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Crimean-Congo haemorrhagic fever outbreak in Middle Anatolia: a multicentre study of clinical features and outcome measures

Mehmet Bakir¹, Mehmet Ugurlu², Basak Dokuzoguz³, Hurrem Bodur³, Mehmet A Tasyaran⁴, Haluk Vahaboglu⁵ and the Turkish CCHF Study Group

¹Klinik Bakteriyoloji & Enfeksiyon Hastaliklari AD., Tip Fakultesi, Cumhuriyet Universitesi, Sivas, Turkey ²Temel Saglik Hizmetleri Genel Mudurlugu, Saglik Bakanligi, Ankara, Turkey ³Klinik Bakteriyoloji & Enfeksiyon Hastaliklari Dept, Numune Hast., Ankara, Turkey ⁴Klinik Bakteriyoloji & Enfeksiyon Hastaliklari AD., Tip Fakultesi, Ataturk Universitesi, Erzurum, Turkey ⁵Klinik Bakteriyoloji & Enfeksiyon Hastaliklari AD., Tip Fakultesi, Kocaeli Unversitesi, Kocaeli, Turkey

Correspondence Haluk Vahaboglu vahabo{at}hotmail.com

Received August 16, 2004
Accepted December 8, 2004

A Crimean-Congo haemorrhagic fever (CCHF) outbreak emerged from 2001 to 2003 in the Middle Anatolia region of Turkey. This study describes the clinical characteristics and outcome features of CCHF patients admitted to four tertiary care hospitals in Turkey. Definitive diagnosis was based on the detection of CCHF virus-specific IgM by ELISA or of genomic segments of the CCHF virus by RT-PCR. Related data were collected by a retrospective chart review. Hospital costs were extracted from the final discharge bills. Univariate and multivariate analyses were conducted to determine the independent predictors of mortality. CCHF virus-specific antibodies or genomic segments were detected in the sera of 99 cases. Seven cases that were treated with ribavirin were excluded from the study. Cases were mostly farmers (83 cases, 90 %), and 60 % had a tick-bite history before the onset of fever. Impaired consciousness and splenomegaly were independent predictors of a fatal outcome.

Abbreviations: CCHF, Crimean-Congo haemorrhagic fever; LOS, length of hospital stay.

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