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» LymeNet Flash » Questions and Discussion » Medical Questions » Taking on Ticks (Crimean-Congo hemorrhagic fever)

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Author Topic: Taking on Ticks (Crimean-Congo hemorrhagic fever)
Melanie Reber
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Taking on Ticks
Asli Ortakmac and Andrew Bast
Newsweek Web Exclusive

While the world focuses on swine flu, another enigmatic virus is making a reappearance. Why hard-hit Turkey is divided on the best defense.

Symptoms of the cryptically named Crimean-Congo hemorrhagic fever are cringe-worthy. After a sudden onset of fever, dizziness, and sore eyes, blood can begin bubbling on the skin. Gums begin to bleed and, if you're unlucky, you die.

Transmitted by bites from infected ticks, the disease, known as CCHF, was first discovered in the Crimea in 1944, and 25 years later emerged in the Congo (hence the name). Yet, in light of recent events, one more country may need to be added to the list: Turkey.

And as swine flu has been declared a pandemic by the World Heath Organization, Turkey is now at the forefront of combating a different puzzling virus. Scientists and the government have diverging views on how to combat the disease, and in turn, Turks are now asking whether their country could engineer an exportable solution and take a lead on a serious global public-health issue.

Since it was first diagnosed, cases of CCHF have been reported in Africa, Asia, the Middle East, and Europe. Its emergence over the last few years in Turkey, however, seems especially acute. It killed seven people in 2003, and 33 in 2007.

In all, between the years 2002 and 2008, a total of 2,597 cases have been reported, and these have left 155 dead. Because the disease especially threatens farmers, fear of tick bites has sparked paranoia among the rural middle of the country, sending some to the emergency room on the weekends to have tick-resembling beauty marks checked out.

According to the Centers for Disease Control in the U.S., fatality rates for CCHF range from anywhere as low as 9 percent to as high as 50 percent. No vaccine exists, and treatments are limited.

The number of Turkish cases has pushed its researchers to the frontlines of CCHF research. Turkish scientists write regularly on the topic in international medical journals and advise organizations like the World Health Organization and the European Union.

Among them is Associate Professor Onder Erg�n�l of the Infectious Diseases and Clinical Microbiology Department at Marmara University, who has been working for the last few years on an early diagnostic test for CCHF that could be put to use in village clinics.

Erg�n�l's project qualified for advanced-level funding from the European Research Council (ERC) last year. He then turned to Turkey's Scientific and Technological Research Council (T�BITAK), but while the Europeans were impressed, the value of his research was lost on his home government.

Erg�n�l was flummoxed. "None of the members of the jury even had a single article about this topic, but they neither considered my project as important, nor were they convinced that I have enough information on an issue that I have been researching for years," he says.

The Turkish government says it's taking a different approach. Various government ministries have been working to educate people living in high-risk regions; officials canvas villages across the country's provinces, equipping Turks with methods of prevention.

"Last August, we ordered all city branches to apply insecticides to sacrificial animals prior to their transport," Ahmet Uygar of the Ministry of Agriculture told NEWSWEEK T�rkiye, NEWSWEEK's Turkish-language partner.

Erg�n�l insists that funding research will push Turkey into the lead on the issue. Work toward a vaccine has accelerated in the last two years, and as long as the disease does not create a serious threat in Europe or the U.S., Turks believe that their doctors are the most likely to develop an effective first response to CCHF.

Developing a vaccine will be long and difficult, however, so the government is focusing on its education strategy in the interim. The next step, they hope, will be eradication.

Adapted from a report written by Asli Ortakmac for NEWSWEEK's Turkish-language partner Newsweek T�rkiye. Additional reporting by Andrew Bast in New York.

URL: http://www.newsweek.com/id/203990

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