Announcement

**Shiloh** · May 26, 2009, 05:34 AM

Re: Turkey: CCHF Cases 2009

Source: http://www.todayszaman.com/tz-web/de...6337&bolum=100

CCHF more fatal than swine flu, claims TVHB head Alkan

The Crimean Congo hemorrhagic fever (CCHF), a viral disease transmitted by ticks, is more deadly than the H1N1 virus, also known as the swine flu, according to Mehmet Alkan, head of the Turkish Veterinary Medical Association (TVHB).

?Around 200 poor Turkish villagers have so far been killed by CCHF. But we have not taken serious measures to fight this disease. Poor villagers are bitten by ticks while they are working on their lands. When it is the poor dying, no one raises their voice. I guess people will react against CCHF when a rich man dies of a tick bite,? Alkan stated.

Mostly infecting animals, CCHF is a viral disease transmitted by ticks. The virus can infect sheep and cattle as well as humans and is fatal if not detected and treated early. It has been responsible for the deaths of more and more people in the country each year since the first recorded infection in Turkey in 2002. Last year, 55 people died in Turkey from CCHF, bringing the total number of CCHF deaths in the country over the past six years to nearly 200.

Alkan asked why authorities were not taking precautions against CCHF as they are doing for swine flu. ?Swine flu has not killed anyone in our country. I am not suggesting that we stop our precautions against swine flu. What I mean is we should fight against CCHF as seriously as we fight against swine flu,? he said.

Swine flu, a rapidly spreading contagious disease that is originated in pigs, has killed scores of people throughout the world. Turkey identified its first two swine flu cases earlier this month in a family traveling to Iraq from the United States.
[B]
?Our successful fight against bird flu has set an example for the whole world. This is also the case for swine flu. I guess we need to take more serious precautions against CCHF,? Alkan added.

Farmer falls victim to CCHF

A patient with CCHF from the northern province of Tokat succumbed to the disease at a Sivas hospital where he was being treated. According to the Anatolia news agency, a tick bit the 74-year-old farmer while he was working in a field in a village in Tokat . He was taken to Sivas Cumhuriyet University Research and Training Hospital, where he died late on Sunday despite medical attention.

26 May 2009, Tuesday
NURULLAH KAYA İSTANBUL

**Shiloh** · May 27, 2009, 09:06 PM

Re: Turkey: CCHF Cases 2009

Source: http://www.todayszaman.com/tz-web/de...6576&bolum=100

CCHF cases and deaths in Turkey by year

*
2002-2003 150 reported cases and 6 deaths
*
2004 249 reported cases and 13 deaths
*
2005 266 reported cases and 13 deaths
*
2006 438 reported cases and 27 deaths
*
2007 717 cases and 33 deaths
*
2008 1,315 reported cases and 135 deaths
*
2009 (first five months) 5 deaths so far

Experts advise vigilance against ticks

Tick bites, which made an appearance in Turkey in 2002, have been tied to the subsequent rise of the deadly viral Crimean Congo hemorrhagic fever (CCHF) in the country.

Since 2002, there have been 2,315 cases of this potentially fatal virus in 100 villages throughout Turkey, with 140 people dying as a result.

The Ministry of Health has produced a map showing regions where people are at risk of contracting CCHF, with the majority of the areas being in the Central Anatolian and central Black Sea regions. The focus at this point in terms of risk appears to be on the regions around G?m?şhane, Tokat, Sivas, Amasya, ?orum, Yozgat, Kastamonu, Karab?k and ?ankırı.

Tick bites tend to be more prevalent when the weather starts to warm up, but this year the first tick bites seen by health professionals came earlier than expected. Experts say that with warmer weather staring earlier than usual, ticks have laid eggs and these eggs have then hatched in advance of their normal time, meaning that people are coming in close contact with ticks earlier than in previous years.

Experts also note that ticks remain active essentially until the weather outside becomes too cold for them and that people will thus have to remain vigilant until November and all through the summer months. Experts also warn people to check their bodies carefully after spending time outdoors, especially in open fields or forest lands.

Dr. Orhan Yıldız of Erciyes University's medical faculty noted that a fully grown tick produces around 6,000 baby ticks yearly and that there is no way to prevent this from happening.

