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Erschienen in: Wiener klinische Wochenschrift 19-20/2020

04.08.2020 | original article

Epidemiological characteristics, clinical and laboratory findings supporting preliminary diagnosis of Crimean-Congo hemorrhagic fever in an endemic region in Turkey

verfasst von: Zuhal Yeşilbağ, Aslı Karadeniz, Safiye Koçulu, Cahit Bekir Kayhan

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 19-20/2020

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Summary

Background

Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease that has various symptoms. Since rapid diagnosis is crucial for survival, understanding the characteristics of patients is important for clinicians while waiting for results. This study aimed to evaluate findings that support the preliminary diagnosis of suspected CCHF in patients and take a look at the management of CCHF in Turkey.

Methods

Demographics, presenting symptoms and laboratory findings of the patients admitted with a suspicion of CCHF, were recorded from the patient files and database of Ministry of Health. A diagnosis of CCHF was based on detection of immunoglobulin M (IgM) antibodies and/or viral RNA. The patients with and without CCHF were compared in terms of differences in epidemiological, clinical and laboratory findings.

Results

Out of 87 patients, 61 (70.1%) were CCHF and 26 (29.9%) were non-CCHF cases. Working with agriculture/livestock, tick exposure, contact with body fluids of animals, travel to rural areas within 2 weeks, fever, headache, leucopenia, anemia, international normalized ratio (INR) elevation were significantly more common in CCHF cases. According to multivariate analysis, tick exposure (odds ratio, OR 9.03, 95% confidence interval, CI 1.96–41.47, p = 0.005), contact with body fluids of animals (OR 14.9, 95% CI 2.23–99.94, p = 0.005), leucopenia (OR 13.65, 95% CI 2.55–72.91, p = 0.02) and anemia (OR 8.41, 95% CI 1.06–66.42, p = 0.04) were independently indicative for CCHF.

