Kırım Kongo Kanamalı Ateşi Tanısıyla İzlenen Hastaların Epidemiyolojik ve Biyokimyasal Olarak Değerlendirilmesi

Abstract

Amaç: Kırım Kongo Kanamalı Ateşi (KKKA), ilk kez 1944 yılında Kırım’da tanımlanmış bir viral hemorajik ateştir. Ülkemizde ilk 2002 yılında Tokat ve çevresindeki salgınla dikkati çekmiştir. Bu çalışmada KKKA hastalarının klinik, epidemiyolojik ve laboratuvar özelliklerinin değerlendirilmesi amaçlanmıştır. Yöntem: Bu çalışma, Atatürk Üniversitesi Tıp Fakültesi, Enfeksiyon Hastalıkları Kliniği’nde Nisan 2012-Ağustos 2013 tarihleri arasında KKKA tanısıyla takip edilen erişkin yaştaki hastalar arasında yapılmıştır. Veriler prospektif olarak toplanıp, IBM-SPSS 20 paket programına kaydedildi. İstatistik analizlerinde Mann-Whitney U, Ki-kare ve Fisher exact testi kullanıldı. Bulgular: Kırım Kongo Kanamalı Ateşi tanısı Refik Saydam Hıfzısıhha Merkezinde hasta serumlarında Enzyme-linked immunosorbent assay (ELISA) ile anti-CCFV IgM ve/veya virüs antijeni real time Polimeraz zincir reaksiyonu (RT-PCR) yöntemi ile konuldu. Toplam 121 olgu alındı. Hastaların 59 (%48,7)’i erkek, 62 (%51,2)’si kadın olup, yaş ortalaması 50.04 ± 18.22 (16-86) yıl idi. Hastaların %62,8’sinde kene teması saptanmıştır. İnkübasyon süresi 3.9±2,7 gün idi. Hastalardan 5 (%4,1)’i ölmüştür. Sonuç: KKKA keneler tarafından taşınan ölümcül bir viral infeksiyondur. Korunmada en önemli faktör kene temasını önlemektir. Endemik bölgede yaşayanlar eğitilmeli, günlük kene kontrolü yapılması anlatılmalıdır. Hastalara yüksek ateş, kas ağrısı, baş ağrısı şikâyetleri ve kene teması mutlaka sorulmalıdır. KKKA olgularının erken tanı ve tedavi ile mortalite ve morbiditelerinin azaltılabileceğine inanmaktayız.

Keywords

• Kırım Kongo Kanamalı Ateşi
• mortalite oranı
• Türkiye

Epidemiological and Biochemical Evaluation of Patients Under Monitoring with A Diagnosis of Crimean-Congo Hemorrhagic Fever

Abstract

Aim: Crimean-Congo Hemorrhagic Fever (CCHF) is a viral hemorrhagic fever. To evaluate the clinical, epidemiological and laboratory characteristics of patients with CCHF. Methods: This study was performed with adult patients under monitoring with diagnosis of CCHF at the Atatürk University Faculty of Medicine Infectious Diseases Clinic between April 2012 and August 2013. Results: Diagnosis of CCHF was based on presence of Enzyme-linked immunosorbent assay (ELISA) anti-CCFV IgM and/or virus antigen at Refik Saydam Hygiene Center (RSHM) in patient serum and/or real time Polymerase Chain Reaction (PCR). One hundred twenty-one cases were included. Fifty-eight (48.7%) of patients were male and 62(51.2%) female, with a mean age of 50.04 ± 18.22 (16-86) years. Contact with ticks was determined in 62.8% of patients. Length of incubation was 3.9±2.7 days. Five patients (4.1%) died. Conclusion: CCHF which is carried by ticks is a fatal viral infection. The most important factor in protection is the prevention of tick contact. People living in endemic regions must be educated and instructed how to perform daily tick checks. Patients have got high fever, myalgia, headache and tick bite must be asked in history. We believe that early diagnosis and treatment of CCHF cases may significantly reduce morbidity and mortality.

Keywords

• Crimean-Congo Hemorrhagic Fever
• mortality rate
• Turkey

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