http://www.bada-uk.org/wordpress/?paged=39
Press Release Newswire – Autism and Lyme Disease are Connected, Lyme-Induced Autism Study Finds
PR Web (press release), WA – Jul 1, 2008
Cases of Lyme disease and autism are skyrocketing in the United States. Is there a link between the two disorders? Research spurred by non-profit foundation says “Yes.”
South Lake Tahoe, CA (PRWEB) July 1, 2008 — Lyme disease may play a role in causing autism according to a recent study published in Medical Hypothesis, a peer-reviewed scientific journal.
A team of five physicians led by Robert Bransfield, M.D., analyzed the two diseases and discovered a connection based on epidemiological findings, symptom similarities, case reports, and laboratory test results.
The Lyme-Induced Autism (LIA) Foundation has paved the way for studies such as this one. Led by Tami Duncan, herself the mother of an autistic child, the LIA Foundation was established in 2006 by a group of parents who suspected the connection but recognized the need for scientific research.
Collaboration on the Medical Hypothesis study began during one of the LIA Foundation national conferences, which have attracted top physicians from around the country.
Charles Ray Jones, M.D., considered the nation’s leading pediatric Lyme specialist, was one of nine presenters at a recent LIA Foundation conference held on April 12, 2008 in Fort Lee, New Jersey. “I’ve treated over 10,000 children with Lyme disease,” Jones said during his presentation. “A good many of the children, we’ve found, have had autism-spectrum disorder.”
Warren Levin, M.D., was also present at the New Jersey conference. He described the case of “a terribly ill autistic kid…who tested positive for Lyme disease.” Subsequent to that case, Dr. Levin “started screening all autistic patients…and nine in a row tested positive for Lyme disease.”
The LIA Foundation hosted their most recent conference on June 27-29, 2008 in Indian Wells, California.
To educate the public about the Lyme-autism connection, LIA Foundation president and co-founder Tami Duncan recently co-authored a book on the topic with author Bryan Rosner. Rosner has written three books on Lyme disease.
“Lyme disease is not the only causative factor in autism,” Rosner says. “We know that many other environmental and genetic triggers are involved. However, Lyme disease is the fastest spreading infectious disease in the United States, with an estimated 200,000 new cases per year. Autism cases are also exploding. If Lyme disease can contribute to the onset of autism, then we are onto something big here.”
In their book, Duncan and Rosner describe a correlation between the geographic incidences of the two diseases. “The ten states with the highest incidence of Lyme disease are the same states with the highest incidence of autism,” Duncan says.
“Research also suggests that Lyme disease can be congenitally transferred from mother to child during pregnancy, even if the mother is unaware that she is infected,” Duncan continues. “This can account for the early onset of Lyme-induced autism in young children.”
Duncan and Rosner do not believe that the Lyme-autism connection hypothesis is new. Their book states that parents, caretakers, and researchers have long suspected the link. But the recent conferences and peer-reviewed studies are important because they attract the attention of the medical community, which can lead to life-saving research.
“New medical truths do not have significant impact until they are packaged and presented according to accepted guidelines,” Rosner says. “The connection is not new, but it is finally receiving proper attention.”
To learn more, visit the LIA Foundation website at http://www.liafoundation.org.
Rosner and Duncan’s book, “The Lyme-Autism Connection,” can be ordered from http://www.lymebook.com/lyme-autism-connection or http://www.amazon.com. The publisher is BioMed Publishing Group, South Lake Tahoe, California, (530) 541-7200.
http://www.prweb.com/releases/autism/lyme-induced-autism/prweb1063944.htm
Cases of Lyme disease and autism are skyrocketing in the United States. Is there a link between the two disorders? Research spurred by non-profit foundation says “Yes.”
South Lake Tahoe, CA (PRWEB) July 1, 2008 — Lyme disease may play a role in causing autism according to a recent study published in Medical Hypothesis, a peer-reviewed scientific journal.
A team of five physicians led by Robert Bransfield, M.D., analyzed the two diseases and discovered a connection based on epidemiological findings, symptom similarities, case reports, and laboratory test results.
