Investigation of The Prevalence of Tick-Borne Encephalitis Virus Antibodies In Patients With Preliminary Diagnosis of Crimean-Congo Hemorrhagic Fever
Abstract
ABSTARCT
Objective: The tick-borne encephalitis virus (TBEV), a flavivirus transmitted by Ixodes spp. ticks, can cause a clinical picture characterized by nonspecific symptoms, as well as more specific conditions such as encephalitis and myelitis. Most patients admitted and followed with a preliminary diagnosis of Crimean-Congo hemorrhagic fever (CCHF) are from regions with a risk of tick exposure. The aim of this study is to determine the epidemiology of TBEV.
Material and Method: A total of 272 adult patients admitted with a preliminary diagnosis of CCHF between April and September 2021 in the Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, XXX University, were included in the study. The diagnosis of CCHF was defined using the criteria established by the CCHF Scientific Committee of the Turkish Ministry of Health. To determine the seroprevalence of TBE, TBEV-IgG antibodies were investigated in patient serum samples using the ELISA method (Anti-TBE Virus ELISA (IgG), Euroimmun, Germany). The results were evaluated by calculating the ratio of the extinction value of the patient sample to the extinction value of calibrator 2. Ratios below 0.8 were considered negative, between 0.8 and 1.1 were considered borderline, and greater than 1.1 were considered positive. Patients with no detected antibodies against TBEV in their serum samples were considered seronegative.
Results: The mean age of the 272 patients included in the study was 49.46 ± 17.48 years (Range: 18-98 years), with 181 (66.5%) being male. All patients' TBEV antibody levels were evaluated as negative. The provinces of residence of the patients were Sivas, Giresun, Tokat, Yozgat, and Erzincan. A history of tick exposure was found in 204 (75%) of the patients, with 143 (79%) of male patients and 61 (67%) of female patients reporting tick exposure.
Conclusion: In this study, the absence of antibodies against TBEV indirectly demonstrated the absence of TBEV in the tick population. However, no study has been conducted to detect the presence of TBEV in the tick population in Sivas province, and our study is the first to address this issue. Nevertheless, further seroepidemiological studies are required.
Supporting Institution
Sivas cumhur
Project Number
T-2022-988
References
- 1- Büyüktuna S.A, Bolat S, Doğan K, Çakır Y, Doğan H.O. Assessment of Serum Beta 2-Microglobulin Levels in Crimean-Congo Hemorrhagic Fever Patients: Implications for Immune Activation and Disease Pathogenesis. Cumhuriyet Science Journal, 2024;45(2):338-42.
- 2- Baysal AÇ, Kıymaz YÇ, Şahin NÖ, Bakır M. Investigation of Long Noncoding RNA-NRAV and Long Noncoding RNA-Lethe Expression in Crimean-Congo Hemorrhagic Fever. J Med Virol. 2024 Dec;96(12):e70142.
- 3- Büyüktuna SA, Yerlitaş Sİ, Zararsız GE, Doğan K, Kablan D, Bağcı G, et al. Exploring free amino acid profiles in Crimean-Congo hemorrhagic fever patients: Implications for disease progression. J Med Virol. 2024;96(5):e29637.
- 4- Schneider H. Uber epidemische acute'meningitis serosa'. Wien. Klin. Wochenschr. 1983; 44: 350-352.
- 5- Kunz C, Heinz FX. Tick-borne encephalitis. Vaccine. 2003;21(1):1-2.
- 6- Lindquist, Lars, and Olli Vapalahti. Tick-borne encephalitis. The Lancet. 2008;371:1861-71.
- 7- Shayan S, Bokaean M, Shahrivar MR, Chinikar S. Crimean-Congo Hemorrhagic Fever. Lab Med. 2015;46(3):180-9.
- 8- Leblebicioglu H, Bodur H, Dokuzoguz B, Elaldi N, Guner R, Koksal I, et al. Case management and supportive treatment for patients with Crimean-Congo hemorrhagic fever. Vector Borne Zoonotic Dis. 2012 Sep;12(9):805-11. doi: 10.1089/ vbz.2011.0896.
- 9- Lani R, Moghaddam E, Haghani A, Chang LY, AbuBakar S, Zandi K. Tick-borne viruses: a review from the perspective of therapeutic approaches. Ticks Tick Borne Dis. 2014 Sep;5(5):457-65. doi: 10.1016/j.ttbdis.2014.04.001.
- 10- Mansfield KL, Johnson N, Phipps LP, Stephenson JR, Fooks AR, Solomon T. Tick-borne encephalitis virus - a review of an emerging zoonosis. J Gen Virol. 2009;90(8):1781-94.
- 11- Süss J. Epidemiology and ecology of TBE relevant to the production of effective vaccines. Vaccine. 2003;21:19-35.
- 12- Ergonul O. Crimean-Congo hemorrhagic fever virus: new outbreaks, new discoveries. Curr Opin Virol. 2012;2(2):215-20.
