Karakecili Faruk, Cikman Aytekin, Aydin Merve, Binay Umut Devrim, Kesik Ozan Arif, Ozcicek Fatih
Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Erzincan University, Erzincan, Turkey.
Department of Medical Microbiology, Faculty of Medicine, Erzincan University, Erzincan, Turkey.
J Vector Borne Dis. 2018 Jul-Sep;55(3):215-221. doi: 10.4103/0972-9062.249479.
BACKGROUND & OBJECTIVES: : Crimean-Congo hemorrhagic fever (CCHF), an illness characterized by fever and hemorrhage, is caused by a CCHF virus (CCHFV). It is an important public health problem in Turkey. The objective of this study was to evaluate the demographic, clinical, and laboratory characteristics and mortality rates of CCHF patients in the northeast region of Turkey.
: A total of 206 patients, diagnosed with CCHF, from northeast region of Turkey were included and evaluated between 2011 and 2017. Real-time reverse transcriptase polymerase chain reaction (RT-PCR) and immunofluorescence (IFA) methods were used for the diagnoses.
: Of the patients included in the study, 77.2% were farmers/livestockers, while 22.8% had other occupations. The incidence of tick bite or tick contact with bare hands was 52.9%. About 94.2% of the patients were living in rural areas and 5.8% in city centers. However, all the patients living in city centers had a history of visit to rural areas. The disease was more common in May, June, and July months. The most common symptoms at the time of admission included fatigue, fever, and widespread body pain, while laboratory findings were thrombocytopenia, leukopenia, and anemia. Bleeding, tachycardia, and rash were the most common findings on physical examination. Of all the patients, 95.6% were identified by RT-PCR and 4.4% by IFA methods. Severe cases constituted 22.3% (46) of the included patients. Throughout the course of this study, 7 (3.4%) patients died, and the remaining 96.6% (199) patients were discharged with a full recovery. Disease severity was significantly correlated with mortality rate and duration of hospitalization (p <0.001 and p = 0.013).
INTERPRETATION & CONCLUSION: : In this study, the mortality rate observed was lower than that reported in the literature because of accessibility of early supportive therapy. It would be beneficial in CCHF treatment to recognize the disease at an early stage, begin supportive treatment quickly, and educate the people living in high-risk areas as well as health care personnel working in these areas.
克里米亚-刚果出血热（CCHF）是一种以发热和出血为特征的疾病，由克里米亚-刚果出血热病毒（CCHFV）引起。它是土耳其一个重要的公共卫生问题。本研究的目的是评估土耳其东北部地区CCHF患者的人口统计学、临床和实验室特征以及死亡率。
纳入2011年至2017年间来自土耳其东北部地区的206例确诊为CCHF的患者并进行评估。采用实时逆转录聚合酶链反应（RT-PCR）和免疫荧光（IFA）方法进行诊断。
纳入研究的患者中，77.2%为农民/牧民，22.8%从事其他职业。蜱叮咬或徒手接触蜱的发生率为52.9%。约94.2%的患者生活在农村地区，5.8%生活在市中心。然而，所有生活在市中心的患者都有去过农村地区的病史。该病在5月、6月和7月更为常见。入院时最常见的症状包括疲劳、发热和全身广泛疼痛，而实验室检查结果为血小板减少、白细胞减少和贫血。出血、心动过速和皮疹是体格检查中最常见的发现。所有患者中，95.6%通过RT-PCR确诊，4.4%通过IFA方法确诊。重症病例占纳入患者的22.3%（46例）。在本研究过程中，7例（3.4%）患者死亡，其余96.6%（199例）患者痊愈出院。疾病严重程度与死亡率和住院时间显著相关（p<0.001和p = 0.013）。
在本研究中，由于早期支持治疗的可及性，观察到的死亡率低于文献报道。在CCHF治疗中，早期识别疾病、迅速开始支持治疗以及对高风险地区居民和这些地区的医护人员进行教育将是有益的。
