Evaluation of the Crimean-Congo Hemorrhagic Fever Cases Followed and Treated in Our Clinic between 2009-2013

Objectives: The Crimean-Congo hemorrhagic fever virus (CCHFV) belongs to the family Bunyaviridae, genus Nairovirus, and causes severe disease in man; the reported case-fatality rate is 3%–30%. The aim of this study was to determine the epidemiological and clinical characteristics of the CCHF cases in our clinic between 2009-2013.

Materials and Methods: Thirty-three patients with the diagnosis of CCHF were followed up in Kayseri Training and Research Hospital between January 2009 and September 2013. Demographic, geographic, climatic, and clinical and laboratory characteristics of all patients were investigated. All of the cases were confirmed by CCHF immunoglobulin M (IgM) and/or PCR RNA positivity.

Results: According to our reports 33 CCHF cases were followed in our clinic. Of the CCHF cases, 63.6% were male. Thirty patients (90.9%) were from rural regions. Seventeen patients (51, 5%) were farmers. The median age was 46.7 years (range18-71 years). On admission, 97% of patients experienced high fever, 100% had weakness, 93.9% had headache. The disease was more usual in May, June, July. Of the CCHF cases, 69.7% had a history of tick bite. On admission, all of the patients had thrombocytopenia, 87.9% had leucopenia, 27.3% had anemia, and 87.9% had elevated AST and ALT. Oral ribavirin treatment was used in 33.3% of the CCHF cases. The case-fatality rate was 12.1% (4/33 patients).

Conclusions: CCHF remains a seasonal problem in the Mid-Eastern Anatolia region of Turkey. The mortality rate in our patients was higher than reported in other studies in our country (12% vs 5%). CCHF should be accompanied with supportive care, especially including early platelet replacement.