The epidemiological, clinical and laboratory evaluation of Crimean-Congo haemorrhagic fever cases in a tertiary-care hospital in Turkey, 2008
Abstract number: R2210
Ataman Hatipoglu C., Bulut C., Yetkin M.A., Karakoyun M.C., Erdinc F.S., Tuncer Ertem G., Oral B., Kinikli S., Demiroz A.P.
Objective: Crimean-Congo haemorrhagic fever (CCHF) is a serious disease caused by the CCHF virus and has been reported in our country since 2002. In this study we present the epidemiological features, clinical and laboratory findings, treatment, and outcome of cases with CCHF followed in Ankara Training and Research Hospital in 2008.
Methods: Eighty-six patients suspected to have CCHF were included in the study. Serum samples were analyzed with specific ELISA for detecting antibodies (IgM and IgG) against CCHF, and also with RT-PCR to investigate the genome of the virus. Those with positive IgM antibodies and/or PCR for CCHF virus in blood evaluated as confirmed case, and those with negative results as suspected cases.
Results: Among 86 patients, 71 were diagnosed as confirmed cases. Of all the patients, 51 (59.3%) were female; mean age was 48.8±18.2 years (1583 years). Seventy-four patients (86%) were living in the rural area. Tick bite history was detected in 57 patients (66.3%) and haemorrhage history in 22 (25.6%). Epistaxis and petechia/purpura were the mostly declared haemorrhagic complaints. Mean time from tick bite to admission to the hospital was 8.6±7.2 days (135 days). The most common symptoms were fever, fatigue, nausea, myalgia and headache (84.9%, 82.6%, 67.4%, 64.0% and 41.9%, respectively). The mean hospital stay of the patients was 7.3±2.9 days (117 days). Median level and minimum and maximum values of some of the laboratory findings were as follows; 2200/mm3 (50029000) for white blood cells, 57500/mm3 (7000361000) for platelets, 126 U/L (101155) for aspartate aminotransferase, 77 U/L (14800) for alanine aminotransferase, 216 U/L (194564) for creatinine phosphokinase, 10.7 seconds (7.0109.0) for protrombin time and 37.0 seconds (20.4105.0) for partial thromboplastin time. Ribavirin and steroid therapies were given to 17 (19.8%) and 22 (25.6%) of the patients, respectively. Among the patients, 44.2% received platelet (random/aferesis), 24.4% fresh frozen plasma and 11.6% erythrocyte infusions. Although supportive therapy was administered, four cases (4.7%) were died because of massive hemorrhage.
Conclusion: In CCHF patients, serum platelet counts, haemoglobin values and protrombin and partial thromboplastin times should be closely monitored. In case who had a deterioration of the related findings, the physicians should consider to adjust supportive therapy.
|Session name:||19th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Helsinki, Finland, 16 - 19 May 2009|
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