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P1044 Serology and immunological study on the infectivity of host animals and ticks (Ixodidae, Argasidae) to CCHF virus in Ardabil Province, Iran
S280 infected case was noticed among animals belonging to the Kordestan region grasslands. Conclusion: The results of this study revealed the endemic spreading of CCHF in the animals in Isfahan province and it needs special attention to prevent the infection in the communities and occupational exposure. P1043 Risk factors among patients with Crimean-Congo haemorrhagic fever N. Tasdelen Fisgin, E. Tanyel, N. Tulek (Samsun, TR) Objectives: Crimean-Congo haemorrhagic fever (CCHF) is a potentially fatal disease caused by Nairovirus in the Bunyaviridae family. Methods: Between 2004 and 2006, patients with typical clinical findings and positive IgM for CCHFV in blood sample were enrolled in the study. Patients were divided 2 subgroup; group I (n: 19) alive patients, group II (n: 5) excites patients. Risk factors including demographic and laboratory data were investigated among 24 patients with CCHF. Results: The median platelet count was significantly lower in excitus group (9400/mm3 ) when compared to alive group (43942/mm3 ). Aspartate transferase (AST) and alanin transferase (ALT) levels were significantly higher in excites group (AST: 2555 U/L, ALT: 1675 U/L) when compared to alive group (AST: 667U/L, ALT: 295U/L). Conclusion: Low platelet count, increased AST and ALT levels could be poor prognostic factors in patients with CCHF P1044 Serology and immunological study on the infectivity of host animals and ticks (Ixodidae, Argasidae) to CCHF virus in Ardabil Province, Iran Z. Telmadarraiy, S. Chinikar, H. Vatandoost, K. Holakoui, F. Faghihi, Z. Zarei, M. Oshaghi (Tehran, IR) Ardabil province is located in North western Iran. The main activities of people in this region is agriculture and cattle rearing. A comprehensive study was carried out in year 2004–2005 for determination of presence in virus in ticks and antibody against CCHF in their hosts. The villages selected randomly and ticks with their host sampled according to standard method. Results showed that the majority of ticks host were cow, sheep, goat, camel, poultry, and buffalo, At the same time all the collected ticks were searched for the presence of CCHF virus using RTPCR method. Among 56 sera of cow and sheep and 3 goats, it is found that 48.7% of sheep, 21.4% of cow and 33.3% of goats was found IgG positive. Different species of soft and hard ticks including Rhipicephalus, Hyalomma, Argas and Ornithodoros was collected from various types of houses, stable and animal shelters. Results of RT-PCR revealed that 33.3% of Hyalomma collected from buffalo was positive to virus, Rhipicephalus bursa and Hyalomma was found positive when they were collected from camel. The figures for Rhipicephalus bursa on goat was 40%. Argas reflexus which was collected on poultry was not infected to CCHF virus. The main species of infected ticks to CCHF was: Rhipicephalus bursa, Haylomma aegypticom, Hyalomma asiaticum, Hylaomma detritum, Hyalomma marginatum, Hyalomma shculzei and Ornithodoros lahorensis. P1045 Clinico-epidemiologic feature and outcome analysis of Crimean-Congo haemorraghic fever in Iran (1999–2006) M. Mardani, M. Goya, M. Zainali, M. Keshtkar Jahromi (Tehran, IR) Background: Crimean Congo Haemorrhagic Fever (CCHF) is a tick borne viral disease reported from more than 30 countries in Africa, Asia, southeast Europe, and the Middle East. The disease has been reported in Iran since 1999. This study is performed to define the last data of CCHF cases in Iran. Methods: Based on records of Ministry of Health of Iran, the epidemiological features and clinico-epidemiological manifestations of confirmed cases since 1999 upto 2006 in Iran have been studied.
17th ECCMID / 25th ICC, Posters Results: 287 out of 666 probable cases were confirmed to have CCHF by positive IgM and/or IgG for CCHF virus. The disease was more prevalent in middle aged men. The maximum incidence was in August and September. The clinical findings were severe headache, myalgia, nausa and fever. Epistaxiy, bleeding from the gums, nose and venopuncture sites, petechia, purpura, melena and hematemesis were common. Large ecchymotic areas developed on trunks, arms and legs. The most common laboratory findings were hematuria, proteinuria, prolonged partia thromboplastin time and AST greater than 100 IU/dl. Most of patients received oral Ribavirin in addition to supportive care including volume expanding intravenous fluids, packed cells, fresh frozen plasma and platelet, management of shock and renal failure and intensive care. 51 confirmed patients died (Mortality rate = 17.7%). The cause of death in the most of patients was intractable haemorrhage, multiorgan failure and shock. Conclusion: It should be noted that case fatality rate has been increased despite the decrease in the incidence of disease recently and providing laboratory facilities in order to have rapid and accurate diagnosis for early treatment of the disease in endemic areas such as our country (Iran) is a priority. P1046 Reappearance of CCHF and other tick-borne arboviruses in the Syrdarya region of the Republic of Uzbekistan A. Kadyrov, D. Shermukhamedova, N. Komilov, S. Umurzakov, E. Bryanseva, M. Nazarbekova (Tashkent, UZ) Objective: In the Syrdarya region of Uzbekistan, vast virgin lands were cultivated for agriculture during the last half of the 20th Century. As a result, natural-foci of arbovirus infections apparently disappeared. For example, there were not any cases of Crimean Congo Haemorrhagic Fever (CCHF) reported there in the