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EPIDEMIOLOGY, CLINICAL AND LABORATORY FEATURES OF CRIMEAN-CONGO HEMORRHAGIC FEVER IN GEORGIA
1Tbilisi State Medical University, Department of Infectious Disease, Georgia.
Insights
Crimean-Congo hemorrhagic fever (CCHF) is a severe tick-borne illness. Predictors of fatality include altered mental status, low platelet counts, high liver enzymes, and prolonged clotting times.
Area of Science:
- Medical Entomology
- Infectious Diseases
- Epidemiology
Background:
- Crimean-Congo hemorrhagic fever virus (CCHFV) is transmitted by Hyalomma ticks and contact with infected blood.
- CCHF presents with fever, rash, and bleeding, and has a high fatality rate (15-85%).
Purpose of the Study:
- To identify predictors of fatality in Crimean-Congo hemorrhagic fever patients.
- Analyze epidemiological, clinical, and laboratory findings associated with CCHF outcomes.
Main Methods:
- Retrospective study of 34 CCHF patients (ages 4-77) in Shua Kartli, Georgia.
- Data collected on demographics, exposure history (tick bites, livestock contact), clinical signs, and laboratory results.
Main Results:
- Fatal cases (3/34) were associated with farming/livestock handling and tick bites.
- Key clinical features include acute onset, high fever, intoxication, hemorrhagic symptoms, thrombocytopenia, elevated aminotransferases, and creatine.
- Fatality predictors identified: altered mental status, severe thrombocytopenia, high aspartate aminotransferase, prolonged prothrombin time, and elevated INR.
Conclusions:
- Farming and tick exposure are significant risk factors in the studied region.
- Early identification of altered mental status, severe thrombocytopenia, and elevated liver enzymes can predict CCHF fatality.
Abstract:
Crimean-Congo hemorrhagic fever virus transmitted to humans by Hyalomma ticks or by direct contact with the blood of infected humans or domestic animals. The most common clinical signs of CCHF are fever, nausea, headache, diarrhea, myalgia, petechial rash, and bleeding. CCHF is a severe disease in humans with a fatality rate up to 15-85%. This study was undertaken to determine the predictors of fatality among patients with CCHF based on epidemiological, clinical, and laboratory findings. 34 patients were enrolled in the study, aged 4 to 77; 17 - male and 17 female. 3 of them were fatal cases. All of them were from Shua Kartli: Khashuri, Gori and Kaspi districts, involved in farming/handling livestock and the history of tick bite was present in most of patients. Evaluation of the epidemiological characteristics of this cases showed that the female to male ratio was nearly similar. The disease is common in the rural areas of the region, mostly in the actively working age group and almost all patients were farmers. The results of our study show that the most cardinal clinical and laboratory features of Crimean-Congo hemorrhagic fever are - acute beginning of disease, high fever, intoxication and hemorrhagic symptoms, thrombocytopenia, high level of aminotransferases and creatine. Predictors of fatality are: an altered mental status, in early stage of disease dramatic decreased thrombocytes count and significantly high level of aspartate aminotransferase, also longer the mean prothrombin time and INR.
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