Retrospective analysis of crimean-congo haemorrhagic fever cases

Abstract

Objective: Crimean-Congo haemorrhagic fever (CCHF) is an endemic zoonotic disease which can display high fatality in Turkey and is caused by the CCHF virus. In this study, we aimed to investigate the epidemiological, laboratory and clinical features of CCHF cases in our province situated in the endemic region. Methods: In this study, the characteristics of 71 CCHF cases over 18 years of age who were hospitalized in our clinic between January 2010 and October 2018 were evaluated retrospectively. Demographic data such as age, gender, occupation, place of residence, exposure to ticks, time period (year, season, month), symptoms, physical examination and laboratory findings such as hemogram, C-reactive protein, creatine kinase (CK), lactic dehydrogenase (LDH), international normalized ratio results, treatments, information about cure and mortality of the patients were obtained from patient files. Results: The mean age (± standard deviation) of 71 cases was 51±24 years, and 40 (56.3%) were men. 51 (71.8%) of the patients were engaged in farming and animal husbandry. A history of tick attachment was found in 44 (62%) of the cases and 32 (72.8%) had a history of removing the tick by themselves. In 11 (15.5%) of the cases, there were no tick attachment history. The highest incidence was in June (33.8%) and in summer (67.6%). The most common symptom was weakness (98.6%). Muscle and joint pains, fever and headache, nausea and/or vomiting and diarrhea were other common symptoms (81.7%, 78.9%, 64.8%, 59.2% and 42.2%, respectively). The most common laboratory findings were thrombocytopenia (95%), elevated CK (74.6%), elevated aspartate aminotransferase and alanine aminotransferase (72%), leukopenia (69%), neutropenia (42%), elevated LDH (47.9%), prolonged prothrombin time (25.3%) and activated partial thromboplastin time (16.9%). Four patients died due to CCHF. Conclusions: Although the number of cases in our region, which is endemic for CCHF, decreases compared to the previous years, it should be considered in patients presenting with fever, myalgia, headache and thrombocytopenia especially in spring and summer.