Conclusion

As it takes a considerable time for a definitive diagnosis, determining epidemiological features and risk factors is an important step for preliminary diagnosis of CCHF as well as early implementation of precautions against nosocomial transmission of the virus.
Literatur
1.
Zurück zum Zitat Al-Abri SS, Abaidani IA, Fazlalipour M, et al. Current status of Crimean-Congo haemorrhagic fever in the World Health Organization Eastern Mediterranean Region: issues, challenges, and future directions. Int J Infect Dis. 2017;58:82–9.CrossRefPubMedCentralPubMed Al-Abri SS, Abaidani IA, Fazlalipour M, et al. Current status of Crimean-Congo haemorrhagic fever in the World Health Organization Eastern Mediterranean Region: issues, challenges, and future directions. Int J Infect Dis. 2017;58:82–9.CrossRefPubMedCentralPubMed
2.
Zurück zum Zitat Messina JP, Pigott DM, Golding N, et al. The global distribution of Crimean-Congo hemorrhagic fever. Trans R Soc Trop Med Hyg. 2015;109:503–13.CrossRefPubMedCentralPubMed Messina JP, Pigott DM, Golding N, et al. The global distribution of Crimean-Congo hemorrhagic fever. Trans R Soc Trop Med Hyg. 2015;109:503–13.CrossRefPubMedCentralPubMed
3.
Zurück zum Zitat Koculu S, Oncul A, Onal O, et al. Evaluation of knowledge of the healthcare personnel working in Giresun province regarding Crimean-Congo hemorrhagic fever before and after educational training. J Vector Borne Dis. 2015;52(2):166–70.PubMed Koculu S, Oncul A, Onal O, et al. Evaluation of knowledge of the healthcare personnel working in Giresun province regarding Crimean-Congo hemorrhagic fever before and after educational training. J Vector Borne Dis. 2015;52(2):166–70.PubMed
5.
Zurück zum Zitat Kilinc C, Gückan R, Capraz M, et al. Examination of the specific clinical symptoms and laboratory findings of Crimean-Congo hemorrhagic fever. J Vector Borne Dis. 2016;53(2):162–7.PubMed Kilinc C, Gückan R, Capraz M, et al. Examination of the specific clinical symptoms and laboratory findings of Crimean-Congo hemorrhagic fever. J Vector Borne Dis. 2016;53(2):162–7.PubMed
6.
Zurück zum Zitat Papa A, Bino S, Llagami A, et al. Crimean-Congo hemorrhagic fever in Albania, 2001. Eur J Clin Microbiol Infect Dis. 2002;21:603–6.CrossRefPubMed Papa A, Bino S, Llagami A, et al. Crimean-Congo hemorrhagic fever in Albania, 2001. Eur J Clin Microbiol Infect Dis. 2002;21:603–6.CrossRefPubMed
8.
Zurück zum Zitat Grard G, Drexler JF, Fair J, et al. Re-emergence of Crimean-Congo hemorrhagic fever virus in Central Africa. PLoS Negl Trop Dis. 2011;5:1350.CrossRef Grard G, Drexler JF, Fair J, et al. Re-emergence of Crimean-Congo hemorrhagic fever virus in Central Africa. PLoS Negl Trop Dis. 2011;5:1350.CrossRef
9.
Zurück zum Zitat Leblebicioglu H, Ozaras R, Irmak H, et al. Crimean-Congo hemorrhagic fever in Turkey: current status and future challenges. Antiviral Res. 2016;126:21–34.CrossRefPubMed Leblebicioglu H, Ozaras R, Irmak H, et al. Crimean-Congo hemorrhagic fever in Turkey: current status and future challenges. Antiviral Res. 2016;126:21–34.CrossRefPubMed
11.
Zurück zum Zitat Estrada-Pena A, Zatansever Z, Gargili A, et al. Modeling the spatial distribution of crimean-congo hemorrhagic fever outbreaks in Turkey. Vector Borne Zoonotic Dis. 2007;7:667–78.CrossRefPubMed Estrada-Pena A, Zatansever Z, Gargili A, et al. Modeling the spatial distribution of crimean-congo hemorrhagic fever outbreaks in Turkey. Vector Borne Zoonotic Dis. 2007;7:667–78.CrossRefPubMed
12.
Zurück zum Zitat Duran A, Küçükbayrak A, Ocak T, et al. Evaluation of patients with Crimean-Congo hemorrhagic fever in Bolu, Turkey. Afr Health Sci. 2013;13(2):233–42.PubMedPubMedCentral Duran A, Küçükbayrak A, Ocak T, et al. Evaluation of patients with Crimean-Congo hemorrhagic fever in Bolu, Turkey. Afr Health Sci. 2013;13(2):233–42.PubMedPubMedCentral
