Crimean-Congo hemorrhagic fever in Turkey

Area of Science:

• Virology
• Infectious Diseases
• Epidemiology

Background:

• Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral disease with significant morbidity and mortality.
• The geographic distribution of CCHF virus is expanding, with recent emergence in new regions.
• Limited data exists on CCHF epidemiology and genetic diversity in the Middle East and surrounding areas.

Purpose of the Study:

• To report the first confirmed cases of CCHF in Turkey.
• To characterize the genetic features of CCHF virus isolates from Turkey.
• To describe the clinical presentation and outcomes of CCHF patients in Turkey, including novel clinical findings.

Main Methods:

• Suspected CCHF cases were identified and investigated in Turkey during 2002-2003.
• Serum samples were tested for CCHF virus immunoglobulin M (IgM) antibodies.
• CCHF virus isolates were obtained and subjected to genetic analysis.
• Clinical data and patient outcomes were collected and analyzed.

Main Results:

• Nineteen suspected cases of CCHF were reported, with six serum samples testing positive for CCHF virus IgM antibodies.
• Two CCHF virus isolates were successfully obtained and genetically analyzed.
• The Turkish CCHF virus isolates showed close genetic relatedness to strains from the former Yugoslavia and southwestern Russia.
• The case-fatality rate among confirmed CCHF patients was 20% (1 of 5), and 11% overall (2 of 19).
• Hemophagocytosis was observed in 50% of patients, a previously unreported clinical manifestation in CCHF.

Conclusions:

• These findings represent the first documented cases of CCHF in Turkey.
• The genetic analysis suggests a potential epidemiological link between CCHF in Turkey and neighboring regions.
• The high prevalence of hemophagocytosis indicates its potential significance as a clinical marker in CCHF.
• The study highlights the need for increased surveillance and awareness of CCHF in Turkey and surrounding areas.