Crimean-Congo Hemorrhagic Fever

Abstract

Crimean-Congo hemorrhagic fever (CCHF), a tick-borne viral hemorrhagic fever, is a zoonotic infection that caused by CCHF virus (CCHFV) of the family Bunyaviridae, genus Nairovirus. Transmission occurs mainly by Hyalomma m. marginatum tick exposure. Blood and bloody excretions of the patients are highly infectious and contact of skin and mucous membrane may lead to CCHF transmission. CCHF was described firstly in the Crimean peninsula in 1944, in former Soviet Union and in Kelkit Valley in 2002 in Turkey. By the year 2013, it has been notified in more than 30 countries of Asia, the Middle East, Southeastern part of Europe and Africa. The disease is characterized by fever and thrombocytopenia, in severe cases, hemorrhage and shock. Although, the case fatality rate for the infection is generally ranged from 10 to 50%, it was reported as 5% for Turkey. Main targets of CCHFV are immune cells and endothelium. Both innate and adaptive immunity are important for fighting against CCHFV in the host. Headache, fever, fatigue and muscle, joint pain, conjunctival injection, facial hyperemia, thrombocytopenia, elevated liver enzymes, hepatomegaly and splenomegaly are the main symptoms and findings for CCHF. Hemorrhagic manifestations including ecchymosis, melena, hematochezia, hematemesis, and epistaxis are commonly seen in severe cases. Supportive treatment is essential and nowadays neither a special drug, nor safe vaccine for humans is available for the treatment and prevention of CCHF. In case of penetrating injury with contaminated material, the oral ribavirin prophylaxis may be offered after the area being washed with soapy water and ethanol. J Microbiol Infect Dis 2014; Special Issue 1: S1-S9

The Laboratory Diagnosis of Important Zoonotic Infections

“…Kesin olgu: (a) Klinik tanımlamaya uyan ve yukarı-da belirtilen laboratuvar kriterlerinden en az birisi ile doğrulanmış olgu veya (b) kesin tanı almış bir olgu ile epidemiyolojik olarak bağlantısı olan olgu (4,12) . (13,14) .…”

“…Akut enfeksiyonda viral RNA varlığının gös-terilmesi "kesin tanı" bulgusudur. (4,7,9,11,12) . Tedavi: Öncelik hastaların vital bulgularının stabil hale getirilmesidir.…”

“…Deneysel çalışmalar ribavin tedavisinin, KKKAV ile enfekte edilmiş infant farelerde virüs titresini azalttığını göstermiştir. KKKAH den iyileşen hastalardan elde edilen serumla atların immünizasyonu ile elde edilen gama globulin, hastalığın erken döneminde yararlı olabilir (12) .…”

Relationship betweenIFNA1,IFNA5,IFNA10, andIFNA17gene polymorphisms and Crimean‐Congo hemorrhagic fever prognosis in a Turkish population range

“…Nowadays the disease is a public health problem in some parts of the world including Turkey [Gunes et al, 2009;Chinikar et al, 2010;Leblebicioglu, 2010;Mertens et al, 2013]. In Turkey, although CCHF cases have been seen since 2002, the disease was first diagnosed in 2003 [Bakir et al, 2005;Elaldi and Kaya, 2014]. A total of 9064 CCHF cases have been reported with a CFR of 4.6% (unpublished data from Turkish Ministry of Health) by the end of 2014.…”

Ratio of neutrophil to lymphocyte Counts in Crimean Congo Hemorrhagic Fever

“…The incubation period for CCHF ranges from 2 to 12 days after the tick bite. This period ranges from 3 to 10 days in nosocomial cases [5,6]. The hemorrhagic period develops rapidly and usually begins between the fifth and seventh days of disease [7].…”