The Lyme-Induced Autism (LIA) Foundation has paved the way for studies such as this one. Led by Tami Duncan, herself the mother of an autistic child, the LIA Foundation was established in 2006 by a group of parents who suspected the connection but recognized the need for scientific research.
Collaboration on the Medical Hypothesis study began during one of the LIA Foundation national conferences, which have attracted top physicians from around the country.
Charles Ray Jones, M.D., considered the nation’s leading pediatric Lyme specialist, was one of nine presenters at a recent LIA Foundation conference held on April 12, 2008 in Fort Lee, New Jersey. “I’ve treated over 10,000 children with Lyme disease,” Jones said during his presentation. “A good many of the children, we’ve found, have had autism-spectrum disorder.”
Warren Levin, M.D., was also present at the New Jersey conference. He described the case of “a terribly ill autistic kid…who tested positive for Lyme disease.” Subsequent to that case, Dr. Levin “started screening all autistic patients…and nine in a row tested positive for Lyme disease.”
The LIA Foundation hosted their most recent conference on June 27-29, 2008 in Indian Wells, California.
To educate the public about the Lyme-autism connection, LIA Foundation president and co-founder Tami Duncan recently co-authored a book on the topic with author Bryan Rosner. Rosner has written three books on Lyme disease.
“Lyme disease is not the only causative factor in autism,” Rosner says. “We know that many other environmental and genetic triggers are involved. However, Lyme disease is the fastest spreading infectious disease in the United States, with an estimated 200,000 new cases per year. Autism cases are also exploding. If Lyme disease can contribute to the onset of autism, then we are onto something big here.”
In their book, Duncan and Rosner describe a correlation between the geographic incidences of the two diseases. “The ten states with the highest incidence of Lyme disease are the same states with the highest incidence of autism,” Duncan says.
“Research also suggests that Lyme disease can be congenitally transferred from mother to child during pregnancy, even if the mother is unaware that she is infected,” Duncan continues. “This can account for the early onset of Lyme-induced autism in young children.”
Duncan and Rosner do not believe that the Lyme-autism connection hypothesis is new. Their book states that parents, caretakers, and researchers have long suspected the link. But the recent conferences and peer-reviewed studies are important because they attract the attention of the medical community, which can lead to life-saving research.
“New medical truths do not have significant impact until they are packaged and presented according to accepted guidelines,” Rosner says. “The connection is not new, but it is finally receiving proper attention.”
To learn more, visit the LIA Foundation website at http://www.liafoundation.org.
Rosner and Duncan’s book, “The Lyme-Autism Connection,” can be ordered from http://www.lymebook.com/lyme-autism-connection or http://www.amazon.com. The publisher is BioMed Publishing Group, South Lake Tahoe, California, (530) 541-7200.
http://www.prweb.com/releases/autism/lyme-induced-autism/prweb1063944.htm
Zimbabwe Guardian: Tick-borne diseases kill cattle
Mon, 30 Jun 2008 02:15:00 +0000
TICK-BORNE and tsetse fly induced diseases in Gwanda, Matabeleland South are reported to be killing cattle.
The diseases have also affected parts of Mberengwa.
“There were a lot of ticks in some parts of Gwanda following the heavy rains we received during the last season.
“Heavy rains increased tick activities and villagers were not dipping their cattle due to lack of dipping chemicals which the country is experiencing,” said Moses Mlalazi a farmer in the Guyu area.
“The countrywide shortage of dipping chemicals was a result of the unavailability of foreign currency. I believe that the cattle deaths are not occurring in Gwanda only, but the problem of tick-borne diseases is a national issue,” said a senior Veterinary Services officer in Gwanda.
He explained that there were two types of tick-borne diseases, anaplasmosis and red water, which are promoted by lack of cattle dipping while tripanosomiasis is a disease, caused by tsetse flies.
He added that the battle to contain these diseases was being hampered by a shortage of acaricide chemical.
“The supply of acaricides has not been regular hence the increase in the prevalence of ticks and other tick borne related diseases,” said the official.
