Changing Disease Course of Crimean-Congo Hemorrhagic Fever in Children, Turkey.

Oygar P. D., Gürlevik S. L., Sağ E., İlbay S., Aksu T., Demir O. O., ...More

Emerging infectious diseases, vol.29, no.2, pp.268-277, 2023 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 29 Issue: 2
  • Publication Date: 2023
  • Doi Number: 10.3201/eid2902.220976
  • Journal Name: Emerging infectious diseases
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, Applied Science & Technology Source, BIOSIS, CAB Abstracts, CINAHL, EMBASE, Environment Index, Food Science & Technology Abstracts, MEDLINE, Public Affairs Index, Veterinary Science Database, Directory of Open Access Journals
  • Page Numbers: pp.268-277
  • Hacettepe University Affiliated: Yes


Crimean-Congo hemorrhagic fever (CCHF), endemic in certain regions of the world, is listed as a priority disease with pandemic potential. Since CCHF was first identified in Turkey, children have been known to experience milder disease than adults. However, during the COVID-19 pandemic, we observed an unusually severe disease course, including hemophagocytic lymphohistiocytosis (HLH). We examined cytokine/chemokine profiles of 9/12 case-patients compared with healthy controls at 3 time intervals. Interferon pathway–related cytokines/ chemokines, including interleukin (IL) 18, macrophage inflammatory protein 3α, and IL-33, were elevated, but tumor necrosis factor-α, IL-6, CXCL8 (formerly IL-8), and cytokines acting through C-C chemokine receptor 2 and CCR5 were lower among case-patients than controls. Interferon pathway activation and cytokines/chemokines acting through CCR2 and CCR5 improved health results among children with severe CCHF. Children can experience severe CCHF, including HLH, and HLH secondary to CCHF can be successfully treated with intravenous immunoglobulin and steroid therapy.