Yıldız noted that as the number of ticks rises, so does the number of cases of people being bitten and getting ill from the tick bites. He points to the early rise in temperatures in some parts of Turkey as having led to early tick egg hatchings.

Yıldız also pointed to general climate change in the world, the limitations placed on rabbit hunting and the wholesale destruction of many chickens in Turkey around the time of the bird flu scare as all being factors that have led to a steep rise in the number of ticks in the nation. He says that more difficult days in fighting these ticks face Turkey in the future.
Early detection saves lives

Dr. Zati Vatansever of Kars Kafkas University's veterinary faculty noted that early detection of a tick on the body can play a large role in preventing serious illness and even death.

Dr. Vatansever noted that many people returning from working or relaxing outdoors are not even aware that they have been bitten by a tick, and he warned: "When people who have been outside in a field or on a picnic return home, they should check themselves carefully. Ticks suck blood from cows. So, if we give certain anti-tick medicine to the cows, we should be able to reduce the numbers of these ticks somewhat. There is no other method that we know of. There is some talk of other ways that could be used to fight ticks, but it's nothing but sensationalism."

Vatansever also noted that while there are 900 different kinds of ticks that have been scientifically identified, there are around 30 different kinds in Turkey, and that one of these carries the virus.

Incorrect information about ticks

Vatansever noted that there is a lot of incorrect information about ticks circulating among people these days. Noting that tick-transmitted viral diseases have been around for a long time, Vatansever said: "This particular virus has existed for a long time, but we didn't know about it. We didn't notice it because there were so few cases. Then we really became aware because the number of cases shot up. There is a considerable level of ecological regeneration going on in Turkey -- from forestry projects to an increase in the number of wild animals. In addition to all this, there is the ongoing migratory trend from villages to cities and towns. The fact that fields are not being fully used and worked has created an ideal environment for wild animals and the ticks that feed off of them. If we look at the ecological regeneration going on since the 1990s, it is much easier for us to understand so much here."

Vatansever also noted that how a person removes a tick from his or her body is not the important thing, but that the real question in terms of the disease entering the body is how long the tick has been feeding off the blood of that person. He said: ?If you are able to remove the tick within the first six to 12 hours, then the risk of contracting a disease is at its lowest. But the longer the tick is attached to your body, the more time there is for the virus to be transmitted into the bloodstream, and thus the risk rises."

28 May 2009, Thursday
TODAY'S ZAMAN ANKARA

**Shiloh** · June 16, 2009, 06:18 AM

Re: Turkey: CCHF Cases 2009

Source: http://www.todayszaman.com/tz-web/de...8050&bolum=101

Nurse dies of CCHF after accidental needle prick

A nurse working at Samsun's Ondokuz Mayıs University Hospital emergency ward died over the weekend after contracting Crimean Congo hemorrhagic fever (CCHF) while treating a patient infected with the tick-borne virus.

K?bra Yazım, 18, was collecting blood from a patient, Ayşe Keskin, when she accidentally pricked her hand with the needle. Keskin, who got a tick stuck on her back on June 6 after working on a farm, died on Thursday.

Yazım, who was also placed under intensive care, died on Saturday, only days after Keskin. Yazım's family accused the hospital of negligence in their daughter's case, while Health Minister Recep Akdağ said he had ordered an investigation into the incident. Last week the D?sseldorf-based Center for Travel Medicine (CRM) warned German travelers about the spread of the potentially fatal tick-borne disease in Turkey. According to the CRM 680 people contracted CCHF in Turkey last year, and 55 died of the disease.

15 June 2009, Monday
TODAY'S ZAMAN WITH WIRES İSTANBUL

**Shiloh** · June 20, 2009, 06:40 AM

Re: Turkey: CCHF Cases 2009

Source: http://www.hurriyet.com.tr/english/d...4818.asp?scr=1

One more life lost due to tick bites
SAMSUN - A man has died from Crimean Congo hemorrhagic fever Friday after he was bitten by a tick in Turkey?s Black Sea region.

Recep Ustaoğlu, 82, died at the Samsun 19 May University Hospital, where he was receiving treatment after being bitten by a tick in his village of Balar?st?.

Ustaoğlu had gone to a state hospital after he removed a tick and bruising appeared on his chest. Doctors at the state hospital thought the farmer was suffering from lung problems and sent him home after treating him.

