ABSTRACT
Crimean-Congo haemorrhagic fever (CCHF) is an arbovirus infection, which is transmitted through ticks or via blood and secretions. Until recently, human cases of CCHF were unknown in Turkey; however, several acute disease cases were reported in 2002. We report on the investigation of a cluster of suspected CCHF cases in the middle part of the Black Sea from May 2002 to October 2003. The medical charts that we reviewed were obtained from all local physicians and our field investigations. 'Suspected case' was defined with regard to time, place, and both clinical and laboratory characteristics. A total of 108 patients were defined as suspected case. Among them 36 patients were reached and blood samples taken for examination for CCHF by using ELISA and RT-PCR. According to the laboratory analysis, 80.6% (29/36) were acute cases and 8.3% (3/36) were past CCHF infections. The overall mortality rate was 5.6%. There was no nosocomial infection; however, there were 2 family clusters. Tick exposure was the most prevalent risk factor (74.2%). A multidisciplinary collaboration should be developed in order to understand the magnitude of the disease and also to keep it under control.
Subject(s)
Antibodies, Viral/blood , Disease Outbreaks , Hemorrhagic Fever Virus, Crimean-Congo/immunology , Hemorrhagic Fever, Crimean/immunology , Female , Hemorrhagic Fever Virus, Crimean-Congo/pathogenicity , Hemorrhagic Fever, Crimean/diagnosis , Hemorrhagic Fever, Crimean/epidemiology , Humans , Male , Tick-Borne Diseases/epidemiology , Turkey/epidemiologyABSTRACT
The aim of this study was to determine the serum adenosine deaminase (ADA) and plasma platelet factor (PF-4) activities in patients with active pulmonary tuberculosis, HIV seropositive subjects, cancer patients (acute and chronic type lymphoblastic leukaemia) and to compare them with the results of healthy individuals. Eighty-eight subjects were enrolled in this study, 24 patients with active pulmonary tuberculosis, 20 patients with HIV seropositive subjects, 24 patients with cancer, 12 patients with acute type lymphoblastic leukaemia, 12 patients with chronic type lymphoblastic leukaemia) patients and 20 healthy individuals. ADA activity was determined in serum samples using colorimetric method and plasma PF4 activity was measured by using a sandwich-type enzyme immunoassay. When all study groups were compared with the control group, mean serum ADA activities were found to be significantly (p<0.01) higher in the sera of patients with active pulmonary tuberculosis (median, range: 39 IU/l), HIV seropositive subjects (median, range: 31 IU/l) than in the sera of cancer patients (median, range: 15) and healthy controls (median, range: 32 IU/l). Plasma PF-4 activities in active pulmonary tuberculosis patients (median, range: 84 IU/ml) were found to be significantly elevated when compared to HIV seropositive subjects (median, range: 59 IU/ml), cancer patients (median, range 55 IU/ml) and healthy individuals (median, range: 56 IU/ml) (p<0.01). Serum ADA and plasma PF-4 activities showed significant alteration in patients with active pulmonary tuberculosis compared to patients with HIV seropositive subjects, cancer patients and healthy individuals. In conclusion, we suggest that serum ADA and PF-4 activities can be used in the diagnosis of tuberculosis as an supplementary laboratory test in combination with clinical and laboratory findings. Further controlled studies are necessary to determine the importance of the PF-4 and ADA activities in patients with active pulmonary tuberculosis, HIV seropositive subjects and cancer patients.
Subject(s)
Adenosine Deaminase/blood , HIV Seropositivity/blood , Leukemia, Lymphoid/blood , Platelet Factor 4/analysis , Tuberculosis, Pulmonary/blood , Adenosine Deaminase/metabolism , Adult , Case-Control Studies , Colorimetry , Female , HIV Antibodies/blood , HIV Seropositivity/enzymology , HIV Seropositivity/immunology , Humans , Immunoenzyme Techniques , Leukemia, Lymphoid/enzymology , Leukemia, Lymphoid/immunology , Male , Mycobacterium tuberculosis/isolation & purification , Platelet Factor 4/metabolism , Sputum/microbiology , Tuberculosis, Pulmonary/diagnosis , Tuberculosis, Pulmonary/enzymologyABSTRACT
The aim of this study was to compare auramin-rhodamine (A-R) and Erlich-Ziehl-Neelsen (EZN) staining techniques for the diagnosis of tuberculosis. Of 311 sputum samples collected from active pulmonary tuberculosis patients and tuberculosis-suspected patients, 103 (33%) were found culture positive. In the direct microscopic examination of EZN stained smears, 86.4% (89/103) of culture positive samples, and 3.8% (8/208) of culture negative samples yielded asido-resistant bacteria, while these rates were 74.8% (77/103) and 11.5% (24/208) for A-R staining method. When culture was accepted as reference method, the specificity and sensitivity of the staining techniques were found as 88.5% and 74.8% for A-R, and 96.2% and 86.4% for EZN, respectively. As a result, it was concluded that, the use of A-R staining alone, could not be an alternative method to EZN staining.
