The first step of the action plan -- developed in coordination with the Ministry of Agriculture and Rural Affairs, the Ministry of Health and the Ministry of Environment and Forestry -- involves the spraying of animal feeding grounds and areas where they seek shelter with pesticides. The second step involves combating environmental conditions conducive to ticks.

Agriculture and Rural Affairs Minister Mehdi Eker said that tons of spraying equipment and pesticide had been sent to the regions at highest risk for tick overpopulation. He also said they had imported a liquid repellent, marketed under the name "Ken-Kov" in Turkey.

Eker said the repellent can be applied topically to the skin and is not harmful to humans, recommending that agricultural workers in particular make use of the product. He added that the repellent has been used in Europe and the United States, and also by soldiers in the field. The ministry has started a pesticide spraying campaign at all tick breeding grounds.

The Ministry of Agriculture and Rural Affairs said the most important factor increasing the tick population in Turkey was an overpopulation of wild pigs, which are the biggest carriers of ticks, and has asked the Ministry of Environment to bring the situation under control.

Environment and Forestry Ministry officials say wolves will be used to balance out the population of wild pigs -- which has reached 300,000 -- while birds will be used in efforts to control the tick population. To that end, the ministry has begun to release wolves into areas where an abundance of wild pigs have been seen.

Officials noted a decrease in the bird population following several cases of bird flu, and have been trying to breed birds that feed on ticks. To direct these birds to tick feeding grounds, officials have already installed 375 artificial forest lakes where animals graze.

The provinces posing the highest risk of CCHF infection are Tokat, Çorum, Yozgat, Samsun, Amasya and Sivas. Tick-bite cases are mostly seen in May and June but are still a serious risk until the end of October, officials said.

In Yozgat, health officials have been distributing a tick repellent spray to the public, targeting three high-risk areas in particular. Provincial Health Director Mustafa Uyanık said they had distributed spray to 841 homes and explained its use to families: The repellent should be sprayed on clothing and left to dry for two hours before wearing. The protection lasts up to three weeks.

Numerous wild and domesticated animals, such as cattle, goats, sheep and hares, can serve as hosts for the virus. Transmission to humans occurs through contact with infected animal blood or ticks.

Last week, a woman from the Central Anatolian province of Yozgat died at an Ankara hospital, where she was being treated for CCHF. The woman contracted the disease from a tick bite she received while grazing her cattle.

The woman's death is the sixth fatal case of CCCHF in the country this year.

Also last weekend, more than 500 İstanbulites who picnicked in rural areas over the holiday weekend filled hospitals on Monday with complaints of tick bites. According to the Anatolia news agency, many of those who had picnicked in İstanbul's Kemerburgaz, Arnavutköy, Sarıyer and Çekmeköy districts noticed upon returning home that ticks were attached to their bodies. Sixty of the individuals were children, Anatolia reported.

Following the increase in the number of tick bite incidents over the weekend, workers from the İstanbul Metropolitan Municipality expedited their task of spraying pesticides in popular picnic areas.

A statement released by the municipality on May 19 said 250 municipal workers were conducting pesticide spraying in green areas and parks across the city where people typically relax. The statement also noted that the spraying aimed to prevent the emergence of diseases carried by ticks and could also be carried out in other places as requested by the public.

In early May, another woman, from the Central Anatolian province of Sivas, died at an Ankara hospital where she was being treated for CCHF. A male victim of CCHF from Çorum, also in Central Anatolia, died in early May after being bitten by a tick while tending his livestock.

Crimean-Congo hemorrhagic fever cost 94 lives in Turkey

In the past five years 94 people have died of CCHF in Turkey.

In documented outbreaks, the fatality rates for patients hospitalized for CCHF have ranged from 9 percent to as high as 50 percent of those afflicted.

People who have come into contact with a tick should be monitored for 10 days following contact and seek professional medical care if symptoms of fever, headache, nausea, vomiting or diarrhea present themselves. Treatment for CCHF is primarily symptomatic and supportive, as there is no established course of treatment.

The onset of CCHF is sudden, with initial signs and symptoms including headache, high fever, back pain, joint pain, stomach pain and vomiting. Red eyes, a flushed face, a red throat and red spots on the palate are common. Symptoms may also include jaundice and in severe cases, changes in mood and sensory perception. As the illness progresses, large areas of severe bruising, severe nosebleeds and uncontrolled bleeding at injection sites can be seen, beginning on about the fourth day of illness and lasting for about two weeks.

CCHF can be transmitted from one infected human to another by contact with infected blood or body fluids. Documented spread of CCHF has also occurred in hospitals due to improper sterilization of medical equipment, reuse of injection needles and contamination of medical supplies.

An infection with a tick-borne virus (Nairovirus) in the family Bunyaviridae causes CCHF. The disease was first identified in the Crimea in 1944 and given the name Crimean hemorrhagic fever. It was then later recognized in 1969 as the cause of illness in the Congo, thus resulting in the current name of the disease.

The first Turkish case of CCHF was reported in 2002. Officials said the disease reached Turkey from Crimea through wild pigs that fled the conflict region at the time. It is found in Eastern Europe, particularly in the former Soviet Union. It is also distributed throughout the Mediterranean, in northwestern China, central Asia, southern Europe, Africa, the Middle East and the Indian subcontinent.

Todayszaman