That same night, Ustaoğlu developed a high fever and started coughing up blood. His family took him to the Samsun 19 May University Hospital, where doctors identified his ailment as Crimean Congo hemorrhagic fever, but it was too late to treat him. A sample of his blood has been sent to Ankara for full confirmation that this viral fever was the cause of the victim?s death.

Last summer, many people died due to this viral fever, which is transmitted by tick bites. Deaths caused by tick bites are being reported this summer as well.

**Shiloh** · June 27, 2009, 08:26 AM

Re: Turkey: CCHF Cases 2009

Source: http://www.newsweek.com/id/203990

Taking on Ticks

While the world focuses on swine flu, another enigmatic virus is making a reappearance. Why hard-hit Turkey is divided on the best defense.
By Asli Ortakmac and Andrew Bast | Newsweek Web Exclusive
Jun 26, 2009

Symptoms of the cryptically named Crimean-Congo hemorrhagic fever are cringe-worthy. After a sudden onset of fever, dizziness, and sore eyes, blood can begin bubbling on the skin. Gums begin to bleed and, if you're unlucky, you die. Transmitted by bites from infected ticks, the disease, known as CCHF, was first discovered in the Crimea in 1944, and 25 years later emerged in the Congo (hence the name). Yet, in light of recent events, one more country may need to be added to the list: Turkey.

And as swine flu has been declared a pandemic by the World Heath Organization, Turkey is now at the forefront of combating a different puzzling virus. Scientists and the government have diverging views on how to combat the disease, and in turn, Turks are now asking whether their country could engineer an exportable solution and take a lead on a serious global public-health issue.

Since it was first diagnosed, cases of CCHF have been reported in Africa, Asia, the Middle East, and Europe. Its emergence over the last few years in Turkey, however, seems especially acute. It killed seven people in 2003, and 33 in 2007. In all, between the years 2002 and 2008, a total of 2,597 cases have been reported, and these have left 155 dead. Because the disease especially threatens farmers, fear of tick bites has sparked paranoia among the rural middle of the country, sending some to the emergency room on the weekends to have tick-resembling beauty marks checked out. According to the Centers for Disease Control in the U.S., fatality rates for CCHF range from anywhere as low as 9 percent to as high as 50 percent. No vaccine exists, and treatments are limited.

The number of Turkish cases has pushed its researchers to the frontlines of CCHF research. Turkish scientists write regularly on the topic in international medical journals and advise organizations like the World Health Organization and the European Union. Among them is Associate Professor Onder Erg?n?l of the Infectious Diseases and Clinical Microbiology Department at Marmara University, who has been working for the last few years on an early diagnostic test for CCHF that could be put to use in village clinics.

Erg?n?l's project qualified for advanced-level funding from the European Research Council (ERC) last year. He then turned to Turkey's Scientific and Technological Research Council (T?BITAK), but while the Europeans were impressed, the value of his research was lost on his home government. Erg?n?l was flummoxed. "None of the members of the jury even had a single article about this topic, but they neither considered my project as important, nor were they convinced that I have enough information on an issue that I have been researching for years," he says.

The Turkish government says it's taking a different approach. Various government ministries have been working to educate people living in high-risk regions; officials canvas villages across the country's provinces, equipping Turks with methods of prevention. "Last August, we ordered all city branches to apply insecticides to sacrificial animals prior to their transport," Ahmet Uygar of the Ministry of Agriculture told NEWSWEEK T?rkiye, NEWSWEEK's Turkish-language partner.

Erg?n?l insists that funding research will push Turkey into the lead on the issue. Work toward a vaccine has accelerated in the last two years, and as long as the disease does not create a serious threat in Europe or the U.S., Turks believe that their doctors are the most likely to develop an effective first response to CCHF. Developing a vaccine will be long and difficult, however, so the government is focusing on its education strategy in the interim. The next step, they hope, will be eradication.

Adapted from a report written by Asli Ortakmac for NEWSWEEK?s Turkish-language partner Newsweek T?rkiye. Additional reporting by Andrew Bast in New York.

**Shiloh** · July 21, 2009, 07:42 AM

Re: Turkey: CCHF Cases 2009

Source: http://www.todayszaman.com/tz-web/ne...in-ankara.html

Two women die of CCHF in Ankara
Two women from the Central Anatolian province of ?orum who had been receiving treatment for Crimean Congo hemorrhagic fever (CCHF) in Ankara died on Sunday.

