Epidemiological characteristics, clinical and laboratory findings supporting preliminary diagnosis of Crimean-Congo hemorrhagic fever in an endemic region in Turkey.

Zuhal Yeşilbağ, Aslı Karadeniz, Safiye Koçulu, Cahit Bekir Kayhan

Wiener klinische Wochenschrift 2020 Oct

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Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne disease that has various symptoms. Since rapid diagnosis is crucial for survival, understanding the characteristics of patients is important for clinicians while waiting for results. This study aimed to evaluate findings that support the preliminary diagnosis of suspected CCHF in patients and take a look at the management of CCHF in Turkey. Demographics, presenting symptoms and laboratory findings of the patients admitted with a suspicion of CCHF, were recorded from the patient files and database of Ministry of Health. A diagnosis of CCHF was based on detection of immunoglobulin M (IgM) antibodies and/or viral RNA. The patients with and without CCHF were compared in terms of differences in epidemiological, clinical and laboratory findings. Out of 87 patients, 61 (70.1%) were CCHF and 26 (29.9%) were non-CCHF cases. Working with agriculture/livestock, tick exposure, contact with body fluids of animals, travel to rural areas within 2 weeks, fever, headache, leucopenia, anemia, international normalized ratio (INR) elevation were significantly more common in CCHF cases. According to multivariate analysis, tick exposure (odds ratio, OR 9.03, 95% confidence interval, CI 1.96-41.47, p = 0.005), contact with body fluids of animals (OR 14.9, 95% CI 2.23-99.94, p = 0.005), leucopenia (OR 13.65, 95% CI 2.55-72.91, p = 0.02) and anemia (OR 8.41, 95% CI 1.06-66.42, p = 0.04) were independently indicative for CCHF. As it takes a considerable time for a definitive diagnosis, determining epidemiological features and risk factors is an important step for preliminary diagnosis of CCHF as well as early implementation of precautions against nosocomial transmission of the virus.

Citation

Zuhal Yeşilbağ, Aslı Karadeniz, Safiye Koçulu, Cahit Bekir Kayhan. Epidemiological characteristics, clinical and laboratory findings supporting preliminary diagnosis of Crimean-Congo hemorrhagic fever in an endemic region in Turkey. Wiener klinische Wochenschrift. 2020 Oct;132(19-20):581-588