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Published Date: 2012-05-17 17:15:00
Subject: PRO/AH/EDR> Crimean-Congo hem. fever - Turkey: (AA) human fatalities
Archive Number: 20120517.1136414

CRIMEAN-CONGO HEMORRHAGIC FEVER - TURKEY: (ANATOLIA), HUMAN FATALITIES
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Date: Wed 16 May 2012
Source: World News UPI.com [edited]
http://www.upi.com/Top_News/World-News/2012/05/16/5-die-of-tick-borne-disease-in-Turkey/UPI-61191337174372/?spt=hs&or=tn


5 people have died in the Black Sea region of Turkey of a disease that can be transmitted by tick bites, officials said; 3 residents of Kastamonu province in northern Turkey were taken to the Ankara Numune Hospital on Tuesday 15 May 2012 and died that day from Crimean-Congo hemorrhagic fever, today's [16 May 2012] Zaman [newspaper] reported. A shepherd from Tokat district in Tokat province and a farmer from Corum province also died of the disease Tuesday.

The disease, which affects mainly farm and slaughterhouse workers in the countryside and in the central Anatolia and Black Sea regions, is normally transmitted by bites from infected ticks or through direct contact with infected blood tissue in livestock. Transmission between humans through exposure to contaminated blood is rare.

As a result of global warming, ticks carrying the virus are multiplying faster, scientists said. The disease, for which there is no vaccine, causes hemorrhage, high fever, muscle pain, and vomiting. In severe cases, the disease can cause a body rash, bleeding from the bowels and gums and renal failure.

The disease, which has a mortality rate of about 30 percent, was 1st identified in the Crimea in 1944 and later appeared in the Congo.

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[In rural parts of central and northern Turkey, Crimean-Congo hemorrhagic fever (CCHF) is an occupational hazard for some types of agricultural workers. CCHF is caused by infection with a tick-borne virus classified in the genus _ Nairovirus_ in the family _Bunyaviridae_. The disease was 1st characterized in the Crimea in 1944 and given the name Crimean hemorrhagic fever. It was then later recognized in 1969 as the cause of illness in the Congo, thus resulting in the current name of the disease. CCHF is found in Eastern Europe, particularly in the former Soviet Union. It is also distributed throughout the Mediterranean, in northwestern China, central Asia, southern Europe, Africa, the Middle East, and the Indian subcontinent.

Ixodid (hard) ticks, especially those of the genus, _Hyalomma_, are both a reservoir and a vector for the CCHF virus. Numerous wild and domestic animals, such as cattle, goats, sheep and hares, serve as amplifying hosts for the virus. Transmission to humans occurs through contact with infected animal blood or ticks. CCHF can be transmitted from one infected human to another by contact with infectious blood or body fluids. Documented spread of CCHF has also occurred in hospitals due to improper sterilization of medical equipment, reuse of injection needles, and contamination of medical supplies.

In humans, the length of the incubation period for the illness appears to depend on the mode of acquisition of the virus. Following infection via tick bite, the incubation period is usually one to 3 days, with a maximum of 9 days. The incubation period following contact with infected blood or tissues is usually 5-6 days, with a documented maximum of 13 days. The mortality rate from CCHF is approximately 30 percent, with death occurring in the 2nd week of illness. In those patients who recover, improvement generally begins on the 9th or 10th day after the onset of illness. General supportive therapy is the mainstay of patient management in CCHF. Intensive monitoring to guide blood volume and component replacement is required. The antiviral drug ribavirin has been used in treatment of established CCHF infection with apparent benefit. Both oral and intravenous formulations seem to be effective. (Further information can be obtained from the WHO Fact Sheet at: http://www.who.int/mediacentre/factsheets/fs208/en/index.html.

An image of a _Hyalomma_ app. tick can be viewed at: http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/cchf.htm).

The provinces of Corum, Kastamonu, and Tokat can be located in the map of the provinces of Turkey at http://www.mapsofworld.com/turkey/turkey-political-map.html. - Mod.CP

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1Cfs.]

See Also

2009
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Crimean-Congo hem. fever - Turkey (05) 20090601.2039
Crimean-Congo hem. fever - Turkey: (SS) 20090514.1808
2008
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Crimean-Congo hem. fever - Turkey (16) 20081125.3717
Crimean-Congo hem. fever - Turkey 20080508.1567
2007
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Crimean-Congo hemorrhagic fever - Turkey 20070610.189
2006
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Crimean Congo hemorrhagic fever - Turkey (05) 20060822.2359
Crimean-Congo hemorrhagic fever - Turkey 20060705.1844
2005
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Crimean-Congo hem. fever - Turkey 20050729.2210
2004
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Crimean-Congo hem. fever - Turkey 2002-2003: 1st report 20041016.2814]
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