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

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Summary

Background

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.

Methods

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.

Results

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.

Conclusion

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.

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Authors and Affiliations

  1. Department of Infectious Diseases and Clinical Microbiology, Bakirkoy Dr. Sadi Konuk Education and Research Hospital, Dr. Tevfik Saglam street, No:11, 34147, Bakırköy/Istanbul, Turkey

    Zuhal Yeşilbağ

  2. Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Maltepe University, Istanbul, Turkey

    Aslı Karadeniz

  3. Department of Infectious Diseases and Clinical Microbiology, Florence Nightingale Hospital, Istanbul, Turkey

    Safiye Koçulu

  4. Health Directorate of Yozgat, Ministry of Health, Yozgat, Turkey

    Cahit Bekir Kayhan

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  1. Zuhal Yeşilbağ
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  2. Aslı Karadeniz
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  4. Cahit Bekir Kayhan
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Correspondence to Zuhal Yeşilbağ.

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Z. Yeşilbağ, A. Karadeniz, S.  Koçulu, and C.B. Kayhan declare that they have no competing interests.

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Yeşilbağ, Z., Karadeniz, A., Koçulu, S. et al. Epidemiological characteristics, clinical and laboratory findings supporting preliminary diagnosis of Crimean-Congo hemorrhagic fever in an endemic region in Turkey. Wien Klin Wochenschr 132, 581–588 (2020). https://doi.org/10.1007/s00508-020-01719-5

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