last 35 years. However; since 2001, lethal cases of CCHF have been registered annually. It has become necessary to reevaluate the presence of, and determine the prevalence of human illness caused by such tick-borne arboviruses in the Syrdarya region. Methods: Specimens were collected during the spring and summer of 2001–2004. The collected field material included: serum of patients with febrile illness of unknown etiology (n = 1238), serum of patients with suspicion of CCHF (n = 167 paired sera), serum from apparently healthy people (n = 3630), serum from contacts of suspected CCHF patients (n = 201), serum of cattle (n = 650), serum of other animals (n = 131), and Hyalomma spp. (H. spp.) ticks (n = 1130). Diagnostic assays for CCHF, Karshi, Tamdy, and Syrdarya Valley Fever viruses (SDVF) included: precipitation reaction in agar (RDPA), complement fixation (CFR), and indirect hemaglutination (IH). Results: Among the patients with fevers of unknown etiology, CCHF was detected in 8, Tamdy in 9, Karshi in 24, SDVF in 5, and a mixed infection was detected in 5 patientsy Among healthy people we detected precipitating antibodies against CCHF virus in 11 samples. Antigens of CCHF, Karshi, Tamdy, and SDVF viruses were detected in H. anatolicum and H. detriticum. Infection of ticks with these viruses was relatively stable during the study period (19.7% (2001), 53.8% (2002), 21.7% (2003), 25% (2004). In cattle, precipitating antibodies against CCHF were detected in 8.6%, Karshi in 7.2%, Tamdy in 5.7%, and SDVF in 4.6% of samples. Conclusions: Tick-borne arbovirus foci were detected in the Syrdarya region. H. anatolicum and H. detriticum are known to parasitise domestic animals and livestock, and are therefore likely contact humans and act as putative vectors for CCHF. Detection of antibodies against CCHF virus among healthy people – 0.35%, shows, that inapparent illness due to infection with CCHF is very low.
17th ECCMID / 25th ICC, Posters Results: 287 out of 666 probable cases were confirmed to have CCHF by positive IgM and/or IgG for CCHF virus. The disease was more prevalent in middle aged men. The maximum incidence was in August and September. The clinical findings were severe headache, myalgia, nausa and fever. Epistaxiy, bleeding from the gums, nose and venopuncture sites, petechia, purpura, melena and hematemesis were common. Large ecchymotic areas developed on trunks, arms and legs. The most common laboratory findings were hematuria, proteinuria, prolonged partia thromboplastin time and AST greater than 100 IU/dl. Most of patients received oral Ribavirin in addition to supportive care including volume expanding intravenous fluids, packed cells, fresh frozen plasma and platelet, management of shock and renal failure and intensive care. 51 confirmed patients died (Mortality rate = 17.7%). The cause of death in the most of patients was intractable haemorrhage, multiorgan failure and shock. Conclusion: It should be noted that case fatality rate has been increased despite the decrease in the incidence of disease recently and providing laboratory facilities in order to have rapid and accurate diagnosis for early treatment of the disease in endemic areas such as our country (Iran) is a priority. P1046 Reappearance of CCHF and other tick-borne arboviruses in the Syrdarya region of the Republic of Uzbekistan A. Kadyrov, D. Shermukhamedova, N. Komilov, S. Umurzakov, E. Bryanseva, M. Nazarbekova (Tashkent, UZ) Objective: In the Syrdarya region of Uzbekistan, vast virgin lands were cultivated for agriculture during the last half of the 20th Century. As a result, natural-foci of arbovirus infections apparently disappeared. For example, there were not any cases of Crimean Congo Haemorrhagic Fever (CCHF) reported there in the last 35 years. However; since 2001, lethal cases of CCHF have been registered annually. It has become necessary to reevaluate the presence of, and determine the prevalence of human illness caused by such tick-borne arboviruses in the Syrdarya region. Methods: Specimens were collected during the spring and summer of 2001–2004. The collected field material included: serum of patients with febrile illness of unknown etiology (n = 1238), serum of patients with suspicion of CCHF (n = 167 paired sera), serum from apparently healthy people (n = 3630), serum from contacts of suspected CCHF patients (n = 201), serum of cattle (n = 650), serum of other animals (n = 131), and Hyalomma spp. (H. spp.) ticks (n = 1130). Diagnostic assays for CCHF, Karshi, Tamdy, and Syrdarya Valley Fever viruses (SDVF) included: precipitation reaction in agar (RDPA), complement fixation (CFR), and indirect hemaglutination (IH). Results: Among the patients with fevers of unknown etiology, CCHF was detected in 8, Tamdy in 9, Karshi in 24, SDVF in 5, and a mixed infection was detected in 5 patientsy Among healthy people we detected precipitating antibodies against CCHF virus in 11 samples. Antigens of CCHF, Karshi, Tamdy, and SDVF viruses were detected in H. anatolicum and H. detriticum. Infection of ticks with these viruses was relatively stable during the study period (19.7% (2001), 53.8% (2002), 21.7% (2003), 25% (2004). In cattle, precipitating antibodies against CCHF were detected in 8.6%, Karshi in 7.2%, Tamdy in 5.7%, and SDVF in 4.6% of samples. Conclusions: Tick-borne arbovirus foci were detected in the Syrdarya region. H. anatolicum and H. detriticum are known to parasitise domestic animals and livestock, and are therefore likely contact humans and act as putative vectors for CCHF. Detection of antibodies against CCHF virus among healthy people – 0.35%, shows, that inapparent illness due to infection with CCHF is very low.