- 13- Ergunay K, Ozer N, Us D, Ozkul A, Simsek F, Kaynas S, Ustacelebi S. Seroprevalence of West Nile virus and tick-borne encephalitis virus in southeastern Turkey: first evidence for tick-borne encephalitis virus infections. Vector Borne Zoonotic Dis. 2007 Summer;7(2):157-61.
- 14- Uyar Y, Akçalı A, Çarhan A, Özkaya E, Ertek M. Türkiye'de Kene Isırığı Öykülü Olgularda Tıck-Borne Encephalıtıs Virüsünün Seroprevalansı. 2007;64(2):21-25
- 15- Ergünay K, Saygan MB, Aydoğan S, Litzba N, Şener B, Lederer S, et al. Confirmed Exposure to Tick‐Borne Encephalitis Virus and Probable Human Cases of Tick‐Borne Encephalitis in Central/Northern Anatolia, Turkey. Zoonoses and Public Health. 2011 May;58(3):220-7.
- 16- Esen B, Gozalan A, Coplu N, Tapar FS, Uzun R, Aslan T, et al. The presence of tick-borne encephalitis in an endemic area for tick-borne diseases, Turkey. Trop Doct. 2008 ;38(1):27-8.
- 17- Gritsun T, Lashkevich V, Gould E. Tick-borne encephalitis. Antiviral Research. 2003 Jan;57(1-2):129-46.
- 18- Dorrbecker B, Dobler G, Spiegel M, Hufert FT. Tickborne encephalitis virus and the immune response of the mammalian host. Travel Med Infect Dis. 2010;8,213-222.
- 19- Bursali A, Keskin A, Şimşek E, Keskin A, Tekin S. A survey of ticks (Acari: Ixodida) infesting some wild animals from Sivas, Turkey. Exp Appl Acarol. 2015;66(2):293-9.
Kırım-Kongo Kanamalı Ateşi Ön Tanısı Almış Hastalarda Kene Kaynaklı Ensefalit Virüsü Antikorlarının Yaygınlığının Araştırılması
Abstract
ÖZET
Amaç: Xodes spp. keneleri tarafından bulaşan bir flavivirüs olan kene kaynaklı ensefalit virüsü (TBEV), nonspesifik semptomlar ile karakterize bir klinik tabloya neden olabileceği gibi daha spesifik bir durum olan ensefalit ve miyelit tablosu oluşabilmektedir. Kırım-Kongo kanamalı ateşi (KKKA) ön tanısı ile yatırılarak takip edilen hastaların çoğu kene ile temas riski olan bölgelerden gelmektedir. Bu çalışmanın amacı TBEV’nin epidemiyolojisinin belirlenmesidir.
Gereç ve Yöntem: XXXXX Üniversitesi Tıp Fakültesi Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Anabilim Dalı servisinde KKKA ön tanısı ile Nisan-Eylül 2021 tarihleri arasında takip edilen 272 erişkin hasta çalışmaya dahil edildi. KKKA tanısı içim, Sağlık Bakanlığı Türkiye KKKA Bilimsel Kurulu tarafından oluşturulan kriterler kullanılarak tanımlandı. TBE seroprevelansını belirlemek amacıyla hasta serum örneklerinden ELISA yöntemi ile (Anti- TBE Virus ELISA (IgG) Euroimmun, Almanya) TBEV-IgG antikorları araştırıldı. Sonuçlar, hasta örneğinin ekstinksiyon değerinin kalibratör 2'nin ekstinksiyon değerine oranı hesaplanarak değerlendirilmiş ve bu oran 0.8’den küçük olarak saptandığında negatif, 0.8 ile 1.1 arasında ise ara değer, 1.1’den büyük saptandığında ise pozitif olarak kabul edilmiştir. Serum örneklerinde TBEV’ye karşı oluşmuş antikor saptanmamış hastalar seronegatif olarak değerlendirildi.
Bulgular: Çalışmaya alınan 272 hastanın yaş ortalaması ± standart sapma (SD) 49,46 ± 17,48 (Sınırlar: 18 -98) yıl olup 181’i (%66,5) erkek idi. Tüm hastaların TBEV antikor düzeyleri negatif olarak değerlendirildi Hastaların ikamet ettiği iller Sivas, Giresun, Tokat, Yozgat ve Erzincan idi. Hastaların 204'ünde (%75) kene temas öyküsü bulunurken, bu sayı erkek hastalarda 143 (%79), kadın hastalarda ise 61 (%67) olarak saptandı.
Sonuç: Çalışmamızda TBEV’ye karşı oluşmuş antikor saptanmamış olması kene popülasyonunda TBEV’nin yokluğunu dolaylı yoldan ortaya koymuştur. Ancak Sivas ilinde kene popülasyonu üzerinde TBEV'nin varlığını saptamaya yönelik bir çalışma bulunmamaktadır ve çalışmamız bu konuda yapılmış ilk çalışma olma özelliğini taşımaktadır. Bununla birlikte, daha fazla seroepidemiyolojik çalışmanın yapılması gerekmektedir.
