Crimean-Congo Hemorrhagic Fever in Man, Republic of Georgia, 2009 | CDC EID

EID Journal Home > Volume 16, Number 8–August 2010

Volume 16, Number 8–August 2010
Letter
Crimean-Congo Hemorrhagic Fever in Man, Republic of Georgia, 2009
Khatuna Zakhashvili, Nikoloz Tsertsvadze, Tamar Chikviladze, Ekaterine Jghenti, Marekhi Bekaia, Tinatin Kuchuloria, Matthew J. Hepburn, Paata Imnadze, and Alexander Nanuashvili
Author affiliations: National Center for Disease Control and Public Health, Tbilisi, Georgia (K. Zakhashvili, N. Tsertsvadze, T. Chikviladze, E. Jghenti, P. Imnadze); O. Ghudushauri National Medical Center, Tbilisi (M. Bekaia); I. Javakhishvili Tbilisi State University, Tbilisi (T. Kuchuloria, P. Imnadze); Technology Management Company, Tbilisi (T. Kuchuloria); US Army Medical Research Institute of Infectious Diseases, Fort Detrick, Maryland, USA (M.J. Hepburn); and Service of Antimicrobial Chemotherapy of Georgia, Tbilisi (A. Nanuashvili)

To the Editor: Crimean-Congo hemorrhagic fever (CCHF) virus is widely distributed in the southwestern regions of the former Soviet Union, the Balkans, the Middle East, western People’s Republic of China, and Africa (1). Public health officials in the Republic of Georgia have long suspected that CCHF occurs in this country, but laboratory confirmation by using molecular diagnostic techniques has not been possible there until recently.

CCHF virus is primarily transmitted by ticks, but other modes of transmission have been described (2 ). This virus infects humans mainly by the bite of adult Hyalomma spp. ticks. Infected sheep and cattle have also been implicated in transmission (3 ). Contact with highly infectious blood from patients has also led to several nosocomial hospital outbreaks, which resulted in the deaths of medical personnel (4,5). It is estimated that exposure to CCHF virus leads to symptoms in 1 of 5 patients exposed to this virus (6 ). Mortality rates up to 30% have been reported (7).

Virus can be isolated from blood of acutely ill patients by cell cultures or by passage through suckling mice. Antigen-detection ELISA is useful for diagnosis, particularly for severe cases (2). PCRs may provide additional sensitivity with no loss of specificity. Antibodies are detectable by a variety of methods and generally appear within 5–14 days of disease onset and coincide with clinical improvement. ELISA detection of immunoglobulin M is an established diagnostic method (2,3 ). Ribavirin may be effective for treatment of patients with severe CCHF; in vitro, animal, and clinical experience with this drug support its use (8 ). No human or veterinary vaccines against CCHF are currently recommended (none are licensed in the United States). We report a patient in Georgia with CCHF.

The patient was a 30-year-old man who lived in suburban Tbilisi, Georgia. Fever and sore throat without distinguishing characteristics developed in the patient. After 7 days of symptoms, gastrointestinal bleeding, melena, and hematemesis developed. He was admitted to the First City Hospital in Tbilisi, Georgia, on August 25, 2009. He reported frequent fishing in rural areas. The patient lived in a private house on the outskirts of the city that had a yard and vegetation. No specific rodent exposures were noted, and no other travel was reported.

open here to see the full-text:
Crimean-Congo Hemorrhagic Fever in Man, Republic of Georgia, 2009 | CDC EID

Suggested Citation for this Article
Suggested citation for this article: Zakhashvili K, Tsertsvadze N, Chikviladze T, Jghenti E, Bekaia M, Kuchuloria T, et al. Crimean-Congo hemorrhagic fever in man, Republic of Georgia, 2009 [letter]. Emerg Infect Dis [serial on the Internet]. 2010 Aug [date cited]. http://www.cdc.gov/EID/content/16/8/1326.htm DOI reference

DOI: 10.3201/eid1608.100181