Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 24, Number 9—September 2018
Synopsis

Systematic Review and Meta-analysis of Postexposure Prophylaxis for Crimean-Congo Hemorrhagic Fever Virus among Healthcare Workers

Önder ErgönülComments to Author , Şiran Keske, Melis Gökçe Çeldir, İlayda Arjen Kara, Natalia Pshenichnaya, Gulzhan Abuova, Lucille Blumberg, and Mehmet Gönen
Author affiliations: Koç University, Istanbul, Turkey (Ö. Ergönül, M.G. Çeldir, İ.A. Kara, M. Gönen); American Hospital, Istanbul (Ş. Keske); Rostov State Medical University, Rostov-on-Don, Russia (N. Pshenichnaya); South-Kazakhstan State Pharmaceutical Academy, Shymkent, Kazakhstan (G. Abuova); National Institute for Communicable Diseases, Johannesburg, South Africa (L. Blumberg)

Main Article

Table

Characteristics and outcomes for healthcare workers exposed to patients with Crimean-Congo hemorrhagic fever virus infection, 1976–2017

Country (references) No. (%)
Exposed, N = 175 High risk, n = 107 Moderate risk, n = 65 Low or no known risk, n = 3 Infected, n = 102 Died, n = 34
Turkey (5,7,2025) 49 (28) 23 (22) 26 (40) 0 19 (19) 3 (9)
Pakistan (15,2632) 45 (26) 21 (20) 24 (36) 0 18 (18) 6 (18)
Germany (6) 18 (10) 18 (17) 0 0 2 (2) 0
Iran (3336) 12 (7) 10 (9) 1 (2) 1 (33) 12 (12) 3 (9)
India (18,19) 8 (5) 5 (5) 3 (5) 0 8 (8) 6 (18)
Russia (8) 8 (5) 6 (6) 0 2 (67) 8 (8) 0
South Africa (9) 8 (5) 3 (3) 5 (8) 0 8 (8) 2 (6)
Tajikistan (37) 7 (4) 7 (7) 0 0 7 (7) 2 (6)
United Arab Emirates (38) 5 (3) 1 (1) 4 (6) 0 5 (5) 2 (6)
Kazakhstan (40) 5 (3) 3 (3) 2 (3) 0 5 (5) 3 (9)
Mauritania (39) 5 (3) 5 (5) 0 0 5 (5) 5 (15)
Sudan (41,42) 3 (2) 2 (2) 1 (2) 0 3 (3) 2 (6)
Albania (12) 1 (1) 1 (1) 0 0 1 (1) 0
Spain (2) 1 (1) (1) 0 0 1 (1) 0

