Evaluation of patients with Crimean-Congo hemorrhagic fever in Bolu, Turkey

Abstract

Background: Crimean-Congo hemorrhagic fever (CCHF), which is associated with a high mortality rate in the Black Sea region of Turkey, has received increasing attention. Objective: In this study, the epidemiological features, clinical and laboratory findings, treatments, and outcomes of patients diagnosed with CCHF between 2006 and 2012 based on data obtained from the Bolu Provincial Directorate of Health (BPDH) were evaluated. Methods: BPDH data were reviewed for the period between 1 January 2006 and 31 July 2012. The locations where the tick had attached to the patient, the site of the tick bite on the patient's body, the dates of tick bite and removal, and the demographic characteristics of each patient were recorded. BPDH data on the total number of tick bites, patients with confirmed CCHF, and deaths due to CCHF in Bolu Province during the study period were also evaluated. Results: A total of 46 patients with CCHF and 38 patients without CCHF but who had been bitten by ticks were admitted to the BPDH. Of the patients with CCHF, 54.3% were female. The mean age of the patients was 46.88 ± 2.05 years (range, 1-79 years). The mortality rate was 8.82%. Patients were predominantly observed in June and July. When the patients were distributed according to their occupations, the majority was houswife (48.6%), followed by animal husbandry worker (27.0%), farmer (10.8%), health worker (5.4%), and other (8.1%). The symptoms of the patients with CCHF included fatigue (60.9%), fever (60.9%), and myalgia (60.9%). Of those patients with CCHF, 41.3% were determined to have a high fever. Conclusions: The probability of developing CCHF decreased as the duration of tick attachment increased. Moreover, although the clinical presentation is important, it is not diagnostic. Physical examination and laboratory findings become more specific in later stages.

Evaluation of cases with a preliminary diagnosis of Crimean- Congo hemorrhagic fever and comparison of characteristics in patients admitted to a secondary care hospital in Kastamonu, Turkey.

“…In Iran, contact with infected humans and animals was higher in the CCHF group than the non-CCHF group, but, a history of tick bite was not a risk factor 20 . Similarly, contact with animals was more commonly reported in CCHF cases than non-CCHF cases, but, a history of tick bite was similar between the two groups in Bolu, Turkey 21 . We found that the frequency of tick bites was significantly higher in CCHF cases than non-CCHF cases (p<0.05).…”

“…In some studies, fever, bleeding, vomiting, headache and diarrhea were reported more frequently in cases with CCHF than non-CCHF cases 20,21 . In our study, there were no significant differences between the two groups in terms of clinical findings during admission (p>0.05).…”

“…In some studies, thrombocytopenia, increased AST-ALT and LDH levels were reported more commonly among cases with CCHF than non-CCHF cases 20,21 . In our study, CK elevation was more common in CCHF cases (p<0.05), but, other laboratory findings during admission were found to be similar between the two groups (p>0.05).…”

“…Despite these limitations, all patients admitted to our hospital were included the study. There are a few studies evaluating cases with a preliminary diagnosis of CCHF [19][20][21][22] . In this regard, there is a need for more comprehensive research.…”

“…This rate ranges between 21% and 57% [19][20][21][22] . In this study, cases of CCHF admitted to a secondary care hospital in Kastamonu in 2013 were evaluated in terms of their clinical, laboratory and epidemiological characteristics.…”