The Lancet Infectious Diseases, Volume 6, Issue 4, Pages 203 - 214, April 2006
doi:10.1016/S1473-3099(06)70435-2Cite or Link Using DOI
Crimean-Congo haemorrhagic fever
Original Text
Dr Önder Ergönül a
CCHF on usein fataali virusinfektio ja sitä kuvataan 30 eri maasta ja mitä kaikkiin lääketieteen kannalta merkittäviin punkkivälitteisiin infektioihin tulee, niin juuri tämä on kaikkein levinnein maapallolla ja sen leviäminen vastaa tietyn punkkilajin esiintymistä. Punkit ovat on Hyalomma lajeja.
Crimean-Congo haemorrhagic fever (CCHF) is an often fatal viral infection described in about 30 countries, and it has the most extensive geographic distribution of the medically important tickborne viral diseases, closely approximating the known global distribution of Hyalomma spp ticks.
Ihmiset infektoituvat punkin puremasta, kun musertavat infektoitunutta punkkia tai oltuaan kontaktissa CCHF tautiseen potilaaseen hänen infektionsa akuutin vaiheen aikana tai jouduttuaan kontaktiin viremisen karjan veren tai kudosten kanssa.
Human beings become infected through tick bites, by crushing infected ticks, after contact with a patient with CCHF during the acute phase of infection, or by contact with blood or tissues from viraemic livestock.
Kliinisissä piirteissä on tavallisesti nähtävissä dramaattinen progredioituminen, johon kuuluu verenvuoto, lihaskivut ja kuume.
Clinical features commonly show a dramatic progression characterised by haemorrhage, myalgia, and fever.
Maksaentsyymit, kreatiniinifosfokinaasi ja maitohappodehydrogenaasi ovat koholla ja verenvuoto indikaattorit osoittavat pitkittymistä.
The levels of liver enzymes, creatinine phosphokinase, and lactate dehydrogenase are raised, and bleeding markers are prolonged.
Endoteelin infektoitumisella on patogeeninen osuutensa.
Infection of the endothelium has a major pathogenic role.
Endoteeli infektoituu suoraan ja sen lisäksi on epäsuoraa viruksen aiheuttamaa tuhoa tai viruksen välittämien isäntäkehosta peräisin olevien liukoisten tekijöitten aiheuttamaa tuhoa, kun endoteeli aktivoituu ja muuttuu jolloin sen toiminta häiriytynee.
Besides direct infection of the endothelium, indirect damage by viral factors or virus-mediated host-derived soluble factors that cause endothelial activations and dysfunction are thought to occur.
Diagnosoitaessa käytetään ELISA and rtPCR menetelmiä
In diagnosis, enzyme-linked immunoassay and real-time reverse transcriptase PCR are used.
Varhaisdiagnoosi on kriittisen tärkeä hoidossa ja nosokomiaalisten infektioitten estossa.
Early diagnosis is critical for patient therapy and prevention of potential nosocomial infections.
Olennaista hoidossa on supportiivinen terapia.
Supportive therapy is the most essential part of case management.
Tuoreet tutkimukset ovat osoittaneet ribavirinistä olevan hyötyä, vaikka lopullisia tieteellisiä johtopäätöksiä ja tutkimuksia puuttuukin.
Recent studies suggest that ribavirin is effective against CCHF, although definitive studies are not available.
Terveydenholtohenkilöstöllä on vakava infektioriski, varsinkin silloin kun he hoitavat niitä potilaita joilla on nenä-. ien-tai vaginavuotoa tai injektiokohdat vuotavat.
Health-care workers have a serious risk of infection, particularly during care of patients with haemorrhages from the nose, mouth, gums, vagina, and injection sites.
Simple barrier precautions have been reported to be effective.
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