13.
Zurück zum Zitat Hekimoğlu HC, Demirci NA. 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. Afr Health Sci. 2014;14(4):873–81.CrossRefPubMedCentralPubMed Hekimoğlu HC, Demirci NA. 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. Afr Health Sci. 2014;14(4):873–81.CrossRefPubMedCentralPubMed
14.
Zurück zum Zitat Yilmaz GR, Buzgan T, Irmak H, et al. The epidemiology of Crimean-Congo hemorrhagic fever in Turkey, 2002–2007. Int J Infect Dis. 2009;13(3):380–6.CrossRefPubMed Yilmaz GR, Buzgan T, Irmak H, et al. The epidemiology of Crimean-Congo hemorrhagic fever in Turkey, 2002–2007. Int J Infect Dis. 2009;13(3):380–6.CrossRefPubMed
15.
Zurück zum Zitat Sisman A. Epidemiologic features and risk factors of Crimean-Congo hemorrhagic fever in Samsun province, Turkey. J Epidemiol. 2013;23(2):95–102.CrossRefPubMedCentralPubMed Sisman A. Epidemiologic features and risk factors of Crimean-Congo hemorrhagic fever in Samsun province, Turkey. J Epidemiol. 2013;23(2):95–102.CrossRefPubMedCentralPubMed
16.
Zurück zum Zitat Ozkurt Z, Kiki I, Erol S, et al. Crimean-Congo hemorrhagic fever in Eastern Turkey: clinical features, risk factors and efficacy of ribavirin therapy. J Infect. 2006;52:207–15.CrossRefPubMed Ozkurt Z, Kiki I, Erol S, et al. Crimean-Congo hemorrhagic fever in Eastern Turkey: clinical features, risk factors and efficacy of ribavirin therapy. J Infect. 2006;52:207–15.CrossRefPubMed
17.
Zurück zum Zitat Vorou R, Pierroutsakos IN, Maltezou HC. Crimean-Congo hemorrhagic fever. Curr Opin Infect Dis. 2007;20:495–500.CrossRefPubMed Vorou R, Pierroutsakos IN, Maltezou HC. Crimean-Congo hemorrhagic fever. Curr Opin Infect Dis. 2007;20:495–500.CrossRefPubMed
18.
Zurück zum Zitat Izadi S, Holakouie-Naieni K, Majdzadeh SR, et al. Seroprevalence of Crimean-Congo hemorrhagic fever in Sistan-va-Baluchestan Province of Iran. Jpn J Infect Dis. 2006;59:326–8.PubMed Izadi S, Holakouie-Naieni K, Majdzadeh SR, et al. Seroprevalence of Crimean-Congo hemorrhagic fever in Sistan-va-Baluchestan Province of Iran. Jpn J Infect Dis. 2006;59:326–8.PubMed
19.
Zurück zum Zitat Akyazi R, Ecevit O. Ticks and Crimean Congo hemorrhagic fever. J Agric OMU. 2006;21(3):340–9. Akyazi R, Ecevit O. Ticks and Crimean Congo hemorrhagic fever. J Agric OMU. 2006;21(3):340–9.
20.
Zurück zum Zitat Mardani M, Keshtkar-Jahromi M. Crimean Congo hemorrhagic fever. Arch Iran Med. 2007;10:204–14.PubMed Mardani M, Keshtkar-Jahromi M. Crimean Congo hemorrhagic fever. Arch Iran Med. 2007;10:204–14.PubMed
21.
Zurück zum Zitat Ergönül O, Celikbaş A, Dokuzoguz B, et al. Characteristics of patients with Crimean-Congo hemorrhagic fever in a recent outbreak in Turkey and impact of oral ribavirin therapy. Clin Infect Dis. 2004;39:284–7.CrossRefPubMed Ergönül O, Celikbaş A, Dokuzoguz B, et al. Characteristics of patients with Crimean-Congo hemorrhagic fever in a recent outbreak in Turkey and impact of oral ribavirin therapy. Clin Infect Dis. 2004;39:284–7.CrossRefPubMed
22.
Zurück zum Zitat Izadi S, Naieni KH, Madjdzadeh SR, et al. Crimean-Congo hemorrhagic fever in Sistan and Baluchestan Province of Iran, a case-control study on epidemiological characteristics. Int J Infect Dis. 2004;8:299–306.CrossRefPubMed Izadi S, Naieni KH, Madjdzadeh SR, et al. Crimean-Congo hemorrhagic fever in Sistan and Baluchestan Province of Iran, a case-control study on epidemiological characteristics. Int J Infect Dis. 2004;8:299–306.CrossRefPubMed
23.
