Crimean Congo Hemorrhagic Fever in Eastern Turkey: Epidemiological and Clinical Evaluation

Abstract

Objective: The present study aimed to evaluate Crimean-Congo Haemorrhagic Fever (CCHF) in patients hospitalized in our hospital. Methods: A total of 61 adult patients who were diagnosed as having CCHF between January 2011 and August 2018, in whom the diagnosis was confirmed by detecting virus-specific IgM by ELISA and/or by showing viral RNA by RT-PCR and who were managed at our clinic were evaluated retrospectively for their epidemiological and clinical findings, treatment and prognosis. Results: Of the 61 cases, 41 (67.2%) were male and 20 (32.8%) female. The mean age of the patients was 45.31±2.12 years. Sixty (98.4%) patients were living in rural area. Forty four patients (72.1 %) had a tick-bite history. According to months, most of the cases were seen in June, July and May, respectively. Fever, weakness and loss of appetite were the most common complaints of the patients. Treatment of ribavirin was started on the day of admission in all patients. One patient who was admitted in the late period died. The other 60 patients were discharged after being healed. Conclusions: Especially during summers when the disease is seen frequently, the history of tick contact should be questioned and tick should be searched in the examination in the patients with suspected clinical findings. A significant number of the patients do not have a known tick contact. Therefore, training meetings should be organized about the symptoms and findings of the disease in the endemic areas and awareness should be raised among the community and the doctors working in emergency services and primary care.

Diagnostic Value of Non-specific Clinical and Laboratory Findings in Patients Suspected of Crimean-Congo Hemorrhagic Fever in an Endemic Region

“…In our study, male: female ratio was comparable between the groups, while history of husbandry was found to be more common (60.5%) in the positive group (p<0.001). The rate of tick bite history varies from 60% to 73% in the literature (2,4,10). We found as 57.9% in the positive group, indicating a lower rate compared to the literature.…”

“…Detection of specific IgM and IgG antibodies using immunofluorescence assay (IFA) and viral RNA using real-time polymerase chain reaction (RT-PCR) are used in the diagnosis (9). In previous studies, the rate of tick bite history ranged from 60% to 73% in cases with CCHF (2,4,10). Thus, CCHF is suspected in cases presented with non-specific findings regardless of tick bite history in endemic regions.…”

Kırım-Kongo Kanamalı Ateşi ile Eş Zamanlı Akut Lenfoblastik Lösemi Tanısı Alan Olgu

“…KKKA genellikle kırsal kesimde yaşayan ve hayvancılıkla uğraşanlarda görülen; cilt, mukoza ve organ kanamalarıyla birlikte ağır seyredebilen kenelerle bulaşan viral kanamalı ateş grubunda bir hastalıktır 2 . Öyküde kene tutunması sorgulanması çok önemli olup olguların %60'ında bu öykü alınabilmektedir 9 . Olgumuz kütüphanede çalışmakta olup hayvan teması olmaması nedeniyle başlangıçta KKKA düşünülmemiş, sonrasında öyküsü derinleştirildiğinde kırsal bölgeye seyahat ettiği ve bu sırada kene tutunduğu öğrenilmiştir.…”

“…Orta, Doğu Anadolu bölgeleri ve Karadeniz'in batı ve güney kesimleri endemik bölgeler olup birçok olgu bil-Çayıröz P, Çayıröz MU, Iltar U, Kurtoğlu E. dirimi bulunmaktadır. Bunun yanında Batı Anadolu bölgelerinde sporadik olarak görülmektedir 9 . Olgumuz 2019 yılında Burdur ilinde görülen ilk olgu özelliğini taşımaktadır 14 .…”

“…Sıvı replasman tedavisi, kanaması olan olgularda buna yönelik kan ürünlerinin replasmanı önceliklidir. Yapılan çalışmalarda hastalığın erken döneminde özellikle vireminin olduğu ilk yedi gün ribavirin kullanılmasının etkili olduğu bildirilmektedir 9 . Bizim olgumuz geç dönemde gelen bir olgu olduğu ve konvalesan dönemde olduğu kabul edildiği için öncelikli olarak ribavirin tedavisi verilmesi planlanmamıştır.…”