Crimean-Congo Hemorrhagic Fever, Kosovo, 2013–2016

Ahmeti, Salih; Berisha, Lindita; Halili, B.; Ahmeti, Florim; Possel, Ronald von; Thomé-Bolduan, Corinna; Michel, Anett; Priesnitz, Simone; Reisinger, Emil C.; Günther, Stephan; Krüger, Andreas; Sherifi, Kurtesh; Jakupi, Xhevat; Hemmer, Christoph Josef; Emmerich, Petra

doi:10.3201/eid2502.171999

Cited by 21 publications

(18 citation statements)

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“…4,12 In addition, somnolence was found to be a predictor of mortality in many other studies. 13 The clinical findings of this study were similar to those previously reported in other stu- dies. 14,15 The most frequently observed symptoms and complications were noted as somnolence, mucosal hemorrhage, petechiae, and acute renal failure.…”

Section: Discussionsupporting

confidence: 90%

An Evaluation of the Different Serum Markers Associated with Mortality in Crimean–Congo Hemorrhagic Fever

Tekin

Engin

2020

Rambam Maimonides Med J

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Background Crimean–Congo hemorrhagic fever (CCHF) is a tick-borne viral disease with a high mortality rate. Although CCHF has been widely investigated over the past decade, a review of the literature indicated no data on the prognostic capacity of the mean platelet volume-to-platelet count ratio (MPVPCR) and the red cell distribution width-to-platelet count ratio (RDWPCR) for the systemic inflammatory response in patients with CCHF. This study aimed to evaluate the prognostic ability of MPVPCR and RDWPCR on mortality in patients with CCHF. Methods A total of 807 patients that were admitted to the Cumhuriyet University Hospital’s Emergency Department from January 2010 to December 2018 were involved. The RDWPCR and MPVPCR were separately calculated via absolute blood red cell and platelet counts at the time of admission. Before performing receiver-operating characteristic (ROC) curve analysis to define the optimum cut-off values of MPVPCR and RDWPCR stepwise logistic regression analysis was used to determine the predictive factors related to mortality in CCHF patients. Results Values of both MPVPCR and RDWPCR were significantly lower in survivors than in non-survivors (MPVPCR: 0.20±0.23 versus 0.55±0.55, P <0.001; RDWPCR: 0.27±0.32 versus 0.77±0.77, P <0.001, respectively). The MPVPCR (odds ratio [OR], 5.95; P =0.048) was an independent predictor for the prognosis of mortality in CCHF patients. The area under the curve in the ROC curve analysis for MPVPCR was 0.876 with a cut-off of 0.21 (sensitivity 87%, specificity 76%). Conclusion At the time of admission, MPVPCR might be a useful predictor of mortality in patients with CCHF.

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Section: Discussionsupporting

confidence: 90%

An Evaluation of the Different Serum Markers Associated with Mortality in Crimean–Congo Hemorrhagic Fever

Tekin

Engin

2020

Rambam Maimonides Med J

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“…Hasanoğlu et al [7] reported no relationship between high fever and mortality. Ahmeti et al [1] reported that non-specific findings did not affect the clinical course of patients. In the present study, the most common symptom was fever, followed by abdominal pain and diarrhea.…”

Section: Discussionmentioning

confidence: 99%

“…Bradycardia and hypotension may develop during this period because of sepsis, septic shock and hemorrhage [12]. Ahmeti et al [1] reported that bradycardia and blood pressure played no role in determining the clinical course. In the present study, fever and heart rate were found to be higher and blood pressure was found to be lower in non-survivors.…”

Section: Discussionmentioning

confidence: 99%

“…Crimean-Congo hemorrhagic fever (CCHF) is a zoonotic disease first described in the 12th century. The causative microorganism is the orthonairovirus from the Nairoviridae family that is carried by ticks in the genus Hyalomma [1,2]. CCHF is endemic to the Balkans, Middle East and Asian regions [1,2].…”

Section: Introductionmentioning

confidence: 99%

“…The causative microorganism is the orthonairovirus from the Nairoviridae family that is carried by ticks in the genus Hyalomma [1,2]. CCHF is endemic to the Balkans, Middle East and Asian regions [1,2]. Although ticks are considered as the principal vector in disease transmission, the transmission of the virus via blood and other body fluids has also been reported [2,3].…”

Section: Introductionmentioning

confidence: 99%

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Factors affecting mortality in Crimean-Congo hemorrhagic fever