Tick-borne diseases affect about 500 million cattle in the whole world and apart from irritation and anaemia in the case of heavy infestations; ticks can cause severe dermatitis, sometimes with secondary infestations of dermatophilus congolensis, which may result in high mortality.
Last, the government spent billions of dollars in buying vaccines to control foot and mouth, black leg and other infections diseases as it embarked on a nationwide restocking exercise to boost the national herd.
http://www.talkzimbabwe.com/news/117/ARTICLE/2826/2008-06-30.html
TICK-BORNE and tsetse fly induced diseases in Gwanda, Matabeleland South are reported to be killing cattle.
The diseases have also affected parts of Mberengwa.
“There were a lot of ticks in some parts of Gwanda following the heavy rains we received during the last season.
“Heavy rains increased tick activities and villagers were not dipping their cattle due to lack of dipping chemicals which the country is experiencing,” said Moses Mlalazi a farmer in the Guyu area.
“The countrywide shortage of dipping chemicals was a result of the unavailability of foreign currency. I believe that the cattle deaths are not occurring in Gwanda only, but the problem of tick-borne diseases is a national issue,” said a senior Veterinary Services officer in Gwanda.
He explained that there were two types of tick-borne diseases, anaplasmosis and red water, which are promoted by lack of cattle dipping while tripanosomiasis is a disease, caused by tsetse flies.
He added that the battle to contain these diseases was being hampered by a shortage of acaricide chemical.
“The supply of acaricides has not been regular hence the increase in the prevalence of ticks and other tick borne related diseases,” said the official.
Tick-borne diseases affect about 500 million cattle in the whole world and apart from irritation and anaemia in the case of heavy infestations; ticks can cause severe dermatitis, sometimes with secondary infestations of dermatophilus congolensis, which may result in high mortality.
Last, the government spent billions of dollars in buying vaccines to control foot and mouth, black leg and other infections diseases as it embarked on a nationwide restocking exercise to boost the national herd.
http://www.talkzimbabwe.com/news/117/ARTICLE/2826/2008-06-30.html
The Telegraph: Tick-borne encephalitis threat in central Europe
Dr Richard Dawood
Last Updated: 3:44PM BST 27/06/2008
With cases of tick-borne encephalitis on the increase, Dr Richard Dawood explains how to avoid a potentially fatal virus.
The number of cases of tick-borne encephalitis (TBE) – a serious viral infection prevalent in central Europe – rose by almost a third last year, according to a leading expert.
Professor Michael Kunze, chairman of the International Scientific Working Group (ISWG) on TBE, says the number of people across Europe who needed hospital treatment for the infection rose from 10,000 cases in 2006 to 13,000 in 2007. The ISWG considers that climate change is partly to blame, with warmer temperatures and more rain creating perfect conditions for ticks to thrive.
Professor Kunze says that this year’s toll could be higher still, as more than two million people travelled to Switzerland and Austria this summer to the UEFA European football championships. Many are expected to stay on to enjoy outdoor activities that could put them at risk.
TBE is an infection of the nervous system, spread by tick bites, that occurs in 30 countries across central Europe, Asia and the Far East. The disease is seasonal, with risk extending from spring to autumn. The risk is highest for those who take part in outdoor activities such as hiking, camping and mountain biking. There is also a risk of infection through consuming dairy products prepared from infected animals.
In severe cases the illness resembles meningitis and without specific testing can be mistaken for it. There is no specific treatment, and some sufferers are left with lasting neurological damage; approximately one per cent of cases are fatal. Within the affected parts of Europe, the risks are widely known and understood. In Austria, for example, an anti-TBE vaccine is offered to the entire population. Elsewhere, many people are ignorant of the disease.
A safe and effective vaccine is available, suitable for adults and for children at least one year old. At least two doses are needed for protection, with a two-week gap between the first and second doses.
How should ticks be removed?
Remove them gently by grasping the head at the point of contact with the skin with fine tweezers. An alternative is to use a thin piece of card with a narrow “V” cut out of it: ease it under the tick until the apex of the “V” is at the head, then lift gently. Do not grasp a tick by its body, since this might force its abdominal contents into the bite, increasing the risk of infection. Retain the tick so that it can be identified later, if necessary. Ticks need to remain attached for several hours for disease transmission to occur, so early removal greatly reduces the risk.
