Crimean Congo haemorrhagic fever Invited Editor

Abstract

Crimean Congo haemorrhagic fever CCHF virüs causes severe disease in humans with a mortality reaching 30 It has the most extensive geographic distribution among the medically important tick borne viral diseases Although it is more frequently recovered from animals without any symptoms sporadic cases or epidemics may also be seen in human beings Acute course of the disease appears with symptoms of generalized pain myalgia fever nausea vomiting abdominal pain diarrhoea ecchymoses and bleeding and findings of elevated liver enzymes thrombocytopenia and leukopenia The knowledge of the presenting features of haemorrhagic fevers is necessary for the clinician as early diagnosis and treatment might potentially decrease mortality and the chance of secondary spread of the infection Ribavirin has been tried in the treatment of Crimean Congo haemorrhagic fever Turk Arch Ped 2008; 43: 108 18 Key words: Crimean Congo haemorrhagic disease tick borne viral haemorrhagic disease

Keywords

• -

Kırım Kongo kanamalı ateşi Çağrılı Editör

Öz

Kırım Kongo kanamalı ateşi KKKA virüsü insanlarda 30 ölüm oranına ulaşan şiddetli kanamayla seyreden hastalığa neden olmaktadır Tıbbi olarak önemli kene kaynaklı hastalıklardan en geniş coğrafik dağılıma sahip olanıdır Hayvanlarda daha sık görülmekle beraber hastalık etkeni olduğu bugüne kadar gösterilememiştir ancak insanlarda tek tük olgular ya da salgınlar şeklinde ağır kanama ile seyreden klinik tablolara neden olabilir Hastalığın akut bulguları yaygın ağrı miyalji ateş bulantı kusma karın ağrısı ishal ekimoz ve kanama ile yüksek transaminaz değerleri trombositopeni ve lökopeni ile belirgin labaratuvar bulguları şeklindedir Erken konulan tanı ve başlanılan tedavi ölüm oranını azalttığı ve enfeksiyonun ikincil olarak yayılımını önlediği için kanamalı hastalığın ilk ortaya çıkan özelliklerinin bilinmesi önemlidir Tedavinin esasını destek tedavisi oluşturmakla birlikte ribavirinin KKKA hastalarda antiviral amaçlı kullanımı söz konusudur Türk Ped Arş 2008; 43: 108 18 Anahtar kelimeler: Kene Kırım Kongo kanamalı ateşi viral kanamalı ateş

Anahtar Kelimeler

• Kene, Kırım Kongo kanamalı ateşi, viral kanamalı ateş

Kaynakça

1. Burt FJ, Leman PA, Smith JF, et al. The use of a reverse transcription-polymerase chain reaction for the detection of viral nucleic acid in the diagnosis of Crimean-Congo haemorrhagic fever. J Virol Methods 1998; 70:129-37.
2. Flick R. Molecular biology of the Crimean-Congo haemorrhagic fever virüs. In Ergonul O, Whitehouse CA (eds). Crimean-Congo Hemorhagic virus. A Global Perspective. Netherlands: Springer 2007; 35-45.
3. International Toxonomy of virüses, Bunyaviridae http://www.ncbi.nlm.nih.gov/ICTVdb/Ictv/fs_bunya.htm# Genus3 (erişim Ağustos 2008).
4. Elliott RM, Schmaljohn CS, Collett MS. Bunyaviridae genome structure and gene expression. Curr Top Microbiol Immunol 1991;169: 91-141.
5. Ergonul O. Crimean-Congo haemorrhagic fever. Lancet Infect Dis 2006; 6: 203-14.
6. Watts DM, Ksiazek TG, Linthicum KJ, Hoogstraal H. Crimean-Congo haemorrhagic fever. In: Monath TP (ed). The arboViruses: epidemiology and ecology, volume 2. Boca Raton: CRCPress, 1988: 177-260.
7. Whitehouse CA. Crimean-Congo haemorrhagic fever. Antivir Res 2004; 64: 145-60.
8. McCormick JB, King IJ. A case-control study of the clinical diagnosis and course of Lassa fever. J Infect Dis 1987; 155: 445-55.

