Kırım-Kongo Kanamalı Ateşi (KKKA): Genel Bakış

Yıl 2023, Cilt: 2 Sayı: 1, 33 - 42, 30.06.2023

Müge Fırat , Mohammed Hussin Hashemı , Mohammed Abd Ali Dawod

Öz

Kırım-Kongo kanamalı ateşi, Nairoviridae familyası Orthonairovirus genusundan Kırım-Kongo kanamalı ateşi virüsünün neden olduğu, ateş ve kanama ile karakterize zoonotik bir hastalıktır. Virüsün insanlara bulaşması, hastalık epidemiyolojisinde önemli rol oynayan özellikle Hyalomma cinsi kenelerin tutunmasıyla gerçekleşmektedir. Ayrıca viremik dönemde hayvanların doku ve salgıları, akut hastalık döneminde ise insanların kan ve vücut sıvıları ile bulaşma olabilmektedir. İnkubasyon süresi virüsün giriş yoluna, alınan virüs miktarına ve konağın bağışıklığına bağlı olarak değişir. Hastalık süresince; ani başlayan baş ağrısı, ateş, kas ağrısı, eklem ağrısı, halsizlik, ishal, karın ağrısı, bulantı ve kusma görülmektedir. Klinik seyri ağır olan hastalarda tabloya kanama eklenebilir. Ölüm oranı %30’a kadar çıkabilmektedir. Ülkemizde ilk olarak 2003 yılında kesin tanısı konmuş olan hastalıkta, özellikle endemik bölgelerde yaşayanların korunma konusunda bilinçlendirilmesi, kenelerle mücadele ve böylelikle virüsle temasın önlenmesi korunma açısından en önemli faktörlerdir. Mevcut derlemede Kırım-Kongo kanamalı ateşi hastalığı ile ilgili genel bir bilgi verilmesi amaçlanmıştır.

Anahtar Kelimeler

Kırım-Kongo kanamalı ateşi, zoonotik, Hyalomma, kene kaynaklı hastalıklar

Crimean-Congo Haemorrhagic Fever (CCHF): An Overview

Öz

Crimean-Congo hemorrhagic fever is a zoonotic disease characterized by fever and bleeding, caused by Crimean-Congo hemorrhagic fever virus from the Orthonairovirus genus of Nairoviridae family. The virus is transmitted to human beings by attachment of ticks of the genus particularly Hyalomma which play an important role in disease epidemiology. In addition, the virus can be transmitted by tissues and secretions of animals in viremic period and by blood and body fluids of people in acute disease period. The incubation period varies depending on the virus entry route, the amount of virus ingested and the immunity of the host. Sudden onset of headache, fever, myalgia, arthralgia, weakness, diarrhea, gastralgia, nausea and vomiting is observed during the disease. Bleeding can be added to the table in patients with a severe clinical course. Mortality rate can reach 30%. The most important factors in terms of protection for the disease which was first diagnosed in our country in 2003 are raising awareness about prevention especially among those living in endemic areas, fighting ticks and thus preventing contact with the virus. It is aimed to give general information about the Crimean-Congo hemorrhagic fever in the current review.