Ayşe ?i?ek, 25, who lived in ?orum's Sungurlu district, was discovered to be carrying the CCHF virus at ?orum State Hospital. ?i?ek was transferred to Ankara Research and Teaching Hospital, where she died Sunday evening. ?i?ek, who was married with four children, was buried in her hometown. Relatives of ?i?ek reported she had been bitten by a tick 10 days ago while she was working in a field.

M?nevver T?r?d?, 60, was hospitalized nearly 10 days ago with a high fever in ?orum's Alaca district. T?r?d? was also transferred to Ankara Research and Teaching Hospital on suspicion that she had contracted the CCHF virus. T?r?d? died at the hospital on Sunday. With the deaths of these two women, the number of people from ?orum who have died of CCHF this year has increased to seven.

21 July 2009, Tuesday
TODAY'S ZAMAN WITH WIRES İSTANBUL

**Treyfish** · August 12, 2009, 08:14 AM

Re: Turkey: CCHF Cases 2009

<TABLE style="BORDER-COLLAPSE: collapse" id=AutoNumber1 border=0 cellSpacing=0 cellPadding=3 width="100%"><TBODY><TR><TD width="100%" colSpan=2>Patients in Samsun KKKA Suspect Killed

<TABLE style="BORDER-COLLAPSE: collapse" id=AutoNumber8 border=0 cellSpacing=0 borderColor=#111111 cellPadding=0 width="100%"><TBODY><TR><TD vAlign=top width=420>Date: 12 August 2009 Wednesday 12:41 hrs
</TD><TD vAlign=top width=90>

Sonraki Haber

Next News

</TD><TD vAlign=top width=16> </TD></TR><TR><TD bgColor=#d8d8d8 height=1 width="100%" colSpan=5></TD></TR></TBODY></TABLE>

</TD></TR><TR><TD style="PADDING-RIGHT: 20px; PADDING-TOP: 5px" vAlign=top width=0 align=right></TD><TD vAlign=top width="100%">Ondokuz Mayis University (OM?) Medical Faculty Hospital, Crimean Congo Fever Kanamalı (KKKA) Diseases of the doubt, a person reported to have been treated.

</TD></TR><TR><TD colSpan=2>Ondokuz Mayis University (OM?) Medical Faculty Hospital, Crimean Congo Fever Kanamalı (KKKA) disease treated with the suspicion that a person was reported killed.

.

Obtain information, according to Amasya'sMerzifon live in a village depends on the county reported that the suspected disease, and 5 days ago KKKA referred to the Hospital of Medical Faculty OM? Mustafa H.

(74) kurtarılamadı.

(74) could not be saved.
Authorities, KKKA disease symptoms such person is found in samples taken from said laboratory results did not win yet certainty. (Anadolu Agency) 4 hours ago .. [1735807]

http://translate.google.com/translat...r%26start%3D10

</TD></TR></TBODY></TABLE>

**Shiloh** · August 14, 2009, 09:14 AM

Re: Turkey: CCHF Cases 2009

Source: http://www.thenational.ae/apps/pbcs....708139885/1138

Rare disease strikes Turkey

Thomas Seibert, Foreign Correspondent

* Last Updated: August 14. 2009 12:26AM UAE / August 13. 2009 8:26PM GMT

ISTANBUL // Like much of the rest of the world, Turkey is busy trying to prevent a major outbreak of swine flu, scanning arriving passengers at airports and ordering millions of doses of vaccine.

But away from the spotlight, another deadly disease is on the march in central Anatolia: Crimean-Congo Hemorrhagic Fever, or CCHF, which is spread by ticks and has already killed more than 50 people this year.

News of the rising death toll has alerted the public. ?CCHF is more dangerous than swine flu,? a headline in a Turkish newspaper said recently. But as CCHF continues to claim lives, some experts said the government is not doing enough to counter the threat.

?If there had been almost 60 deaths from a disease in Germany, that would be a sensation, but in Turkey, it?s hardly on the agenda,? Mehmet Alkan, president of the Turkish Union of Veterinary Doctors, said yesterday. ?Authorities have been doing something, but it?s not enough.?