Do ticks spread other diseases?
Yes. Lyme disease is also on the increase in Europe. Even if you have been vaccinated, it is worth taking careful precautions to avoid tick bites.
How do I prevent them?
In high-risk areas, wear long trousers and tuck them into your socks. Light-coloured clothing makes ticks more visible. Inspect your skin carefully for ticks at the end of each day – travelling companions should inspect each other. Ticks can be tiny, and perhaps two thirds of tick bites pass unnoticed. The best available tick repellent is the insecticide permethrin, available as a liquid or a spray: apply it liberally to clothing, especially socks and trouser legs.
What should I do if I’m bitten?
Don’t panic and seek advice, ideally from local doctors. The risk of TBE infection from a single bite has been estimated at between 1 in 200 and 1 in 1,000. Report a fever, rash or any other symptoms right away.
Dr Dawood is a specialist in travel medicine at the Fleet Street Clinic (020 7353 5678).
http://www.telegraph.co.uk/travel/travelnews/2202634/Tick-borne-encephalitis-threat-in-central-Europe.html
Last Updated: 3:44PM BST 27/06/2008
With cases of tick-borne encephalitis on the increase, Dr Richard Dawood explains how to avoid a potentially fatal virus.
The number of cases of tick-borne encephalitis (TBE) – a serious viral infection prevalent in central Europe – rose by almost a third last year, according to a leading expert.
Professor Michael Kunze, chairman of the International Scientific Working Group (ISWG) on TBE, says the number of people across Europe who needed hospital treatment for the infection rose from 10,000 cases in 2006 to 13,000 in 2007. The ISWG considers that climate change is partly to blame, with warmer temperatures and more rain creating perfect conditions for ticks to thrive.
Professor Kunze says that this year’s toll could be higher still, as more than two million people travelled to Switzerland and Austria this summer to the UEFA European football championships. Many are expected to stay on to enjoy outdoor activities that could put them at risk.
TBE is an infection of the nervous system, spread by tick bites, that occurs in 30 countries across central Europe, Asia and the Far East. The disease is seasonal, with risk extending from spring to autumn. The risk is highest for those who take part in outdoor activities such as hiking, camping and mountain biking. There is also a risk of infection through consuming dairy products prepared from infected animals.
In severe cases the illness resembles meningitis and without specific testing can be mistaken for it. There is no specific treatment, and some sufferers are left with lasting neurological damage; approximately one per cent of cases are fatal. Within the affected parts of Europe, the risks are widely known and understood. In Austria, for example, an anti-TBE vaccine is offered to the entire population. Elsewhere, many people are ignorant of the disease.
A safe and effective vaccine is available, suitable for adults and for children at least one year old. At least two doses are needed for protection, with a two-week gap between the first and second doses.
How should ticks be removed?
Remove them gently by grasping the head at the point of contact with the skin with fine tweezers. An alternative is to use a thin piece of card with a narrow “V” cut out of it: ease it under the tick until the apex of the “V” is at the head, then lift gently. Do not grasp a tick by its body, since this might force its abdominal contents into the bite, increasing the risk of infection. Retain the tick so that it can be identified later, if necessary. Ticks need to remain attached for several hours for disease transmission to occur, so early removal greatly reduces the risk.
Do ticks spread other diseases?
Yes. Lyme disease is also on the increase in Europe. Even if you have been vaccinated, it is worth taking careful precautions to avoid tick bites.
How do I prevent them?
In high-risk areas, wear long trousers and tuck them into your socks. Light-coloured clothing makes ticks more visible. Inspect your skin carefully for ticks at the end of each day – travelling companions should inspect each other. Ticks can be tiny, and perhaps two thirds of tick bites pass unnoticed. The best available tick repellent is the insecticide permethrin, available as a liquid or a spray: apply it liberally to clothing, especially socks and trouser legs.
What should I do if I’m bitten?