Main Article

References
  1. Ergönül  O. Crimean-Congo haemorrhagic fever. Lancet Infect Dis. 2006;6:20314. DOIPubMedGoogle Scholar
  2. Negredo  A, de la Calle-Prieto  F, Palencia-Herrejón  E, Mora-Rillo  M, Astray-Mochales  J, Sánchez-Seco  MP, et al.; Crimean Congo Hemorrhagic Fever@Madrid Working Group. Autochthonous Crimean-Congo hemorrhagic fever in Spain. N Engl J Med. 2017;377:15461. DOIPubMedGoogle Scholar
  3. Tarantola  A, Ergonul  O, Tattevin  P. Estimates and prevention of Crimean-Congo hemorrhagic fever risks for health-care workers. In: Ergonul O, Whitehouse CA, editors. Crimean-Congo hemorrhagic fever: a global perspective. Dordrecht (the Netherlands): Springer; 2007. p. 281–94.
  4. Bausch  DG, Hadi  CM, Khan  SH, Lertora  JJ. Review of the literature and proposed guidelines for the use of oral ribavirin as postexposure prophylaxis for Lassa fever. Clin Infect Dis. 2010;51:143541. DOIPubMedGoogle Scholar
  5. Celikbas  AK, Dokuzoğuz  B, Baykam  N, Gok  SE, Eroğlu  MN, Midilli  K, et al. Crimean-Congo hemorrhagic fever among health care workers, Turkey. Emerg Infect Dis. 2014;20:4779. DOIPubMedGoogle Scholar
  6. Conger  NG, Paolino  KM, Osborn  EC, Rusnak  JM, Günther  S, Pool  J, et al. Health care response to CCHF in US soldier and nosocomial transmission to health care providers, Germany, 2009. Emerg Infect Dis. 2015;21:2331. DOIPubMedGoogle Scholar
  7. Guner  R, Hasanoglu  I, Tasyaran  MA, Yapar  D, Keske  S, Guven  T, et al. Is ribavirin prophylaxis effective for nosocomial transmission of Crimean-Congo hemorrhagic fever? Vector Borne Zoonotic Dis. 2014;14:6015. DOIPubMedGoogle Scholar
  8. Pshenichnaya  NY, Nenadskaya  SA. Probable Crimean-Congo hemorrhagic fever virus transmission occurred after aerosol-generating medical procedures in Russia: nosocomial cluster. Int J Infect Dis. 2015;33:1202. DOIPubMedGoogle Scholar
  9. Richards  GA. Nososcomial transmission of viral haemorrhagic fever in South Africa. S Afr Med J. 2015;105:70912. DOIPubMedGoogle Scholar
  10. Leblebicioglu  H, Sunbul  M, Guner  R, Bodur  H, Bulut  C, Duygu  F, et al. Healthcare-associated Crimean-Congo haemorrhagic fever in Turkey, 2002-2014: a multicentre retrospective cross-sectional study. Clin Microbiol Infect. 2016;22:387.e14. DOIPubMedGoogle Scholar
  11. Papa  A, Bino  S, Llagami  A, Brahimaj  B, Papadimitriou  E, Pavlidou  V, et al. Crimean-Congo hemorrhagic fever in Albania, 2001. Eur J Clin Microbiol Infect Dis. 2002;21:6036. DOIPubMedGoogle Scholar
  12. Harxhi  A, Pilaca  A, Delia  Z, Pano  K, Rezza  G. Crimean-Congo hemorrhagic fever: a case of nosocomial transmission. Infection. 2005;33:2956. DOIPubMedGoogle Scholar
  13. Fisher-Hoch  SP, Khan  JA, Rehman  S, Mirza  S, Khurshid  M, McCormick  JB. Crimean Congo-haemorrhagic fever treated with oral ribavirin. Lancet. 1995;346:4725. DOIPubMedGoogle Scholar
  14. Altaf  A, Luby  S, Ahmed  AJ, Zaidi  N, Khan  AJ, Mirza  S, et al. Outbreak of Crimean-Congo haemorrhagic fever in Quetta, Pakistan: contact tracing and risk assessment. Trop Med Int Health. 1998;3:87882. DOIPubMedGoogle Scholar
  15. Swanepoel  R, Shepherd  AJ, Leman  PA, Shepherd  SP, McGillivray  GM, Erasmus  MJ, et al. Epidemiologic and clinical features of Crimean-Congo hemorrhagic fever in southern Africa. Am J Trop Med Hyg. 1987;36:12032. DOIPubMedGoogle Scholar
  16. van de Wal  BW, Joubert  JR, van Eeden  PJ, King  JB. A nosocomial outbreak of Crimean-Congo haemorrhagic fever at Tygerberg Hospital. Part IV. Preventive and prophylactic measures. S Afr Med J. 1985;68:72932.PubMedGoogle Scholar
