Ahmet Hakan ÜNLÜ, Esra GÜRBÜZ, Abdurrahman EKİCİ, Hasan YILMAZ

Evaluation of seroprevalence and clinical and laboratory findings of patients admitted to health institutions in Gümüşhane with suspicion of Crimean-Congo hemorrhagic fever

Background/aim: To determine the seroprevalence and evaluate clinical findings and laboratory results of patients prediagnosed with Crimean-Congo hemorrhagic fever (CCHF) in Gümüşhane. Materials and methods: Included in the cross-sectional study were 362 patients (162 female, 200 male) between 0 and 94 years of age, who were followed up after receiving a preliminary diagnosis of CCHF between January 2011 and December 2019. Anamnesis, age, sex, clinical findings, laboratory results, epidemiological and clinical evaluations, severity criteria, risk factor reviews, and a comparison of the suspected negative cases with positive cases were analyzed retrospectively. Patients included in the study were evaluated as RNApositive by polymerase chain reaction (PCR) or IgM-positive by ELISA. Results: Of the 362 patients admitted to health institutions with a preliminary diagnosis of CCHF, 242 were diagnosed as CCHFpositive (66.9%). Moreover, 196 of those CCHF-positive patients (81%) were admitted to health institutions during the summer months. Statistical analyses revealed a significant relationship between the incidence of CCHF and patients who had been in contact with animals, lived in rural areas, and had engaged in farming and animal husbandry. In addition, fever, headache, diffuse bodily pain, nausea and vomiting, diarrhea, fever of 38 °C or higher, tachycardia, elevated ALT/AST, creatine kinase (CK), and lactate dehydrogenase (LDH) levels, leukopenia, and thrombocytopenia were detected in the CCHF-positive patients. Significant relations were found between this disease and these symptoms. However, there was no significant relationship between the statistical evaluation of the disease and bloody diarrhea, bodily bruises, rash, unconsciousness, gingival bleeding, hypotension, epistaxis, petechiae, splenomegaly, ecchymosis, hematuria, maculopapular rash, gastrointestinal system complaints, anemia, or elevation of the international normalized ratio and activated partial thromboplastin time duration, separately. Conclusion: Of the 362 patients, 66.9% (242) of those who received a preliminary diagnosis of CCHF were indeed CCHF-positive in Gümüşhane. It was concluded that CCHF remains an important endemic disease in Gümüşhane. In addition, elevated ALT/AST, CK, and LDH levels, leukopenia, and thrombocytopenia in patients presenting with headache, fever, fever of 38 °C or higher, generalized body pain, nausea/vomiting, diarrhea, and tachycardia will play a pivotal role in the preliminary diagnosis of CCHF.Key words: Crimean-Congo hemorrhagic fever, seroprevalence, clinical and laboratory findings

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