Zurück zum Zitat Bakir M, Ugurlu M, Dokuzoguz B, Turkish CCHF Study Group, et al. Crimean-Congo haemorrhagic fever outbreak in Middle Anatolia: a multicentre study of clinical features and outcome measures. J Med Microbiol. 2005;54(4):385–9.CrossRefPubMed Bakir M, Ugurlu M, Dokuzoguz B, Turkish CCHF Study Group, et al. Crimean-Congo haemorrhagic fever outbreak in Middle Anatolia: a multicentre study of clinical features and outcome measures. J Med Microbiol. 2005;54(4):385–9.CrossRefPubMed
24.
Zurück zum Zitat Yilmaz GR, Buzgan T, Torunoglu MA, et al. A preliminary report on Crimean-Congo haemorrhagic fever in Turkey, March–June 2008. Euro Surveill. 2008;13:189.CrossRef Yilmaz GR, Buzgan T, Torunoglu MA, et al. A preliminary report on Crimean-Congo haemorrhagic fever in Turkey, March–June 2008. Euro Surveill. 2008;13:189.CrossRef
25.
Zurück zum Zitat Mostafavi E, Pourhossein B, Chinikar S. Clinical symptoms and laboratory findings supporting early diagnosis of Crimean-Congo hemorrhagic fever in Iran. J Med Virol. 2014;86:1188–92.CrossRefPubMed Mostafavi E, Pourhossein B, Chinikar S. Clinical symptoms and laboratory findings supporting early diagnosis of Crimean-Congo hemorrhagic fever in Iran. J Med Virol. 2014;86:1188–92.CrossRefPubMed
26.
Zurück zum Zitat Bente DA, Forrester NL, Watts DM, et al. Crimean-Congo hemorrhagic fever: history, epidemiology, pathogenesis, clinical syndrome and genetic diversity. Antiviral Res. 2013;100:159–89.CrossRefPubMed Bente DA, Forrester NL, Watts DM, et al. Crimean-Congo hemorrhagic fever: history, epidemiology, pathogenesis, clinical syndrome and genetic diversity. Antiviral Res. 2013;100:159–89.CrossRefPubMed
27.
Zurück zum Zitat Mertens M, Schmidt K, Ozkul A, et al. The impact of Crimean-Congo hemorrhagic fever virus on public health. Antiviral Res. 2013;98:248–60.CrossRefPubMed Mertens M, Schmidt K, Ozkul A, et al. The impact of Crimean-Congo hemorrhagic fever virus on public health. Antiviral Res. 2013;98:248–60.CrossRefPubMed
28.
Zurück zum Zitat Erenler AK, Kulaksiz F, Ülger H, et al. Predictors of Crimean-Congo hemorrhagic fever in the emergency department. Eur Rev Med Pharmacol Sci. 2015;19(20):3811–6.PubMed Erenler AK, Kulaksiz F, Ülger H, et al. Predictors of Crimean-Congo hemorrhagic fever in the emergency department. Eur Rev Med Pharmacol Sci. 2015;19(20):3811–6.PubMed
29.
30.
Zurück zum Zitat Schwarz TF, Nsanze H, Ameen AM. Clinical features of Crimean-Congo haemorrhagic fever in the United Arab Emirates. Infection. 1997;25:364–7.CrossRefPubMed Schwarz TF, Nsanze H, Ameen AM. Clinical features of Crimean-Congo haemorrhagic fever in the United Arab Emirates. Infection. 1997;25:364–7.CrossRefPubMed
31.
Zurück zum Zitat Cevik MA, Erbay A, Bodur H, et al. Clinical and laboratory features of Crimean-Congo hemorrhagic fever: predictors of fatality. Int J Infect Dis. 2008;12:374–9.CrossRefPubMed Cevik MA, Erbay A, Bodur H, et al. Clinical and laboratory features of Crimean-Congo hemorrhagic fever: predictors of fatality. Int J Infect Dis. 2008;12:374–9.CrossRefPubMed
32.
Zurück zum Zitat Frangoulidis D, Meyer H. Measures undertaken in the German Armed Forces Field Hospital deployed in Kosovo to contain a potential outbreak of Crimean-Congo hemorrhagic fever. Mil Med. 2005;170:366–9.CrossRefPubMed Frangoulidis D, Meyer H. Measures undertaken in the German Armed Forces Field Hospital deployed in Kosovo to contain a potential outbreak of Crimean-Congo hemorrhagic fever. Mil Med. 2005;170:366–9.CrossRefPubMed
Metadaten
Titel
Epidemiological characteristics, clinical and laboratory findings supporting preliminary diagnosis of Crimean-Congo hemorrhagic fever in an endemic region in Turkey
verfasst von
Zuhal Yeşilbağ
Aslı Karadeniz
Safiye Koçulu
Cahit Bekir Kayhan
Publikationsdatum
04.08.2020
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 19-20/2020
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-020-01719-5

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