Don’t panic and seek advice, ideally from local doctors. The risk of TBE infection from a single bite has been estimated at between 1 in 200 and 1 in 1,000. Report a fever, rash or any other symptoms right away.
Dr Dawood is a specialist in travel medicine at the Fleet Street Clinic (020 7353 5678).
http://www.telegraph.co.uk/travel/travelnews/2202634/Tick-borne-encephalitis-threat-in-central-Europe.html
Disseminated Lyme disease after short-duration tick bite
Michael A. Patmas, MD, FACP and Carolina Remorca, MD. JSTD 1994; 1:77-78.
Lyme disease, an Ixodes tick-borne spirochetal infection, has been the subject of much controversy. One problematic area has been the prophylactic treatment of deer-tick bites in endemic areas. Some have argued against routine antimicrobial prophylaxis based upon the belief that transmission of Borrelia burgdorferi is unlikely before 24-48 hours of tick attachment. Others have suggested that it is cost effective to administer prophylactic antibiotics against Lyme disease when embedded deer-tick bites occur in endemic areas. Herein, a case of disseminated Lyme disease after only 6 hours of tick attachment is presented. The current recommendation against treatment of short-duration tick bites may need reconsideration, particularly in hyperendemic areas. Color pictures.
http://www.jstd.org/abstracts/v1n3_94.html
Lyme disease, an Ixodes tick-borne spirochetal infection, has been the subject of much controversy. One problematic area has been the prophylactic treatment of deer-tick bites in endemic areas. Some have argued against routine antimicrobial prophylaxis based upon the belief that transmission of Borrelia burgdorferi is unlikely before 24-48 hours of tick attachment. Others have suggested that it is cost effective to administer prophylactic antibiotics against Lyme disease when embedded deer-tick bites occur in endemic areas. Herein, a case of disseminated Lyme disease after only 6 hours of tick attachment is presented. The current recommendation against treatment of short-duration tick bites may need reconsideration, particularly in hyperendemic areas. Color pictures.
http://www.jstd.org/abstracts/v1n3_94.html
Today’s Zaman: ‘Awareness of tick-borne disease must be raised’
22 June 2008, Sunday NURSEL DİLEK ANKARA
The cases of Crimean-Congo hemorrhagic fever (CCHF), a viral disease transmitted by ticks, is increasing year by year, a fact that Associate Professor Zati Vatansever says is due to lack of awareness of the disease in rural areas, where it is most common.
“Mostly seen in rural areas, transmitted to people by ticks, increasing between the months of April and October, coming suddenly and killing within two weeks,” reported the dailies and television news broadcasts over the last several months. CCHF seems to be the new threat to the Turkish population. Experts say the disease, whose victims have increased fivefold in the last five years, will become an even bigger problem in coming years. Seen six years ago for the first time in Turkey, CCHF has killed 134 people in the country thus far. Infecting two doctors and one other medical staff member at the Ankara Numune Education and Research Hospital, the seriousness of disease has reached an alarming point.
CCHF and Turkey
CCHF entered world medical literature back in the 1940s. In the summer of 1944, it was seen in Russian soldiers transporting agricultural products in Western Crimea for the first time. In 1956, the same disease was witnessed in Congo, which is how the disease got its name. The history of the disease in Turkey does not go back that far; CCHF was first observed here in the summer of 2002.
Esra Demir, working as a nurse at the Tokat Social Security Authority (SSK) Hospital, in 2002 suddenly felt unwell and was taken to the Ankara Hacettepe University Hospital. Despite all the attempts to treat her, she died after one week and her reason of death was recorded as unknown. However, six more people died in a short period in Tokat, a province in the Black Sea region, and the deaths were announced as “deaths with unknown reasons” to the media. The Ministry of Health at first thought that this unknown disease resembled Q fever, a disease caused by infection with the bacterium Coxiella burnetii. Yet upon finding that the symptoms were not quite the same as those of Q fever, blood samples were sent to the laboratories of the Pasteur Institute in France. The tests conducted there finally confirmed that the disease was CCHF.
