Pediatric cases of Crimean-Congo hemorrhagic fever in Turkey

Background: The aim of the present study was to identify the epidemiological, clinical and laboratory features of Crimean-Congo hemorrhagic fever (CCHF) virus infection in children. Methods: Fifty children infected with CCHF virus in 20052010, and hospitalized in the Dr Sami Ulus Maternity and Children's Health and Diseases Training and Research Hospital in Ankara, were included. All the patients had positive IgM and/or polymerase chain reaction for CCHF virus. Results: Of the 50 patients, 19 were female and 31 were male. Patients were between 8 months and 15 years of age. The majority (82%) of patients had a history of tick bite. Fever (100%), hemorrhagic symptoms (76%), nauseavomiting (60%), tonsillopharyngitis (50%), malaise (50%), myalgia (46%) and maculopapular rash (24%) were the most common presenting clinical features. Mean platelet count on admission was 110 880/mm3, and the lowest was 7000/mm3. The mean of the lowest white blood cell count was 2860/mm3. Other pathological laboratory findings (asparate aminotransferase, alanine aminotransferase, lactate dehydrogenase and creatine kinase) were elevated, and prothrombin time and activated partial thromboplastin time were prolonged. Twenty-three patients (46%) were given ribavirin. No side-effect of ribavirin was seen. No patient died because of CCHF disease. Conclusion: CCHF virus infections are seen mostly in boys and school children and the adolescent age group. Tick bite is the major risk factor. Fever and hemorrhage are the most frequent presenting symptoms. Tonsillopharyngitis and rash on face or body are probably the most remarkable clinical findings in this disease. The CCHF disease course in Turkey may be mild in children.