Re-evaluation of 400 Crimean-Congo hemorrhagic fever cases in an endemic area: is ribavirin treatment suitable?

Vector Borne Zoonotic Dis. 2012 Sep;12(9):812-6. doi: 10.1089/vbz.2011.0694. Epub 2011 Oct 18.

Abstract

Background: Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral disease, seen in various regions around the world, leading to death following a clinical syndrome of hemorrhagic fever.

Methods: This trial was conducted in Tokat State Hospital that is located in an endemic area. Four hundred patients referring to hospital between 2007 and 2009 and diagnosed as having CCHF with RT-PCR were enrolled in this trial. Ribavirin was not administered to any patient. Epidemiological, clinical, and laboratory findings of CCHF and factors affecting mortality were evaluated.

Results: Twenty patients (5%) died and 380 patients recovered (95%). It was found that mean age, white blood cells (WBC), active tromboplastine time (aPTT), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) values were significantly higher in patients who died, as compared with recovered cases and the difference was significant. Platelet values were significantly lower in patients who died, as compared with recovered cases.

Conclusions: Age, male gender, high levels of ALT, AST, WBC aPTT values, platelet levels, and decrease in these values during follow-up are indicative of a poor prognosis. Use of ribavirin is not required in treatment of CCHF.

MeSH terms

  • Adult
  • Aged
  • Alanine Transaminase / blood
  • Animals
  • Antiviral Agents / pharmacology
  • Antiviral Agents / therapeutic use*
  • Aspartate Aminotransferases / blood
  • Blood Cell Count
  • Endemic Diseases*
  • Female
  • Hemorrhagic Fever Virus, Crimean-Congo / drug effects*
  • Hemorrhagic Fever Virus, Crimean-Congo / genetics
  • Hemorrhagic Fever Virus, Crimean-Congo / isolation & purification
  • Hemorrhagic Fever, Crimean / blood
  • Hemorrhagic Fever, Crimean / diagnosis
  • Hemorrhagic Fever, Crimean / drug therapy*
  • Hemorrhagic Fever, Crimean / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Retrospective Studies
  • Ribavirin / pharmacology
  • Ribavirin / therapeutic use*
  • Tick Bites / complications
  • Ticks / virology
  • Turkey / epidemiology

Substances

  • Antiviral Agents
  • Ribavirin
  • Aspartate Aminotransferases
  • Alanine Transaminase