Kavak¹,

Gürbüz²

2019

Journal of Surgery and Medicine

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This is an open access article distributed under the terms of the CreativeCommons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND 4.0) where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. AbstractAim: Crimean-Congo hemorrhagic fever is a viral disease that is transmitted by infected ticks and has high mortality.We aim to determine the factors affecting mortality in patients with Crimean-Congo hemorrhagic fever (CCHF). Methods: Age, gender, number of ticks, tick removal procedures, tick location, time to hospital admission, symptoms, physical examination findings, vital signs, laboratory parameters and factors affecting mortality were evaluated. The study was designed as a retrospective cohort study. Results: The median age of the 172 patients was 46 (range, 18-78) years, and 73.8% of the patients were men. The mortality rate was high in patients with delayed time to hospital admission, those who were bitten on the head and neck region, those who had a high number of tick bites, those who had removed the tick themselves or had the tick removed by a relative and those who had impaired consciousness (P=0.001, P<0.001, P<0.001, P<0.001 and P=0.002, respectively). Bleeding was detected in 87.2% of cases. The frequency of ecchymosis, pleural effusion, hematuria, hematemesis and melena occurrence was high in non-survivors (P<0.001, P<0.001, P<0.001, P=0.006 and P=0.006, respectively). Fever and heart rate were significantly higher, systolic and diastolic blood pressure was significantly lower in non-survivors (P<0.001, P<0.001, P=0.006 and P<0.001, respectively). Additionally, the white blood cell (WBC) count, international normalized ratio (INR), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were significantly higher and platelet count were significantly lower in non-survivors (P<0.001 for all). Conclusion: We found that in patients with CCHF, bleeding was a major factor associated with mortality. Factors such as a number of ticks, the number of people removing the ticks and tick location were found to affect mortality. We believe that blood tests and vital parameters can be used to predict mortality in patients with CCHF. Öz Amaç: Kırım kongo kanamalı ateşi enfekte kenelerle bulaşan ve yüksek mortaliteye sahip viral bir hastalıktır. Kırım Kongo Kanamalı Ateşi (KKKA) hastalarında mortalite üzerinde etkili faktörleri belirlemeyi amaçladık. Yöntemler: Hastaların yaş, cinsiyet, kene teması, kene sayısı, kenenin kim tarafından çıkarıldığı, kenenin vücuttaki lokalizasyonu, hastaneye başvuru süresi, semptomları, fizik muayene ve vital bulguları, laboratuvar parametreleri ve mortaliteye etki eden faktörler değerlendirildi. Çalışma retrospektif kohort olarak dizayn edildi. Bulgular: 172 hastanın yaş ortancası 46 (18-78) yıl olup, olguların %73,8'i erkekti. Hastaneye başvurusu geç olan, baş ve boyun bölgesinden ısırılmış olan, ısıran kene sayısı fazl...

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A One Health approach to study the circulation of tick-borne pathogens: A preliminary study

et al. 2021

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Tick-borne pathogens (TBPs) have complex life cycles involving tick vectors and vertebrate hosts. However, there is limited empirical evidence on the zoonotic circulation of TBPs. In this study, we used a One Health approach to study the possible circulation of TBPs in ticks, animals and humans within a rural household in the foothills of the Fruška Gora mountain, northern Serbia. The presence of TBP DNA was assessed using microfluidic PCR (25 bacterial species, 7 parasite species, 5 bacterial genera, 3 parasite genera) in animal, human and tick samples and the presence of tick-borne encephalitis virus (TBEV) RNA was screened for using RT-qPCR on tick samples. In addition, Lyme borreliosis serology was assessed in patients sera. Rhipicephalus sanguineus and Ixodes ricinus ticks were identified on dogs and Haemaphysalis punctata was identified on house walls. Rickettsia helvetica was the most common pathogen detected in pooled R. sanguineus and I. ricinus tick samples, followed by Hepatozoon canis . None of the H. punctata tick samples tested positive for the presence of TBPs. Anaplasma phagocytophilum and Rickettsia monacensis were the most frequent pathogens detected in dogs, followed by Rickettsia felis , whereas Anaplasma bovis was the only pathogen found in one of the goats tested. None of the human blood samples collected from family members tested positive for the presence of TBPs. Although microfluidic PCR did not detect Borrelia sp. in any of the tested tick or blood samples, a family member with a history of Lyme disease was seropositive for Borrelia burgdorferi sensu lato (s.l.). We conclude that, despite the presence of TBPs in tick and vertebrate reservoirs, there is no evidence of infection with TBPs across various components of the epidemiological chain in a rural Fruška Gora household.

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Crimean-Congo Hemorrhagic Fever, Kosovo, 2013–2016

Cited by 21 publications

References 10 publications

An Evaluation of the Different Serum Markers Associated with Mortality in Crimean–Congo Hemorrhagic Fever

An Evaluation of the Different Serum Markers Associated with Mortality in Crimean–Congo Hemorrhagic Fever

Factors affecting mortality in Crimean-Congo hemorrhagic fever

A One Health approach to study the circulation of tick-borne pathogens: A preliminary study

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