most of Africa. CCHFV is maintained in vertical and horizontal transmission cycles involving ixodid ticks and a variety of wild and domestic vertebrates, which do not show signs of illness. The virus circulates in a number of tick genera, but Hyalomma ticks are the principal source of human infection, probably because both immature and adult forms actively seek hosts for the blood meals required at each stage of maturation. CCHF occurs most frequently among agricultural workers following the bite of an infected tick, and to a lesser extent among slaughterhouse workers exposed to the blood and tissues of infected livestock and medical personnel through contact with the body fluids of infected patients. CCHFV is the most genetically diverse of the arboviruses, with nucleotide sequence differences among isolates ranging from 20% for the viral S segment to 31% for the M segment. Viruses with diverse sequences can be found within the same geographic area, while closely related viruses have been isolated in far distant regions, suggesting that widespread dispersion of CCHFV has occurred at times in the past, possibly by ticks carried on migratory birds or through the international livestock trade. Reassortment among genome segments during co-infection of ticks or vertebrates appears to have played an important role in generating diversity, and represents a potential future source of novel viruses. In this article, we first review current knowledge of CCHFV, summarizing its molecular biology, maintenance and transmission, epidemiology and geographic range. We also include an extensive discussion of CCHFV genetic diversity, including maps of the range of the virus with superimposed phylogenetic trees. We then review the features of CCHF, including the clinical syndrome, diagnosis, treatment, pathogenesis, vaccine development and laboratory animal models of CCHF. The paper ends with a discussion of the possible future geographic range of the virus. For the benefit of researchers, we include a Supplementary Table listing all published reports of CCHF cases and outbreaks in the English-language literature, plus some principal articles in other languages, with total case numbers, case fatality rates and all CCHFV strains on GenBank.

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Section: Predictors Of Survival or Deathmentioning

confidence: 99%

Crimean-Congo hemorrhagic fever: History, epidemiology, pathogenesis, clinical syndrome and genetic diversity

et al. 2013

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“…The overall mortality rate of CCHF disease was 17.3% in this study. Our mortality rate is higher than the average for Turkey (5.4%) (32). In the current study, decreased platelet counts, increased LDH and prolonged aPTT were identified as predictors of mortality in univariate analysis.…”

Section: Discussionmentioning

confidence: 38%

“…Serum ChT could be a prognostic marker in patients with CCHF. Different predictors of fatality were reported as risk factors for CCHF (27,(29)(30)(31)(32), and those previously defined severity criteria were not always consistent. These criteria include decreased platelet counts, prolonged aPTT, increased AST, ALT and LDH activities in a univariate analysis from five different studies.…”

Section: Discussionmentioning

confidence: 82%

Serum chitotriosidase enzyme activity in patients with Crimean-Congo hemorrhagic fever

Kurt

Çaycı

Öngürü

et al. 2009

Clinical Chemistry and Laboratory Medicine

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Background: Crimean-Congo hemorrhagic fever (CCHF) is a public health problem in many countries. Chitotriosidase (ChT) is an enzyme secreted by activated macrophages that catalyzes the hydrolysis of chitin and chitin-like substrates. The goal of this study was to assess the relationship between serum ChT activity and mortality. Methods: ChT activities on the first day of hospitalization were analyzed in serum from 46 patients with CCHF and 36 healthy controls. Serum ChT activities and other clinical and laboratory parameters for patients with non-fatal and fatal CCHF were compared. Results: The median ChT activity was increased in all patients with CCHF w189.9 (134.8-246.6) nmol/mL/hx. The median ChT activity in the non-fatal CCHF group w220.2 (180.6-290.1) nmol/mL/hx was higher compared with the fatal CCHF group w29.2 (16.5-45.7) nmol/mL/hx (p-0.001). In univariate analysis, platelet count, lactate dehydrogenase (LDH), and activated partial thromboplastin time were associated with mortality. Conclusions: This is the first study investigating the association of serum ChT enzyme activity with mortality from CCHF. This study suggested that relatively low ChT enzyme activities may be a prognostic marker in patients with CCHF. Clin Chem Lab Med 2009;47:1543-7.

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“…6 In trials conducted on CCHF, leukocytosis, elevated ALT and AST, PT and aPTT and LDH (lactate dehydrogenase) values were used in assessing prognosis. 4,11,12 No information is available in the literature indicating the role of blood groups in the prognosis of CCHF. In the current trial, high ALT and AST levels and low leukocyte and platelet values were observed, in accordance with the results of other trials.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 The disease is prevalent in a wide geographic area encompassing Asia, Eastern Europe, Africa, and Russia. 3,4 Since 2002 it has been seen in central, northern, and eastern regions of Turkey. 5 CCHF is transmitted to humans via tick bites and may lead to symptoms of fever, nausea, asthenia, headache, abdominal pain, diarrhea, myalgia, petechia, and bleeding.…”

Section: Introductionmentioning

confidence: 99%

Is blood group associated with mortality in Crimean-Congo Hemorrhagic Fever?

Duygu¹

2011

JMID

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Objectives: In this trial, our purpose was to determine the distribution of blood groups in Tokat region and CrimeanCongo hemorrhagic fever (CCHF) patient group and to investigate the impact of blood groups on fatal prognosis of the disease. Material and Method:Demographic and laboratory values and blood groups of patients were recorded. In addition, distribution of blood groups among blood donors who referred to the blood center during same time interval was determined.Results: Distribution of blood groups among CCHF patients and donors in blood center were found to be similar to Turkish data (P>0.05). On the other hand, a discrepancy was determined in blood group distribution of CCHF patients with a fatal outcome, with a significantly high rate of AB Rh negative blood group in this patient group (P<0.001). Conclusion:We suggest that blood group may be associated with mortality in CCHF patients and AB Rh negative blood group may be an indicator of poor prognosis. J Microbiol Infect Dis 2011;1(3):118-121

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Clinical and laboratory features of Crimean-Congo hemorrhagic fever: predictors of fatality

Abstract: Thrombocytopenia of < or = 20 x 10(9)/l, a prolonged aPTT > or = 60s, the existence of melena, and somnolence were independent predictors of fatality.

Cited by 169 publications

References 20 publications

Crimean-Congo hemorrhagic fever: History, epidemiology, pathogenesis, clinical syndrome and genetic diversity

Crimean-Congo hemorrhagic fever: History, epidemiology, pathogenesis, clinical syndrome and genetic diversity

Serum chitotriosidase enzyme activity in patients with Crimean-Congo hemorrhagic fever

Is blood group associated with mortality in Crimean-Congo Hemorrhagic Fever?

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