Turkey Fights Ebola-Like Fever Outbreak*

By MARIA CHENG
The Associated Press
August 9, 2006; 8:14 PM

LONDON -- Turkey is battling the largest recorded outbreak of
Crimean-Congo Hemorrhagic Fever, which has killed at least 20 people
this year, and experts said Tuesday more cases of the Ebola-like disease
are inevitable in coming months.

The fever is primarily an animal disease, but can also affect humans. It
is endemic to parts of Africa, Asia and Eastern Europe and is
transmitted by ticks, which thrive on sheep and cattle.

Infected people can transmit the virus by blood, saliva or droplets from
sneezing. The disease causes a sharp drop in platelets, which allow the
blood to clot. Without rapid treatment by antivirus drugs and
replacement of platelets, victims can bleed to death.

"We will unfortunately keep seeing cases at least until September, when
the virus starts to slow down because of the cold weather," said Dr.
Onder Ergonul, an associate professor at Marmara University, who has
been involved with the government's response to the outbreak.

Most of the cases have occurred in six provinces in the Black Sea and
Central Anatolia region: Tokat, Sivas, Gumushane, Amasya, Yozagat and Corum.

Authorities at the World Health Organization are awaiting further
information from the Turkish government, including where the other cases
have arisen. Turkish authorities say no cases have been reported in the
tourist areas along the Mediterranean coast.

By Aug. 4, there were 242 cases of the disease, including 20 deaths,
making it the largest reported outbreak since it was first identified in
1944, authorities said.

Last week, a nurse treating Crimean-Congo hemorrhagic fever patients
died after being infected accidentally by a needle. To date, four health
care workers have been infected, though there have not been any reports
of the virus spreading in hospitals.

"There have been large outbreaks of this virus before, but we are
concerned about the size of this particular outbreak in Turkey," said
Dr. Bernardus Ganter, the World Health Organization's Regional Adviser
for Communicable Diseases in the European Region.

One of the reasons for the increased numbers, Ganter said, could be a
more sophisticated detection system. Turkey's first outbreak of the
disease was in 2002, and surveillance has strengthened considerably since.

"We are reassured that the outbreak appears limited to only one part of
Turkey, in Anatolia," said Ergonul. More than 90 percent of cases have
been reported in people who have had direct contact with animals,
according to Ergonul.

In an attempt to control the outbreak, Turkish authorities have
instituted stronger surveillance for the disease across the country, and
are attempting to educate the population about how they can minimize the
risks of contracting the disease by avoiding contact with ticks.

Veterinarians and entomologists are also looking at ways to control the
tick population.

With several previous outbreaks of the disease in recent years, Turkey
has considerable expertise in treating patients.

WHO has been in frequent contact with the Turkish Ministry of Health,
and is ready to send teams to the region if requested to do so. Ganter
said the transmission season was expected to last until October.