Detection of 327 CCHF cases in Tokat province shows that it is one of the most affected regions in Turkey. Thus the question arises, why Tokat? To understand this, we must explore the conditions causing the disease in the province and the characteristics of infected ticks.
Female ticks pose greater threat
Vatansever, associate professor at the department of parasitology at the veterinary school of Kafkas University, has been conducting research on ticks since 1989. And since 2004, when the disease began to spread, the professor has been analyzing CCHF-infected ticks and the domestic and wild animals that carry them. There are 850 tick species in the world, with 32 of them present in Turkey; however, not all ticks carry the CCHF virus. The virus is carried by ticks of the Hyalomma marginatum marginatum species. Virus-carrying ticks lodge in small wild animals such as mice or rabbits and in wild birds. They mature on these smaller animals and then move on to large wild animals, cattle and people. After the ticks feed on their host, they detach themselves and while male ticks die soon thereafter, females die after laying their eggs. Stating that the real threat is posed by female ticks, Vatansever noted: “Three to 5 percent of eggs of a tick bearing the CCHF virus are also contaminated. In this sense, female ticks present more of a threat than males.”
How ticks choose a host
Unless ticks find a suitable host, they live for an average of one year. In temperatures of 16-18 degrees Celsius, their life spans can extend up to three years. The characteristics of virus-carrying ticks are different from other ticks. The ticks of the Hyalomma species are also known as hunters. These ticks burrow into soil, unlike many other ticks that live on plants. They can feel vibrations and heat, while also being able to smell and identify carbon dioxide from exhalation. Vatansever noted that the infected ticks attach themselves to people who are sitting or lying down, not moving. “They feel vibrations and sense heat and carbon dioxide emitted from people and gravitate toward them. They start climbing from a person’s feet and look for an area on which to attach themselves.”
Ornithologist Ahmet Kütükçü emphasized another crucial point. He said migratory birds, particularly storks, play an active role in spreading the disease. “Yet the real host for the ticks are not birds, but rodents,” he noted.
The number of CCHF virus-transmitting ticks is increasing in the world, and this is related to an increase in suitable conditions, which include heat, humidity and proper hosts, Vatansever noted. He also explained that while only 40 percent of tick species can reproduce under normal weather conditions, the ecological changes caused by global warming have led to warmer weather, which prolongs the life span of ticks and facilitates their reproduction. Virus-carrying ticks are able to survive in regions where ocean climates — typical of the Black Sea region — and semi-arid climates — typical of central Anatolia and eastern Anatolia — meet, and those types of ticks prefer areas with small trees and cattle. Conducting field studies on the range of virus-carrying ticks, Vatansever found that Çorum, Amasya, Tokat, Yozgat, Sivas, Erzurum and Artvin are at the highest risk. The least hazardous regions are the Mediterranean and Black Sea coasts, Vatansever said.
‘Rural areas should be more concerned about risk’
Taking a closer look at the deaths caused by ticks reveals that cattle owners, farmers and shepherds are the most at-risk population. In addition, soldiers, campers and picnickers, veterinarians, forest workers and health staff working in infected areas are at risk. The percentage of deaths among elderly people over 70 is also striking.
Noting that the CCHF-transmitting ticks live on cattle and wild animals, Vatansever said it is pointless to worry about ticks in urban areas. However, the professor complained about ignorance in rural areas. “People in rural areas live with ticks from their childhood to adulthood, and they think they know about ticks. When they see photographs of ticks in newspapers, they say that the ticks in the photos do not resemble those living in their villages. They are exposed to tick bites every summer, but they remove them on their own. The village people do not want to believe that CCHF-carrying ticks can be fatal. And then they want to believe the nonsense alleging that the ticks are sent from Israel. Unfortunately it is very hard to do away with these kinds of beliefs,” he said, adding that he believes if rural people had just a little concern over the ticks, they would take simple measures to protect themselves.
