Crimean-Congo Haemorrhagic Fever Cases Without Travel History to Endemic Areas in Adıyaman

Abstract

Objective: We aimed to draw attention for the first time to patients with Crimean-Congo haemorrhagic fever (CCHF) who lived in rural Adıyaman with no travel history to endemic areas. Methods: Five cases with fever living in rural areas and diagnosed as CCHF in Emergency Department, Training and Research Hospital, Adıyaman University between May 2014 and June 2015 were evaluated. Polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA) were used in Microbiology Reference Laboratory of Public Health Institute of Turkey to detect CCHF virus RNA and IgM antibodies, respectively. Results: A tick was found in the inguinal region of one patient during physical examination after admission. Three patients had a history of tick bite, while there was no history of tick contact in one patient. All patients received supportive treatment. Two patients were given fresh frozen plasma and platelet suspension because of bleeding and thrombocytopenia. All patients were discharged with full recovery. Conclusions: More attention should be given to detailed medical history and physical examination if there is no explanation for clinical picture in patients with fever living in rural areas and admitted to emergency department during months when the CCHF cases are common in Turkey. Scalp, inguinal and axillary regions of patients should be carefully checked for tick attachment.