9. Le Guenno B. Emerging virüses. Sci Am 1995; 273: 56-64.
10. Centers for Disease Control and Prevention. Bioterrorism agents/diseases. http://www.bt.cdc.gov/Agent/Agentlist.asp (erişim Şubat, 2006).
11. Arda B, Acıduman A. A historical perspective of infectious diseases with reference to Crimean-Congo haemorrhagic fever. In: Ergonul O, Whitehouse CA (eds). Crimean-Congo hemorhagic virus a global perspective. Netherlands: Springer, 2007; 13-22.
12. Simpson DIH. Viral haemorrhagic fevers of man. Bull WHO 1978; 56: 819-32.
13. Papa A, Ma B, Kouidou S, et al. Genetic characterization of the mRNA segment of Crimean-Congo haemorrhagic fever virus strains, China. Emerg Infect Dis 2002; 8: 50-3.
14. Simpson DIH, Knight EM, Courtois G, Williams MC, Weinbern MP, Kibukamusoke JW. Congo virüs: a hitherto undescribed virus occuring in Africa. Human isolations-clinical notes. East Afr Med J 1967; 44: 86-92.
15. Altaf A, Luby S, Ahmed AJ, et. al. Outbreak of Crimean-Congo haemorrhagic fever in Quetta, Pakistan: contact tracing and risk assessment. Trop Med Int Health 1998; 3: 878-82.
16. Country report Pakistan. Vector-borne diseases in Pakistan. Inter-Country workshop on developing a regional strategy for integrated vector management for malaria and other vector-borne diseases, Khortoum, Sudan, 2003: 21-3.
17. el-Azazy OM, Scrimgeour EM. Crimean-Congo haemorrhagic fever virüs infection in the western province of Saudi Arabia. Trans R Soc Trop Med Hyg 1997; 91: 275-8.
18. Williams RJ, Al-Busaidy S, Mehta FR, et al. Crimean-Congo haemorrhagic fever: a seroepidemiological and tick survey in the Sultanate of Oman. Trop Med Int Health 2000; 5: 99-106.
19. Papa A, Christova I, Papadimitriou E, Antoniadis A. Crimean-Congo haemorrhagic fever in Bulgaria. Emerg Infect Dis 2004; 10: 1465-7.
20. Hoogstraal H. The epidemiology of tick-borne Crimean-Congo haemorrhagic fever in Asia, Europe, and Africa. J Med Entomol 1979; 15: 307-417.
21. Gozalan A, Akin L, Rolain JM, et al. Epidemiological evaluation of a possible outbreak in and nearby Tokat province. Mikrobiyol Bul 2004; 38: 33-44.
22. Yılmaz GR, Buzgan T, Torunoğlu MA, et al. A preliminary report on Crimean-Congo haemorrhagic fever in Turkey, March -June 2008. Eurosurveillance 2008; 13: 18953.
23. www.saglık.gov.tr erişim 15 Ağustos 2008.
24. www.hurriyet.com.tr erişim 15 Ağustos 2008.
25. Communicable Disease Surveillance and Response http://www.euro.who.int/surveillance/outbreaks/20080806_1 (erişim 18 Ağustos 2008).
26. Zeller HG, Cornet JP, Camicas JL. Experimental transmission of Crimean-Congo haemorrhagic fever virus by west African wild ground-feeding birds to Hyalomma marginatum rufi pes ticks. Am J Trop Med Hyg 1994; 50: 676-81.
27. Aydın L, Bakırcı S. Geographical distribution of ticks in Turkey. Parasitol Res 2007; 101: 163-6.
28. LeDue JW. Epidemiology of haemorrhagic fever viruses. Rev Infect Dis 1989; 11: 730-5.
29. Harxhi A, Pilaca A, Delia Z, Pano K, Rezza G. Crimean-Congo haemorrhagic fever: a case of nosocomial transmission. Infection. 2005; 33: 295-6.
30. van de Wal BW, Joubert JR, van Eeden PJ, King JB. A nosocomial outbreak of Crimean-Congo haemorrhagic fever at Tygerberg Hospital. Part IV. Preventive and prophylactic measures. S Afr Med J 1985; 68: 729-32.
