Follow-up of patients with tick bite in terms of Crimean Congo hemorrhagic fever: Is tick bite enough for diagnosis?

Crimean-Congo hemorrhagic fever (CCHF) is a multi-systemic tick born viral disease caused by a Nairovirus of the Family Bunyaviridae. Findings of disease are with fever, myalgia, chills, headache, vomiting and hemorrhagic manifestations. Infection is transmitted to humans by tick bite or by close contact with freshly slaughtered meat or blood from viremic animals. Since the tests of virus load consume much time, we preferred to study whether the findings obtained from anamnesis and physical exams of patients would be beneficial in predicting the clinical courses of patients. Files of 13 cases, who admitted to our clinic in the years 2006-2007 with the complaint of tick bite, were examined in this study. Anamnesis, physical and laboratory findings were recorded. Eleven of the cases were male. The age average was found to be 8.4 years (3-15). The period of first reference to our clinic was 3.4 days (1-8) on average. Bite size were 0.7 mm (0.4-1.4). The biggest bite was related to an adult tick. While serologic tests from the cases were found to be negative in twelve cases (92.3%), CCHF Immunoglobulin M taken on the third day was positive in one case (7.7%).This case was the one with biggest bite. In conclusion, the severity of the findings of CCHF is in correspondence with the size of virus load transferred. According to this study findings, size of tick and tick bite may be informative about the virus load and indirectly about the clinical outcome. Recording these findings for the future cases would be advised.