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Evaluation of Children with Crimean-Congo Hemorrhagic Fever in the Central Blacksea Region

Belet, Nurşen MD*; Top, Ayşe MD; Terzi, Özlem MD; Arslan, Hatice Nilden MD; Baysal, Kemal MD§; Şensoy, Gülnar MD

The Pediatric Infectious Disease Journal: August 2014 - Volume 33 - Issue 8 - p e194–e197
doi: 10.1097/INF.0000000000000281
Original Studies

Background: Crimean-Congo hemorrhagic fever (CCHF) is endemic in some regions of our country. It is seen in all age groups; however, its prevalance is low in children. The studies on CCHF have been mostly in adults. The aim of this study was to evaluate the epidemiologic, demographic, clinical and laboratory findings of children with CCHF.

Methods: Between May 2008 and September 2011, the medical records of patients who were admitted to the Children Infectious Diseases Service of Ondokuz Mayis University School of Medicine with positive blood IgM by enzyme-linked immunosorbent assay or polymerase chain reaction positive for CCHF were retrospectively evaluated. Epidemiologic and demographic features, clinical and laboratory data and therapy were recorded.

Results: Fifty-four patients with the diagnosis of CCHF were recorded between May 2008 and September 2011. Main symptoms during hospital admission were fever (98%), vomiting (59%), headache (39%), nausea (39%), diarrhea (22%), abdominal pain (22%), bleeding (22%) and rash (20%). During admission, thrombocytopenia was found in 74%, elevated aspartate aminotransferase in 61%, leucopenia in 57%, elevated creatine kinase (33%) and alanine aminotransaminase (29%), and prolonged prothrombin time and partial thromboplastine time in 28% were noted. Thirty-nine patients received ribavirin treatment. During clinical follow up, bradycardia was recorded in 18 patients (33%) all of whom received ribavirin treatment. One patient died.

Conclusions: This study reports the largest series of children with CCHF and the first to describe bradycardia associated with ribavirin therapy.

From the *Department of Pediatric Infectious Diseases; Department of Pediatrics; Department of Public Health; and §Department of Pediatric Cardiology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey.

Accepted for publication January 17, 2014.

The authors have no funding or conflicts of interest to disclose.

Address for correspondence: Nurşen Belet, Ondokuz Mayis University Faculty of Medicine, Department of Pediatric Infectious Diseases, 55100 Samsun, Turkey. E-mail:

© 2014 by Lippincott Williams & Wilkins, Inc.