31. Karti SS, Odabasi Z, Korten V, et al. Crimean-Congo haemorrhagic fever in Turkey. Emerg Infect Dis 2004; 19: 1379-84.
32. Swanepoel R, Shepherd AJ, Leman PA, et al. Epidemiologic and clinical features of Crimean-Congo haemorrhagic fever in Southern Africa. Am J Trop Med Hyg 1987; 36: 120-32.
33. Mehmet Bakır. Kırım Kongo kanamalı ateşi kliniği ve olgular. XXXI. Türk Mikrobiyoloji Kongre Kitabı 2004: 213-4.
34. Saluzzo JF, Aubry P, McCormick J, Digoutte JP. Haemorrhagic fever caused by Crimean Congo haemorrhagic fever virüs in Mauritania. Trans R Soc Trop Med Hyg 1985; 79: 268.
35. Geisbert TW, Jahrling PB. Exotic emerging viral diseases: progress and challenges. Nat Med 2004; 10: S110-21.
36. Feldman H, Jones S, Klenk HD, Schnittler HJ. Ebola virus: from discovery to vaccine. Nat Immunol 2003; 3: 677-85.
37. Shepherd AJ, Swanepoel R, Leman PA. Antibody response in Crimean-Congo haemorrhagic fever. Rev Infect Dis 1989; 11: 801-06.
38. Saijo M, Tang Q, Shimayi B, et al. Recombinant nucleoprotein based serological diagnosis of Crimean-Congo haemorrhagic fever virus infections. J Med Virol 2005; 75: 295-9.
39. Burt FJ, Leman PA, Abbott JC, Swanepoel R. Serodiagnosis of Crimean-Congo haemorrhagic fever. Epidemiol Infect 1994; 113: 551-62.
40. Schwarz TF, Nsanze H, Longson M, et al. Polymerase chain reaction for diagnosis and identification of distinct variants of Crimean-Congo haemorrhagic fever virus in the United Arab Emirates. Am J Trop Med Hyg 1996; 55: 190-6.
41. Drosten C, Gottig S, Schilling S, et al. Rapid detection and quantification of RNA of Ebola and Marburg virüses, Lassa virus, Crimean-Congo haemorrhagic fever virus, Rift Valley fever virus, dengue virus, and yellow fever virus by real-time reverse transcription-PCR. J Clin Microbiol 2002; 40: 2323-30.
42. Watts DM, Ussery MA, Nash D, Peters CJ. Inhibition of Crimean-Congo haemorrhagic fever viral infectivity yields in vitro by ribavirin. Am J Trop Med Hyg 1989; 41: 581-5.
43. WHO. Crimean-Congo haemorrhagic fever. ttp://www.who. int/mediacentre/factsheets/fs208/en/ (erişim Şubat 2006).
44. Vassilenko SM, Vassilev TL, Bozadjiev LG, Bineva IL, Kazarov GZ. Specific intravenous immunoglobulin for Crimean-Congo haemorrhagic fever. Lancet 1990; 335: 791-2.
45. Ankara İl Sağlık Müdürlüğü internet sayfası http://www.asm. gov.tr/ShowNotice.Asp?pTip=3&pId=213 (erişim 20 Ağustos 2008).
46. Kara A. Kene çıkartılması. Çocuk Sağlığı ve Hastalıkları Dergisi (Baskıda).
47. www.saglik.gov.tr (30/12/2003 tarihli ve B100TSH0110002/20 409 sayılı genelge, 31/03/2004 tarihli ve B100TSH0110002/5367 (2004/46) B100TSH0110002/3580 (2005/40) sayılı genelge, 14/07/2006 tarihli ve B100TSH0110002-104-02-01 sayılı genelgeler).
48. Gammons M, Salam G. Tick removal. Am Fam Phys 2002; 66: 643-4.
49. Lyme disease. Tick removal. CDC Division of vector borne infectious diseases website. Son güncellenme 20 Temmuz 2005. (http://www.cdc.gov/ncidod/dvbid/lyme/ld_tickremoval.htm).
50. Briault A. Manual removal of ticks. Vet Rec 2006;159: 641.
51. Colyar M. Tick removal techniques. Adv Nurse Pract 2006; 14: 26-7.
52. Pitches DW. Removal of ticks: a review of the literature. Euro Surveill 2006;11:E060817.4.