title: Crimean-Congo hemorrhagic fever in Turkey.
abstract: In 2002 and 2003, a total of 19 persons in Turkey had suspected cases of Crimean-Congo hemorrhagic fever (CCHF) or a similar viral infection. Six serum samples were tested; all six were found positive for immunoglobulin M antibodies against CCHF virus. Two of the samples yielded CCHF virus isolates. Genetic analysis of the virus isolates showed them to be closely related to isolates from former Yugoslavia and southwestern Russia. These cases are the first of CCHF reported from Turkey. Eighteen patients handled livestock, and one was a nurse with probable nosocomial infection. The case-fatality rate was 20% among confirmed CCHF case-patients (1 of 5 patients), and the overall case-fatality rate was 11% (2 of 19 patients). In addition to previously reported symptoms and signs, we report hemophagocytosis in 50% of our patients, which is the first report of this clinical phenomenon associated with CCHF.
authors.affiliation: Karadeniz Technical University, School of Medicine, Department of Internal Medicine, Division of Hematology, Trabzon, Turkey. samikarti@yahoo.com
authors.forename: S Sami
authors.initials: SS
authors.lastname: Karti
authors.forename: Zekaver
authors.initials: Z
authors.lastname: Odabasi
authors.forename: Volkan
authors.initials: V
authors.lastname: Korten
authors.forename: Mustafa
authors.initials: M
authors.lastname: Yilmaz
authors.forename: Mehmet
authors.initials: M
authors.lastname: Sonmez
authors.forename: Rahmet
authors.initials: R
authors.lastname: Caylan
authors.forename: Elif
authors.initials: E
authors.lastname: Akdogan
authors.forename: Necmi
authors.initials: N
authors.lastname: Eren
authors.forename: Iftihar
authors.initials: I
authors.lastname: Koksal
authors.forename: Ercument
authors.initials: E
authors.lastname: Ovali
authors.forename: Bobbie R
authors.initials: BR
authors.lastname: Erickson
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Vincent
authors.forename: Stuart T
authors.initials: ST
authors.lastname: Nichol
authors.forename: James A
authors.initials: JA
authors.lastname: Comer
authors.forename: Pierre E
authors.initials: PE
authors.lastname: Rollin
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Ksiazek
mesh_terms: D000328:Adult; D000914:Antibodies, Viral / Q000097:blood; D005260:Female; D003225:Hemorrhagic Fever Virus, Crimean-Congo / Q000145:classification / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D006479:Hemorrhagic Fever, Crimean / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000821:virology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D010587:Phagocytosis; D010802:Phylogeny; D017422:Sequence Analysis, DNA; D014421:Turkey / Q000453:epidemiology
chemical_list: D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M