According to official figures released last week, 53 people have died from CCHF since January. There have been more than 3,000 cases since the disease first appeared in Turkey in 2002, with at least 208 deaths. There were 63 fatal cases last year, statistics posted on the website of the health ministry in Ankara show.

CCHF is transmitted by a virus found in ticks. According to the World Health Organisation, or WHO, the disease was named after Crimea, where it was first described in 1944, and after the Congo, where it was identified a decade later. Countries at risk stretch from China to Africa and south-western Europe and include the Arabian Peninsula, the WHO said.

Symptoms of CCHF, which has been compared to Ebola and Lassa fever, include a sudden high fever, vomiting and bleeding. There is no vaccine. According to the Centres for Disease Control and Prevention in the US, mortality rates in hospitalised cases vary between nine per cent and 50 per cent.

?Unfortunately, CCHF is a disease without a vaccine and without a specific treatment,? Turan Buzgan, a senior health ministry official in Ankara, told reporters last week.

Doctors said the most effective ways to fight CCHF are precautions such as wearing long-sleeved shirts, and tucking trouser legs into socks while out in the field, as well as a quick and professional removal of ticks from the body.

In Turkey, rural regions in the northern part of central Anatolia have been most severely hit. Although there has been a case of a young nurse dying from the disease after she was infected by the blood of a CCHF patient, most of the victims have been farmers who were bitten by ticks while working on their fields. Officials say 95 per cent of cases have occurred in 1,200 villages.

Dr Alkan said the fact that most cases had occurred in poor rural areas had contributed to a lack of attention for the problem. ?Poor people are the victims, not the ones in luxury homes in the cities.? If ticks ever entered the villas of the rich, ?more would be done. I am not saying that in an ideological sense but from a humanitarian point of view?.

In some parts of the country, suspected cases of CCHF have triggered panic. When an elderly man was brought to hospital in the western town of Balikesir after allegedly being bitten by a tick last month, medical personnel were given face masks and the clinic stopped accepting other patients. The CCHF suspicion later turned out to be unfounded.

Dr Alkan called for a comprehensive effort to tackle CCHF. That plan should include different ministries as well as scientists and should be regarded as a long-term effort to defeat the disease. ?At the moment, there is no well-planned approach,? he said. Instead, Turkey?s health authorities have focused their attention on swine flu. There are 240 confirmed cases in the country, according to the latest official count, but there have not been any deaths. Ten million people are to be vaccinated against the flu before the end of the year, while another 10 million doses of vaccine are expected to arrive in the country early next year.

Measures to prevent the spread of the flu have been in place for months. Passengers flying into Turkey have to fill out forms to inform authorities how they can be contacted in case another person from the same flight is diagnosed with swine flu. Infra-red cameras have been installed in arrival halls of major airports to identify passengers suffering from high fever.

Recep Akdag, the health minister, rejected accusations that the fight against CCHF was being overshadowed by efforts to prevent a mass outbreak of swine flu. CCHF was not connected to a worldwide pandemic such as swine flu, the minister told reporters in June.

tseibert@thenational.ae

**Shiloh** · September 7, 2009, 07:49 AM

Re: Turkey: CCHF Cases 2009- 61 deaths to date

Source: http://www.todayszaman.com/tz-web/ne...-8-months.html

CCHF claims 61 in first 8 months

As the summer comes to a close, ticks, a seasonal menace, continue to cause illness and death around the country, with six people dying last week of tick-borne Crimean-Congo Hemorrhagic Fever (CCHF), thus bringing the year-to-date tally of CCHF victims to 61.

According to data from the Ministry of Health, between Jan. 1 and Aug. 31, 274 cases of CCHF were detected, 61 of which were fatal. While 1,298 cases were diagnosed in the same period of 2008, only 59 lost their lives.

Efforts to eradicate ticks, which can be found in almost 1,200 Turkish villages, continue full speed. Ministry of Health officials carry out education and awareness campaigns, distribute tick repellent and spray for ticks in affected areas. Officials warn, however, that many citizens do not take necessary precautions to avoid tick bites and their resulting illnesses.

07 September 2009, Monday
TODAY'S ZAMAN WITH WIRES

Announcement

Turkey: CCHF Cases 2009- 61 deaths to date

Turkey: CCHF Cases 2009- 61 deaths to date

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