Tick bites kill within two weeks
The CCHF virus is transferred to people and animals via tick bites. While the virus does not necessarily kill animals, it is often fatal for people. Symptoms of the infection are sudden fever, nausea, headache, vomiting and diarrhea. Bleeding of different parts of body may also accompany these symptoms. Hürrem Bodur, the chief of the Department of Infectious Diseases at Ankara Numune Hospital, explained the course of the disease, saying: “There are platelets circulating in the blood in the human body functioning as bleeding clotters. But entering into human body via tick bites, the virus causes the number of platelet cells to decrease, which damages the veins and which, in turn, causes hemorrhage. External hemorrhage in parts like the nose and ears or internal hemorrhage, causing parts of the body to appear bruised and purplish, may occur as a result of decreasing platelets,” Bodur said.
Experts say that disease symptoms appear within one to three days or 10 days at most after the virus enters a person’s body. It is vital for a patient to stay in the hospital after infection. Patients who survive after two weeks become permanently immune to the disease. Raising awareness is of crucial importance to effectively combat the disease. Experts have suggested that more action be taken in high-risk areas by the ministries of health and agriculture. A regular inspection of the animal population in problematic regions is another important step to take. Widespread education campaigns need to be conducted to raise awareness of the people in rural areas.
http://www.todayszaman.com/tz-web/detaylar.do?load=detay&link=145449&bolum=101
The cases of Crimean-Congo hemorrhagic fever (CCHF), a viral disease transmitted by ticks, is increasing year by year, a fact that Associate Professor Zati Vatansever says is due to lack of awareness of the disease in rural areas, where it is most common.
“Mostly seen in rural areas, transmitted to people by ticks, increasing between the months of April and October, coming suddenly and killing within two weeks,” reported the dailies and television news broadcasts over the last several months. CCHF seems to be the new threat to the Turkish population. Experts say the disease, whose victims have increased fivefold in the last five years, will become an even bigger problem in coming years. Seen six years ago for the first time in Turkey, CCHF has killed 134 people in the country thus far. Infecting two doctors and one other medical staff member at the Ankara Numune Education and Research Hospital, the seriousness of disease has reached an alarming point.
CCHF and Turkey
CCHF entered world medical literature back in the 1940s. In the summer of 1944, it was seen in Russian soldiers transporting agricultural products in Western Crimea for the first time. In 1956, the same disease was witnessed in Congo, which is how the disease got its name. The history of the disease in Turkey does not go back that far; CCHF was first observed here in the summer of 2002.
Esra Demir, working as a nurse at the Tokat Social Security Authority (SSK) Hospital, in 2002 suddenly felt unwell and was taken to the Ankara Hacettepe University Hospital. Despite all the attempts to treat her, she died after one week and her reason of death was recorded as unknown. However, six more people died in a short period in Tokat, a province in the Black Sea region, and the deaths were announced as “deaths with unknown reasons” to the media. The Ministry of Health at first thought that this unknown disease resembled Q fever, a disease caused by infection with the bacterium Coxiella burnetii. Yet upon finding that the symptoms were not quite the same as those of Q fever, blood samples were sent to the laboratories of the Pasteur Institute in France. The tests conducted there finally confirmed that the disease was CCHF.
Detection of 327 CCHF cases in Tokat province shows that it is one of the most affected regions in Turkey. Thus the question arises, why Tokat? To understand this, we must explore the conditions causing the disease in the province and the characteristics of infected ticks.
Female ticks pose greater threat
Vatansever, associate professor at the department of parasitology at the veterinary school of Kafkas University, has been conducting research on ticks since 1989. And since 2004, when the disease began to spread, the professor has been analyzing CCHF-infected ticks and the domestic and wild animals that carry them. There are 850 tick species in the world, with 32 of them present in Turkey; however, not all ticks carry the CCHF virus. The virus is carried by ticks of the Hyalomma marginatum marginatum species. Virus-carrying ticks lodge in small wild animals such as mice or rabbits and in wild birds. They mature on these smaller animals and then move on to large wild animals, cattle and people. After the ticks feed on their host, they detach themselves and while male ticks die soon thereafter, females die after laying their eggs. Stating that the real threat is posed by female ticks, Vatansever noted: “Three to 5 percent of eggs of a tick bearing the CCHF virus are also contaminated. In this sense, female ticks present more of a threat than males.”
