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The current situation of Crimean-Congo Hemorrhagic Fever

Önder Ser, Hüseyin Çetin.

Crimean-Congo hemorrhagic fever (CCHF) is a fatal disease caused by infection with a tick-borne virus, a member of Nairovirus genus in the family Bunyaviridae. The CCHF virus is transmitted to humans by the bites of infected ticks, contact with blood or body fluids of CCHF patients or viremic livestock or crushing infected ticks with unprotected hands. Ixodid (hard) ticks, especially Hyalomma genus, are both vector and reservoir for the CCHF virus. CCHF disease have been recorded in an expanding geographic area that currently includes more than thirty countries in Africa, southeastern Europe (especially the Balkans), Asia and the Middle East. Migratory birds and movement of livestock may play an important role in the transportation of infected ticks or CCHF virus from endemic areas to non-endemic areas. Risk groups include humans living in endemic areas, farmers, veterinarians, health-care workers, butchers and soldiers. The incubation period of disease is generally 3-14 days. While the case fatality rate is approximately 30% in the world, this rate is approximately 5% in Turkey. The first CCHF case was reported in 2002 from Tokat province which is located in the Kelkit Valley in Turkey. According to Turkish Ministry of Health data, totally 8047 CCHF cases were declared and 396 of these cases dead between 2002 and 2014. H. marginatum is main tick species responsible for CCHF epidemic in Turkey. Laboratory diagnosis of CCHF is performed by identification of the viral RNA and/or antigens, the detection of specific antibodies and isolation of virus. Currently, there are no vaccine for protection from CCHF and specific antiviral drug for treatment of disease. The main treatment of disease is supportive therapy. Ribavirin is the only antiviral drug used in the treatment of CCHF patients but its effectiveness remains controversial. To protect people from disease, tick populations should be controlled and avoided from contact with ticks and virus.

Key words: Crimean-Congo hemorrhagic fever, Hyalomma, Tick-borne virus

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