Anahtar Kelimeler

Crimean-Congo hemorrhagic fever, zoonotic, Hyalomma, tick-borne diseases

Kaynakça

• Bajpai S, Nadkar, MY (2011) Crimean Congo hemorrhagic fever: requires vigilance and not panic. J Assoc Physicians India 59: 164-167
• Ballinger MJ, Medeiros AS, Qin J, Taylor DJ (2017) Unexpected differences in the population genetics of phasmavirids (Bunyavirales) from subarctic ponds. Virus Evol 3(1):vex015
• Bente DA, Forrester NL, Watts DM, McAuley AJ, Whitehouse CA, Bray M (2013) Crimean-Congo hemorrhagic fever: history, epidemiology, pathogenesis, clinical syndrome and genetic diversity. Antiviral Res 100(1):159-89
• Bernard C, Holzmuller P, Bah MT, Bastien M, Combes B, Jori F, Grosbois V, Vial L (2022) Systematic review on Crimean-Congo hemorrhagic fever enzootic cycle and factors favoring virus transmission: special focus on France, an apparently free-disease area in Europe. Front Vet Sci 9: 932304
• Bodur H, Akinci E, Ascioglu S, Onguru P, Uyar Y (2012) Subclinical infections with Crimean-Congo hemorrhagic fever virus, Turkey. Emerg Infect Dis 18: 640-642
• Carter SD, Surtees R, Walter CT, Ariza A, Bergeron É, Nichol ST, Hiscox JA, Edwards TA, Barr JN (2012) Structure, function, and evolution of the Crimean-Congo hemorrhagic fever virus nucleocapsid protein. J Virol 86 (20): 10914-23
• Casals J (1969) Antigenic similarity between the virus causing Crimean hemorrhagic fever and Congo virus. Proc Soc Exp Biol Med 131(1):233-6
• CDC (2021) Bunyavirales. https://www.cdc.gov/vhf/virus-families/bunyaviridae. Erişim tarihi: 22.06.2023 Çevik M (2004) Kırım-Kongo kanamalı ateşi: Klinik özellikleri. Klimik Derg 17:59-61
• Cevik MA, Erbay A, Bodur H, Gulderen E, Bastug A, Kubar A, Akinci E (2008) Clinical and laboratory features of Crimean-Congo hemorrhagic fever: Predictors of fatality. Int J Infect Dis 12:37-49
• Çıtıl R, Eğri M, Önder Y, Duygu F, Bulut YE, Yaşayancan Ö, Yıldız Çeltek N, Şahin Ş (2021) Determination of seroprevalence and risk factors of Crimean-Congo haemorrhagic fever (CCHF) in the endemic region in Turkey: A population-based cross-sectional study. J Trop Med 9945089
• Deyde VM, Khristova ML, Rollin PE, Ksiazek TG, Nichol ST (2006) Crimean-Congo hemorrhagic fever virus genomics and global diversity. J. Virol 80: 8834-8842
• Duran A, Küçükbayrak A, Ocak T, Hakyemez NI, Taş T, Karadağ M, Mengeloğlu ZF (2013) Evaluation of patients with Crimean-Congo hemorrhagic fever in Bolu, Turkey. Afr Health Sci 13(2): 233-242
• Ergonul O (2006) Crimean-Congo haemorrhagic fever. Lancet Infect Dis 6:203-14
• Ergonul O, Tuncbilek S, Baykam N, Celikbas A, Dokuzoguz B (2006) Evaluation of serum levels of interleukin (IL)-6, IL-10, and tumor necrosis factor-alpha in patients with Crimean-Congo hemorrhagic fever. J Infect Dis 193: 941-944
• Ertugrul B, Kirdar S, Ersoy OS, Ture M, Erol N, Ozturk B, Sakarya S (2012) The seroprevalence of Crimean-Congo haemorrhagic fever among inhabitants living in the endemic regions of Western Anatolia. Scand J Infect Dis 44: 276-281
• Garrison AR, Alkhovsky Альховский Сергей Владимирович SV, Avšič-Županc T, Bente DA, Bergeron É, Burt F, Di Paola N, Ergünay K, Hewson R, Kuhn JH, Mirazimi A, Papa A, Sall AA, Spengler JR, Palacios G, Consortium IR (2020) ICTV virus taxonomy profile: Nairoviridae. J Gen Virol 101(8):798-799
• Geisbert TW, Jahrling PB (2004) Exotic emerging viral diseases: progress and challenges. Nat Med 10: S110-121 Hawman DW, Feldmann H (2018) Recent advances in understanding Crimean-Congo hemorrhagic fever virus. F1000Res 7: F1000 Faculty Rev-715
• Hoogstraal H (1979) The epidemiology of tick-borne Crimean-Congo hemorrhagic fever in Asia, Europe, and Africa. J Med Entomol 15(4), 307-417
• Kırdar S, Ertuğrul MB (2009) Kırım-Kongo kanamalı ateşi. ADÜ Tıp Fakültesi Dergisi 10(2): 45-52
• Leblebicioglu H, Ozaras R, Irmak H, Sencan I (2016) Crimean-congo hemorrhagic fever in Turkey: current status and future challenges. Antiviral Res 126:21-34
• Mardani M, Rahnavardi M, Rajaeinejad M, Naini KH, Chinikar S, Pourmalek F, Rostami M, Shahri MH (2007) Crimean-Congo hemorrhagic fever among health care workers in Iran: a seroprevalence study in two endemic regions. Am J Trop Med Hyg 76: 443-445
• Mazzola LT, Kelly-Cirino C (2019) Diagnostic tests for Crimean-Congo haemorrhagic fever: a widespread tickborne disease. BMJ Glob. Health 4(Suppl 2): e001114
• Messina JP, Pigott DM, Golding N, Duda KA, Brownstein JS, Weiss DJ, Gibson H, Robinson TP, Gilbert M, William Wint GR, Nuttall PA, Gething PW, Myers MF, George DB, Hay SI (2015) The global distribution of Crimean-Congo hemorrhagic fever. Trans R Soc Trop Med Hyg 109(8):503-13
• Öngörü P, Bodur H (2012) Kırım Kongo kanamalı ateşi. J Exp Clin Med 29(3s):175-81
• Sağlık Bakanlığı (2017) KKKA afiş ve broşürler. https://hsgmdestek.saglik.gov.tr/tr/zoonotikvektorel-kkka/zoonotikvektorel-kkka-afis Erişim tarihi: 22.06.2023
• Sağlık Bakanlığı (2023) Kırım Kongo kanamalı ateşi (hekim dışı sağlık personeline yönelik). https://hsgmdestek.saglik.gov.tr/depo/birimler/zoonotik-vektorel-hastaliklar-db/zoonotik-hastaliklar/1-KKKA/7-Sunumlar/KKKA_Sunum_Hekim_Disi_Saglik_Personeline_Yonelik_2023.pdf Erişim tarihi: 22.06.2023 Schnittler HJ, Feldmann H (2003) Viral hemorrhagic fever--a vascular disease?. J Thromb Haemost 89:967-72
• Schwarz TF, Nsanze H, Ameen AM (1997) Clinical features of Crimean-Congo haemorrhagic fever in the United Arab Emirates. Infection 25:364-7
• Whitehouse CA (2004) Crimean-Congo hemorrhagic fever. Antivir Res 64:145-60
• WHO (2022) Crimean-Congo haemorrhagic fever. https://www.who.int/news-room/fact-sheets/detail/crimean-congo-haemorrhagic-fever Erişim tarihi: 22.06.2023
• WHO (2023) Crimean-Congo haemorrhagic fever. https://www.who.int/health-topics/crimean-congo-haemorrhagic-fever#tab=tab_1 Erişim tarihi: 22.06.2023