How ticks choose a host
Unless ticks find a suitable host, they live for an average of one year. In temperatures of 16-18 degrees Celsius, their life spans can extend up to three years. The characteristics of virus-carrying ticks are different from other ticks. The ticks of the Hyalomma species are also known as hunters. These ticks burrow into soil, unlike many other ticks that live on plants. They can feel vibrations and heat, while also being able to smell and identify carbon dioxide from exhalation. Vatansever noted that the infected ticks attach themselves to people who are sitting or lying down, not moving. “They feel vibrations and sense heat and carbon dioxide emitted from people and gravitate toward them. They start climbing from a person’s feet and look for an area on which to attach themselves.”
Ornithologist Ahmet Kütükçü emphasized another crucial point. He said migratory birds, particularly storks, play an active role in spreading the disease. “Yet the real host for the ticks are not birds, but rodents,” he noted.
The number of CCHF virus-transmitting ticks is increasing in the world, and this is related to an increase in suitable conditions, which include heat, humidity and proper hosts, Vatansever noted. He also explained that while only 40 percent of tick species can reproduce under normal weather conditions, the ecological changes caused by global warming have led to warmer weather, which prolongs the life span of ticks and facilitates their reproduction. Virus-carrying ticks are able to survive in regions where ocean climates — typical of the Black Sea region — and semi-arid climates — typical of central Anatolia and eastern Anatolia — meet, and those types of ticks prefer areas with small trees and cattle. Conducting field studies on the range of virus-carrying ticks, Vatansever found that Çorum, Amasya, Tokat, Yozgat, Sivas, Erzurum and Artvin are at the highest risk. The least hazardous regions are the Mediterranean and Black Sea coasts, Vatansever said.
‘Rural areas should be more concerned about risk’
Taking a closer look at the deaths caused by ticks reveals that cattle owners, farmers and shepherds are the most at-risk population. In addition, soldiers, campers and picnickers, veterinarians, forest workers and health staff working in infected areas are at risk. The percentage of deaths among elderly people over 70 is also striking.
Noting that the CCHF-transmitting ticks live on cattle and wild animals, Vatansever said it is pointless to worry about ticks in urban areas. However, the professor complained about ignorance in rural areas. “People in rural areas live with ticks from their childhood to adulthood, and they think they know about ticks. When they see photographs of ticks in newspapers, they say that the ticks in the photos do not resemble those living in their villages. They are exposed to tick bites every summer, but they remove them on their own. The village people do not want to believe that CCHF-carrying ticks can be fatal. And then they want to believe the nonsense alleging that the ticks are sent from Israel. Unfortunately it is very hard to do away with these kinds of beliefs,” he said, adding that he believes if rural people had just a little concern over the ticks, they would take simple measures to protect themselves.
Tick bites kill within two weeks
The CCHF virus is transferred to people and animals via tick bites. While the virus does not necessarily kill animals, it is often fatal for people. Symptoms of the infection are sudden fever, nausea, headache, vomiting and diarrhea. Bleeding of different parts of body may also accompany these symptoms. Hürrem Bodur, the chief of the Department of Infectious Diseases at Ankara Numune Hospital, explained the course of the disease, saying: “There are platelets circulating in the blood in the human body functioning as bleeding clotters. But entering into human body via tick bites, the virus causes the number of platelet cells to decrease, which damages the veins and which, in turn, causes hemorrhage. External hemorrhage in parts like the nose and ears or internal hemorrhage, causing parts of the body to appear bruised and purplish, may occur as a result of decreasing platelets,” Bodur said.
Experts say that disease symptoms appear within one to three days or 10 days at most after the virus enters a person’s body. It is vital for a patient to stay in the hospital after infection. Patients who survive after two weeks become permanently immune to the disease. Raising awareness is of crucial importance to effectively combat the disease. Experts have suggested that more action be taken in high-risk areas by the ministries of health and agriculture. A regular inspection of the animal population in problematic regions is another important step to take. Widespread education campaigns need to be conducted to raise awareness of the people in rural areas.
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