Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 29, Number 2—February 2023
CME ACTIVITY - Synopsis

Crimean-Congo Hemorrhagic Fever, Spain, 2013–2021

Helena Miriam Lorenzo Juanes1, Cristina Carbonell1, Begoña Febrer Sendra, Amparo López-Bernus, Alberto Bahamonde, Alberto Orfao, Carmen Vieira Lista, María Sánchez Ledesma, Ana Isabel Negredo, Beatriz Rodríguez-Alonso, Beatriz Rey Bua, María Paz Sánchez-Seco, Juan Luis Muñoz Bellido, Antonio Muro, and Moncef Belhassen-GarcíaComments to Author 
Author affiliations: Universidad de Salamanca, Salamanca, Spain (H. Lorenzo-Juanes, C. Carbonell, B. Febrer-Sendra, A. López-Bernus, A. Orfao, C. Viera Lista, M. Sánchez Ledesma, B. Rodriguez Alonso, B. Rey Bua, J.L. Muñoz Bellido, A. Muro, M. Belhassen-Garcia); Instituto de Investigación Biomédica de Salamanca, Salamanca (H.M. Lorenzo Juanes, C. Carbonell, B. Febrer Sendra, A. López-Bernus, C. Vieira Lista, B. Rodriguez-Alonso, B. Rey Bua, M.P. Sánchez-Seco, A. Muro, M. Belhassen-Garcia); Hospital Universitario de Salamanca, Salamanca (H.M. Lorenzo Juanes, C. Carbonell, M. Sánchez Ledesma, B. Rodríguez-Alonso, B. Rey Bua); Hospital El Bierzo, Ponferrada, Spain (A. Bahamonde); Centro de Investigación del Cáncer, Salamanca (A. Orfao); Centro de Investigación Biomédica en Red de Cáncer, Madrid, Spain (A. Orfao); Centro Nacional de Microbiologiia, Majadahonda, Spain (A.I. Negredo, M.P. Sánchez-Seco); Red de Investigación Colaborativa en Enfermedades Tropicales, Madrid (A.I. Negredo, M.P. Sánchez-Seco, J.L. Muñoz Bellido); Centro de Investigación Biomédica en Red en Enfermedades Infecciosas, Madrid (A.I. Negredo, M.P. Sánchez-Seco)

Main Article

Table 2

Main clinical and laboratory data of patients with Crimean-Congo hemorrhagic fever, Spain, 2013–2021*

Characteristic Patient no. and source
1 (10) 2 (10) 3 (12) 4 (13) 5 6 7 8 (11) 9 10
Main clinical data
Tick bite Y N Y N Y Y Y Y Y Y
First symptom Fever Fever Fever Fever Fever Fever Fever Fever Fever Fever
Fever duration, d 4 5 6 6 9 5 4 4 4 5
Days from first symptom to admission 3 2 4 5 9 7 3 2 4 12
Digestive symptoms Y Y Y N Y N Y Y Y Y
Any bleeding
 Y
 Y
 Y
 N
 Y
 N
 Y
 Y
 N
 Y
Laboratory data†
Hemoglobin, g/dL 13.4 13.9 13.5 14.1 14.6 15.5 13.4 14.4 17 17
Leukocytes, × 103 cells/mm3 13.9 6.2 10.7 3.1 2.4 2.3 5.5 1.5 2.8 11.1
Neutrophils, % 85.5 83 90 62 33 66.4 69 63 68.5 90
Lymphocytes, % 7.9 10.2 5 27 38 26.1 25 31 24.4 4
Platelets, × 103/mm3 30 174 229 41 44 32 7 44 76 159
Glucose, mg/d 80 102 83 135 110 134 280 106 116 491
Creatinine, mg/dL 1.69 1.24 0.83 1.33 0.92 0.75 4.8 0.67 0.85 1.1
CRP, mg/L 87.6 2.9 ND 15.2 0.3 0.65 3.72 0.6 0.55 52
AST, U/L 203 24 20 347 273 273 1,305 494 107 72
ALT, U/L 88 37 9 161 281 135 347 171 141 70
Ferritin, ng/mL ND ND >40,000‡ 15,718 34,044 28,393 60,000 ND 7,878 1,147
Bilirubin, mg/dL 0.9 0.5 0.5 0.7 0.43 0.35 1.4 0.29 0.58 ND
GGT, U/L ND ND ND 425 272 132 1,420 77 136 ND
ALP, U/L ND ND ND 103 84 59 239 58 72 91
LDH, U/L ND ND 172 721 358 589 2,311 1,085 341 272
Triglycerides, mg/dL ND ND ND ND ND 407‡ ND ND 164‡ ND
Prothrombin time, s 18.1 15.6 10.7 10.2 10 12 13 12 11 ND
Prothrombin activity, % 52.8 62 104 106 123 99 86 81 102 84
Partial thromboplastin time, s 18.1 48.7 26.2 43.8 30.2 52.7 61.4 128 ND 29
Functional fibrinogen, mg/dL ND 265.9 320 605 281 304 156 141 272 325
D-dimer, ng/mL ND 35,200 ND ND ND 1.3 5.5 3.48 ND ND
Genotype
 III
 III
 IV
 V
 III
 III
 III
 ND
 V
 ND
Treatment
 DOX; support
 DOX; Ribavirin ev/orally for 9 d
 DOX; support
 DOX
DOX; ribavirin orally for 10 d§
 DOX; ribavirin orally for 10 d§
 DOX support
 DOX; support
 DOX
DOX; support
Length of stay, d 9 23 8 6 22 9 2 17 9 8

*Source is indicated if other than this study. ALP, alkaline phosphatase; ALT, alanine aminotransferase; AST, aspartate aminotransferase; CRP, C-reactive protein; DOX, doxycycline; GGT, gamma-glutamyl transferase; LDH, lactate dehydrogenase; ND, no data. †Analysis upon admission or during the first 24 hours. ‡Analysis performed during hospital admission. §In accordance with World Health Organization guidelines.

Main Article

1These authors contributed equally to this article.

Page created: January 23, 2023
Page updated: January 23, 2023
Page reviewed: January 23, 2023
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external