Ribavirin as a post-exposure prophylaxis agent in Crimean Congo
hemorrhagic fever
Abstract
Background: Crimean-Congo hemorrhagic fever (CCHF) is a severe
viral illness with high mortality rates. Nosocomial transmission poses a
significant risk to healthcare workers (HCWs).
Materials/methods: In this study, we evaluated the
effectiveness of ribavirin in post-exposure prophylaxis (PEP) among HCWs
with high-risk contacts. Exposures are grouped into 3 categories. The
high-risk group consisted of HCWs who were directly exposed to blood or
bodily fluids. We also included HCWs who participated in CPR without
wearing appropriate PPE to the high-risk group. The moderate-risk group
consisted of HCWs without a visible exposure to blood or bodily fluids
but handled patient without appropriate PPE. Results: At least
38 HCWs had contact with the index fatal patient. None of the HCWs who
had contact with the patient had appropriate PPE. Patient’s PCR and IgM
were positive for CCHF. Among all known contacts, all HCWs in high and
moderate risk groups (n:24) received PEP with ribavirin. No moderate or
severe side effects were observed due to ribavirin. None of the HCWs
developed nosocomial CCHF. Conclusions: There are still
life-threatening gaps in the compliance of the HCWs to standard
precautions. Ribavirin seems an effective and well tolerated agent for
PEP of nosocomial CCHF.