Arslan Mustafa, Comoglu Senol
Department of Infectious Diseases and Clinical Microbiology, Amasya Sabuncuoglu Serefeddin Training and Research Hospital, Amasya, Turkiye.
Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Umraniye Training and Research Hospital, Istanbul, Turkiye.
North Clin Istanb. 2024 Jun 25;11(3):177-183. doi: 10.14744/nci.2023.09815. eCollection 2024.
Crimean-Congo hemorrhagic fever (CCHF) is a viral zoonosis transmitted by ticks and may have an acute and severe course with fever, bleeding, muscle aches, headache, diarrhea, weakness, and similar non-specific symptoms. This study aimed to determine the distribution of CCHF cases in Amasya province, which is endemic for this disease, according to districts, epidemiological, clinical, laboratory, and treatment characteristics.
The characteristics of 88 CCHF cases over 18 who were admitted to our clinic and treated between January 2013 and January 2023 were evaluated retrospectively. Demographic data such as age, gender, occupation, district of residence, history of tick contact, the incubation period of the disease, period of development of the disease (months, years), length of hospital stay, symptoms, physical examination and laboratory findings, blood product replacement therapies applied, recovery and mortality status of the patients were reached by scanning the patient files.
The mean age (±standard deviation) of 88 cases was 48±18 years, and 53 (60.2%) were male. Of the patients, 68 (77.3%) were engaged in farming and animal husbandry, and 79 (89.7%) lived in villages and hamlets. Tasova district had the highest frequency of cases, with 29 (32.9%) patients. June was the most common month for the disease, with 31 (35.2%) cases. The most common symptom on admission was fatigue, with a rate of 93%. Other symptoms included myalgia and arthralgia (83.2%), fever (65%), headache (64.4%), nausea-vomiting (43.5%), conjunctival hyperemia (35.2%), and diarrhea (21.7%). In clinical follow-up, bleeding was missed in 15 (17.04%) patients. On admission to the hospital, there were elevated levels of thrombocytopenia (92%), leukopenia (84.1%), aspartate aminotransferase and alanine aminotransferase (86.3%), creatinine phosphokinase (71.6%), and lactate dehydrogenase (76.1%). None of the patients were given ribavirin treatment. Our mortality rate was 3.40% with three patients.
Amasya is an endemic area for CCHF with all its districts. In our province's spring and summer months, tick contact history and the farming-livestock profession should be questioned in patients with fever complaints in clinic admissions, especially emergency services. In the case of the detection of thrombocytopenia in these patients, CCHF should be kept in mind.
克里米亚-刚果出血热（CCHF）是一种由蜱传播的病毒性人畜共患病，可能呈急性重症病程，伴有发热、出血、肌肉疼痛、头痛、腹泻、虚弱及类似的非特异性症状。本研究旨在根据地区、流行病学、临床、实验室及治疗特征，确定该病流行区阿马西亚省CCHF病例的分布情况。
回顾性评估2013年1月至2023年1月期间入住我院门诊并接受治疗的88例18岁以上CCHF病例的特征。通过查阅患者病历获取年龄、性别、职业、居住地区、蜱接触史、疾病潜伏期、发病时间（月、年）、住院时间、症状、体格检查及实验室检查结果、应用的血液制品替代疗法、患者的康复及死亡状况等人口统计学数据。
88例患者的平均年龄（±标准差）为48±18岁，男性53例（60.2%）。患者中，68例（77.3%）从事农牧业，79例（89.7%）居住在村庄和小村落。塔索瓦区病例数最多，有29例（32.9%）患者。6月是该病最常见的发病月份，有31例（35.2%）病例。入院时最常见的症状是乏力，发生率为93%。其他症状包括肌痛和关节痛（83.2%）、发热（65%）、头痛（64.4%）、恶心呕吐（43.5%）、结膜充血（35.2%）和腹泻（21.7%）。在临床随访中，15例（17.04%）患者漏诊出血症状。入院时，血小板减少症（92%）、白细胞减少症（84.1%）、天冬氨酸转氨酶和丙氨酸转氨酶（86.3%）、肌酸磷酸激酶（71.6%）及乳酸脱氢酶（76.1%）水平均升高。所有患者均未接受利巴韦林治疗。3例患者死亡，死亡率为3.40%。
阿马西亚省所有地区均为CCHF流行区。在我省春夏季节，门诊尤其是急诊收治有发热主诉的患者时，应询问其蜱接触史及农牧业职业史。若这些患者检测到血小板减少症，应考虑CCHF。
