Case Study: Managing Endemic CCHFV in Turkey
In the agricultural heartlands of central Turkey, summer is both a season of harvest and heightened vigilance. Alongside ripening crops comes the peak activity of Hyalomma ticks, the primary vector of Crimean-Congo Hemorrhagic Fever virus (CCHFV).
Prof. Ilhan Cetin from Sivas Cumhuriyet University has spent years navigating this seasonal threat. Speaking at the PREPARE-TID webinar, he offered a rare, detailed look at how CCHFV continues to shape public health in the region and how targeted surveillance, rapid diagnosis, and innovative tools are changing the outcome for patients.
Epidemiological Snapshot
While CCHFV was first detected serologically in 1982, it wasn’t until 2002 that the first clinical case was confirmed in Turkey. Since then, the country has recorded more than 15,000 confirmed cases between 2002 and 2024.
In 2022 alone:
- 1,310 cases were reported nationwide
- 205 patients received treatment at Sivas University Hospital
- The seasonal peak came in July, with 125 new cases in that month alone
- Mortality rate: ~5.6%, significantly lower than the 10–30% global average for untreated severe cases, largely due to early detection and improved supportive care
Who Is Most at Risk?
The median age of patients was 56 years, consistent with trends in other endemic zones where middle-aged rural populations are disproportionately affected.
Breakdown of occupations and exposures:
- 80% were agricultural workers
- 12% worked in animal husbandry
- 66% had recent tick attachment
- 34% reported direct contact with animal blood or tissue
- Fewer than 2% were veterinarians or healthcare workers, suggesting nosocomial and occupational exposures remain rare under current biosafety protocols
Geographically, cases often cluster in ecological niches like the Kelkid Valley, where high livestock density meets abundant tick populations and limited vector control infrastructure.
Diagnostics and Clinical Response
Early detection is key. In Turkey’s clinical workflow:
- RT-PCR is performed during the acute phase
- ELISA and neutralization assays are run at reference centers for confirmation
- Supportive care includes IV fluids, plasma, platelets, and paracetamol
- Treatment protocols call for daily platelet counts and liver function tests
Globally, fatalities in untreated severe CCHFV cases are concentrated between days 8–11 post-onset. In Turkey, improved awareness campaigns in rural provinces like Tokat, Sivas, and Erzincan have been critical in lowering mortality.
Prof. Cetin closed his talk with a clear message: “We must expand tick surveillance and bring quick and on-site diagnostics to rural clinics.”
SwiftX™ Virus: Field-Ready NA Extraction
That challenge was met head-on by Dr. Andy Wende of Xpedite Diagnostics, who presented a solution designed for the realities of fieldwork and resource-limited settings.
The SwiftX™ Virus kit, CE-IVD marked and validated in collaboration with PREPARE-TID partner labs, uses reverse purification chemistry to extract viral DNA/RNA from human serum or plasma in just ~6 minutes, without centrifuges, cold storage, ethanol, or chaotropic salts.
- Sample types: Whole blood, plasma, serum
- Extraction time: ~6 minutes
- Heat-based lysis at 95°C
- No ethanol, chaotropic salts, or specialized equipment
- Compatible with RT-qPCR, RT-RPA/RAA, SYBR/probe-based assays.
- Inhibitor-resistant chemistry designed for unpurified clinical matrices
- Shelf-stable reagents suitable for transport at ambient temperature and storage at 2-8°C
This innovation enables rapid, robust extraction in the field or in resource-limited settings. It has been designed specifically for mobile labs, field hospitals, and decentralized testing networks.
Validation Across Europe: Pathogens and Performance
The performance of SwiftX™ Virus was validated through a multicenter trial conducted at four European partner institutions, Padova, Sivas and Belgrade, against a spectrum of pathogens.
Diagnostic targets included:
- Arboviruses: Dengue virus (DENV), West Nile virus (WNV), Chikungunya virus (CHIKV), Yellow Fever virus (YFV), Usutu virus (USUV)
- Hemorrhagic fever viruses: CCHFV
Findings:
- 100% sensitivity in CCHFV and DENV samples across all sites
- Superior inhibitor tolerance
- Direct compatibility with field-deployable PCR systems (e.g., BioRanger, miniPCR)
For Dr. Wende, the point isn’t just speed, it’s access. “By removing dependency on complex equipment, we’re making extraction more equitable” he told the audience. In other words: whether it’s a field epidemiologist in the hills of Sivas, a veterinarian in a rural clinic, or a clinician in a metropolitan hospital, all should have the same ability to get fast, reliable results, no matter how different their settings or resources may be.
SwiftX™ Virus turns that philosophy into a tangible tool, one that can be packed in a bag, set up on a bench, and deliver ready-to-use nucleic acids before a traditional workflow has even finished its first spin.
Conclusion: Molecular Diagnostics as Preparedness Infrastructure
The PREPARE-TID webinar showcased how diagnostic tools, if adapted to real-world conditions, can serve as the front line of epidemic response. Whether through urine-based PCR, portable sequencing, or field-deployable extraction technologies, innovation is aligning with urgent public health needs.
Take your diagnostics to the next level
- Request a SwiftX™ Virus trial kit – now available as CE-IVD – or protocol walkthrough (here)
- Watch the full PREPARE-TID webinar recording on YouTube (here)
- If you would like to collaborate with us, contact us (here)