Seroprevalence of Crimean–Congo hemorrhagic fever among health care workers in a hospital in an endemic region of Turkey

Abstract

Introduction: Crimean-Congo Hemorrhagic Fever (CCHF) can also be transmitted through unprotected contact directly with blood or body fluids as well as from laboratories. This study aimed to determine the seroprevalence of CCHF disease in the employees of the State Hospital of Yozgat Province, located in Central Anatolia of Turkey, and also to present the risk factors for healthcare workers. Methodology: A total of 112 volunteer employees of Yozgat State Hospital were included in the study. The study volunteers were divided into two groups: one having had a contact with CCHF patients and patient's samples and the other a non-contact group. Results: In the contact group, 2 (2.9%) out of 67 subjects tested positive for anti-CCHF IgG; however, in the non-contact group, none of the subjects tested positive (Fisher's exact test p > 0.05). Of the two employees who tested positive, one was working at the microbiology laboratory and the other was from the emergency department. Conclusion: Although cases of nosocomial transmission of CCHF have been reported previously, questions on the mode of transmission of the disease are still unanswered. The risk factors for the disease should, therefore, be identified in order to take the necessary measures.

Seroprevalence of Crimean-Congo hemorrhagic fever in humans in the World Health Organization European region: A systematic review

“…The studies conducted in Turkey also showed high variability. Most studies showed a seroprevalence that ranged from low values (0.5% [44], 1.2% [38], 1.8% [49], 2.3% [50], and 3.7% [42]) to moderate values (9.6% [48], 10% [4], 10.9% [41], 12.8% [45], 13.6% [47], 14.4% [34], and 15.8% [37]. One study showed a much higher prevalence (19.6% [39]), but this study was performed in an endemic area in southwestern Turkey.…”

“…factor was the tick exposure; tick exposure includes direct physical contact, tick bites, tick removal from people and animals and exposure to ticks around the working and home environments [12,31,33,[35][36][37]39,43,45,[47][48]52]. To a lesser extent, health care workers (physicians and nurses), veterinarians [38,44,[48][49] and individuals with slaughtering-associated jobs [6,30,31] were also more likely to have the presence of CCHFV IgG antibodies. Minor risk factors, such as gender and aging (risk markers) have been reported in some studies [4,29,31,33,[35][36][39][40][41][42]45,47,50] in association with the presence of antibodies, but the heterogeneity of the studies and the populations that were evaluated prevent us from exhaustively affirming these results.…”

“…Minor risk factors, such as gender and aging (risk markers) have been reported in some studies [4,29,31,33,[35][36][39][40][41][42]45,47,50] in association with the presence of antibodies, but the heterogeneity of the studies and the populations that were evaluated prevent us from exhaustively affirming these results. Other risk factors that were evaluated were related to geographical aspects, such as residence in a hilly territory/living at an altitude [32][33], living in rural vs urban areas [26,37,47,50], in adobe houses [51], geographic regions as Black Sea Coast [36][37][38][39][40][41] and others [27,31,35,48] or endemic areas [40,43,47,49].…”

“…PRISMA flowchart of identified and selected studies in the systematic review.https://doi.org/10.1371/journal.pntd.0008094.g001PLOS NEGLECTED TROPICAL DISEASESarticles[51][52][53]. Even though the geographical origin was diverse, most studies were performed in Turkey (central Europe) (13 articles)[4,34,[37][38][39][41][42][44][45][47][48][49][50] and in Greece (western Europe) (7 articles)[6,26,[29][30][31][32][33].…”

Seroprevalence of Crimean Congo Hemorrhagic Fever Virus in Occupational Settings: Systematic Review and Meta-Analysis

“…Due to the high prevalence in animal species, CCHFV has the potential to be acknowledged as a pathogen of occupational interest among workers occupationally exposed to animals, animal products, and animal bodies (e.g., abattoir workers, animal farmers, rangers/hunters, veterinarians, etc.) [ 12 , 13 , 21 , 22 , 23 , 24 , 25 ], but also in subjects occupationally exposed to contaminated bodily fluids (i.e., healthcare workers) [ 12 ], as otherwise suggested by previous reports on small nosocomial outbreaks [ 26 , 27 , 28 ]. Even though working in direct contact with infected animals and animal products has been repeatedly associated with increased risk for CCHFV infection, and despite that several systematic reviews on CCHFV in humans have been published [ 8 , 12 ], including some estimates on the seroprevalence rate among healthcare workers [ 8 , 10 , 21 ], to the best of our knowledge, no comprehensive summary of seroepidemiological studies from occupational settings has ever been published.…”