Project Number
T-2022-988
References
- 1- Büyüktuna S.A, Bolat S, Doğan K, Çakır Y, Doğan H.O. Assessment of Serum Beta 2-Microglobulin Levels in Crimean-Congo Hemorrhagic Fever Patients: Implications for Immune Activation and Disease Pathogenesis. Cumhuriyet Science Journal, 2024;45(2):338-42.
- 2- Baysal AÇ, Kıymaz YÇ, Şahin NÖ, Bakır M. Investigation of Long Noncoding RNA-NRAV and Long Noncoding RNA-Lethe Expression in Crimean-Congo Hemorrhagic Fever. J Med Virol. 2024 Dec;96(12):e70142.
- 3- Büyüktuna SA, Yerlitaş Sİ, Zararsız GE, Doğan K, Kablan D, Bağcı G, et al. Exploring free amino acid profiles in Crimean-Congo hemorrhagic fever patients: Implications for disease progression. J Med Virol. 2024;96(5):e29637.
- 4- Schneider H. Uber epidemische acute'meningitis serosa'. Wien. Klin. Wochenschr. 1983; 44: 350-352.
- 5- Kunz C, Heinz FX. Tick-borne encephalitis. Vaccine. 2003;21(1):1-2.
- 6- Lindquist, Lars, and Olli Vapalahti. Tick-borne encephalitis. The Lancet. 2008;371:1861-71.
- 7- Shayan S, Bokaean M, Shahrivar MR, Chinikar S. Crimean-Congo Hemorrhagic Fever. Lab Med. 2015;46(3):180-9.
- 8- Leblebicioglu H, Bodur H, Dokuzoguz B, Elaldi N, Guner R, Koksal I, et al. Case management and supportive treatment for patients with Crimean-Congo hemorrhagic fever. Vector Borne Zoonotic Dis. 2012 Sep;12(9):805-11. doi: 10.1089/ vbz.2011.0896.
- 9- Lani R, Moghaddam E, Haghani A, Chang LY, AbuBakar S, Zandi K. Tick-borne viruses: a review from the perspective of therapeutic approaches. Ticks Tick Borne Dis. 2014 Sep;5(5):457-65. doi: 10.1016/j.ttbdis.2014.04.001.
- 10- Mansfield KL, Johnson N, Phipps LP, Stephenson JR, Fooks AR, Solomon T. Tick-borne encephalitis virus - a review of an emerging zoonosis. J Gen Virol. 2009;90(8):1781-94.
- 11- Süss J. Epidemiology and ecology of TBE relevant to the production of effective vaccines. Vaccine. 2003;21:19-35.
- 12- Ergonul O. Crimean-Congo hemorrhagic fever virus: new outbreaks, new discoveries. Curr Opin Virol. 2012;2(2):215-20.
- 13- Ergunay K, Ozer N, Us D, Ozkul A, Simsek F, Kaynas S, Ustacelebi S. Seroprevalence of West Nile virus and tick-borne encephalitis virus in southeastern Turkey: first evidence for tick-borne encephalitis virus infections. Vector Borne Zoonotic Dis. 2007 Summer;7(2):157-61.
- 14- Uyar Y, Akçalı A, Çarhan A, Özkaya E, Ertek M. Türkiye'de Kene Isırığı Öykülü Olgularda Tıck-Borne Encephalıtıs Virüsünün Seroprevalansı. 2007;64(2):21-25
- 15- Ergünay K, Saygan MB, Aydoğan S, Litzba N, Şener B, Lederer S, et al. Confirmed Exposure to Tick‐Borne Encephalitis Virus and Probable Human Cases of Tick‐Borne Encephalitis in Central/Northern Anatolia, Turkey. Zoonoses and Public Health. 2011 May;58(3):220-7.
- 16- Esen B, Gozalan A, Coplu N, Tapar FS, Uzun R, Aslan T, et al. The presence of tick-borne encephalitis in an endemic area for tick-borne diseases, Turkey. Trop Doct. 2008 ;38(1):27-8.
- 17- Gritsun T, Lashkevich V, Gould E. Tick-borne encephalitis. Antiviral Research. 2003 Jan;57(1-2):129-46.
- 18- Dorrbecker B, Dobler G, Spiegel M, Hufert FT. Tickborne encephalitis virus and the immune response of the mammalian host. Travel Med Infect Dis. 2010;8,213-222.
- 19- Bursali A, Keskin A, Şimşek E, Keskin A, Tekin S. A survey of ticks (Acari: Ixodida) infesting some wild animals from Sivas, Turkey. Exp Appl Acarol. 2015;66(2):293-9.
Details
| Primary Language | English |
|---|---|
| Subjects | Implementation Science and Evaluation |
| Journal Section | Research Article |
| Authors | |
| Project Number | T-2022-988 |
| Early Pub Date | March 29, 2025 |
| Publication Date | March 29, 2025 |
| Submission Date | February 22, 2025 |
| Acceptance Date | March 18, 2025 |
| Published in Issue | Year 2025Volume: 47 Issue: 1 |
