Crimean-Congo Haemorrhagic Fever Cases Without Travel History to Endemic Areas in Adiyaman/Adiyaman'da Endemik Bolgelere Seyahat Oykusu Olmayan Kirim- Kongo Kanamali Atesi Olgulari

• Published in: KLIMIK dergisi Vol. 30; no. 3; p. 142
• Main Authors: Sayiner, Hakan Sezgin, ahin, Mehmet Selim, Biyik, Murat, Selcuk, Mustafa Yavuz, Aksoz, Selcuk, Oznas, Orhan
• Format: Journal Article
• Language: English
• Published: AVES 01-12-2017
• Subjects: Crimean hemorrhagic fever; Disease susceptibility; Distribution; Forecasts and trends; Rural health; Turkey
• ISSN: 1301-143X
• DOI: 10.5152/kd.2017.34

Objective: We aimed to draw attention for the first time to patients with Crimean-Congo haemorrhagic fever (CCHF) who lived in rural Adiyaman with no travel history to endemic areas. Methods: Five cases with fever living in rural areas and diagnosed as CCHF in Emergency Department, Training and Research Hospital, Adiyaman University between May 2014 and June 2015 were evaluated. Polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA) were used in Microbiology Reference Laboratory of Public Health Institute of Turkey to detect CCHF virus RNA and IgM antibodies, respectively. Results: A tick was found in the inguinal region of one patient during physical examination after admission. Three patients had a history of tick bite, while there was no history of tick contact in one patient. All patients received supportive treatment. Two patients were given fresh frozen plasma and platelet suspension because of bleeding and thrombocytopenia. All patients were discharged with full recovery. Conclusions: More attention should be given to detailed medical history and physical examination if there is no explanation for clinical picture in patients with fever living in rural areas and admitted to emergency department during months when the CCHF cases are common in Turkey. Scalp, inguinal and axillary regions of patients should be carefully checked for tick attachment. Klimik Dergisi 2017; 30(3): 142-5. Key Words: Crimean-Congo haemorrhagic fever virus, tick bites, Adiyaman. Amac: Bu calismayla, endemik bolgeye seyahat oykusu olmasa da Adiyaman ilinde Kirim-Kongo kanamali atesi (KKKA) olan hastalarla karsilasilabilecegine ilk kez dikkat cekmek istedik. Yontemler: Mayis 2014-Haziran 2015 tarihleri arasinda, Adiyaman Universitesi Egitim ve Arastirma Hastanesi Acil Servisi'ne yatirilarak KKKA tanisi konulmus, kirsal bolgede yasayan ve atesi olan bes hasta degerlendirildi. KKKA virusu RNA'si polimeraz zincir reaksiyonu (PCR)'yla, IgM antikorlari "enzyme-linked immunosorbent assay" (ELISA) yontemiyle Turkiye Halk Sagligi Kurumu Mikrobiyoloji Referans Laboratuvari'nda saptandi. Bulgular: Bir hastada yatirildiktan sonra yapilan fiziksel inceleme sirasinda inguinal bolgede kene saptandi. Diger hastalardan ucunun oykusunde kene tutunmasi saptanirken bir olguda kene tutunmasi oykusu yoktu. Tum hastalara destek tedavisi uygulandi. Iki hastaya kanama ve trombositopeni nedeniyle taze donmus plazma ve trombosit suspansiyonu da verildi. Hastalar sifayla taburcu edildi. Sonuclar: Ulkemizde KKKA olgularinin sik goruldugu aylarda acil servise atesle basvurmus kirsal bolgede yasayan hastalarda, klinik tabloyu aciklayacak herhangi bir neden bulunamadiginda, oykunun derinlestirilmesine ve fizik muayeneye daha fazla onem verilmelidir. Hastalarin sacli derileri, kasik bolgeleri ve koltuk altlari, kene tutunmasi acisindan dikkatle incelenmelidir. Klimik Dergisi 2017; 30(3): 142-5. Anahtar Sozcukler: Kirim-Kongo kanamali atesi virusu, kene tutunmalari, Adiyaman.