  17. Mishra  AC, Mehta  M, Mourya  DT, Gandhi  S. Crimean-Congo haemorrhagic fever in India. Lancet. 2011;378:372. DOIPubMedGoogle Scholar
  18. Patel  AK, Patel  KK, Mehta  M, Parikh  TM, Toshniwal  H, Patel  K. First Crimean-Congo hemorrhagic fever outbreak in India. J Assoc Physicians India. 2011;59:5859.PubMedGoogle Scholar
  19. Stewart  LA, Clarke  M, Rovers  M, Riley  RD, Simmonds  M, Stewart  G, et al.; PRISMA-IPD Development Group. Preferred reporting items for systematic review and meta-analyses of individual participant data. The PRISMA-IPD statement. JAMA. 2015;313:165765. DOIPubMedGoogle Scholar
  20. Bulut  C, Yilmaz  GR, Karakoc  E, Önde  U, Kocak Tufan  Z, Demiröz  AP. Risk of Crimean-Congo haemorrhagic fever among healthcare workers. Presented at: 19th European Congress of Clinical Microbiology and Infectious Diseases; May 16–19, 2009; Helsinki, Finland.
  21. Guven  G, Talan  L, Altintas  ND, Memikoglu  KO, Yoruk  F, Azap  A. An unexpected fatal CCHF case and management of exposed health care workers. Int J Infect Dis. 2017;55:11821. DOIPubMedGoogle Scholar
  22. Parlak  E, Ertürk  A, Koşan  Z, Parlak  M, Özkurt  Z. A nosocomial outbreak of Crimean-Congo hemorrhagic fever. J Microbiol Infect Dis. 2015;5:59. DOIGoogle Scholar
  23. Yildirmak  T, Tulek  N, Bulut  C. Crimean-Congo haemorrhagic fever: transmission to visitors and healthcare workers. Infection. 2016;44:6879. DOIPubMedGoogle Scholar
  24. Tütüncü  EE, Gurbuz  Y, Ozturk  B, Kuscu  F, Sencan  I. Crimean Congo haemorrhagic fever, precautions and ribavirin prophylaxis: a case report. Scand J Infect Dis. 2009;41:37880. DOIPubMedGoogle Scholar
  25. Sunbul  M, Esen  S, Fletcher  TE, Dilek  A, Guler  N, Beeching  NJ, et al. A fatal case of healthcare associated Crimean-Congo haemorrhagic fever with severe disease and multi-organ failure. J Infect. 2016;72:2535. DOIPubMedGoogle Scholar
  26. Burney  MI, Ghafoor  A, Saleen  M, Webb  PA, Casals  J. Nosocomial outbreak of viral hemorrhagic fever caused by Crimean Hemorrhagic fever-Congo virus in Pakistan, January 1976. Am J Trop Med Hyg. 1980;29:9417. DOIPubMedGoogle Scholar
  27. Bangash  SA, Khan  EA. Treatment and prophylaxis with ribavirin for Crimean-Congo Hemorrhagic Fever—is it effective? J Pak Med Assoc. 2003;53:3941.PubMedGoogle Scholar
  28. Athar  MN, Baqai  HZ, Ahmad  M, Khalid  MA, Bashir  N, Ahmad  AM, et al. Short report: Crimean-Congo hemorrhagic fever outbreak in Rawalpindi, Pakistan, February 2002. Am J Trop Med Hyg. 2003;69:2847.PubMedGoogle Scholar
  29. Hasan  Z, Mahmood  F, Jamil  B, Atkinson  B, Mohammed  M, Samreen  A, et al. Crimean-Congo hemorrhagic fever nosocomial infection in a immunosuppressed patient, Pakistan: case report and virological investigation. J Med Virol. 2013;85:5014. DOIPubMedGoogle Scholar
  30. Yadav  PD, Patil  DY, Shete  AM, Kokate  P, Goyal  P, Jadhav  S, et al. Nosocomial infection of CCHF among health care workers in Rajasthan, India. BMC Infect Dis. 2016;16:624. DOIPubMedGoogle Scholar
  31. Yadav  PD, Raut  CG, Mourya  DT. Re-occurrence of Crimean-Congo haemorrhagic fever in Ahmedabad, Gujarat, India (2012): a fatal case report. Indian J Med Res. 2013;138:10278.PubMedGoogle Scholar
  32. Jamil  B, Hasan  RS, Sarwari  AR, Burton  J, Hewson  R, Clegg  C. Crimean-Congo hemorrhagic fever: experience at a tertiary care hospital in Karachi, Pakistan. Trans R Soc Trop Med Hyg. 2005;99:57784. DOIPubMedGoogle Scholar
  33. Naderi  HR, Sarvghad  MR, Bojdy  A, Hadizadeh  MR, Sadeghi  R, Sheybani  F. Nosocomial outbreak of Crimean-Congo haemorrhagic fever. Epidemiol Infect. 2011;139:8626. DOIPubMedGoogle Scholar
  34. Naderi  HR, Sheybani  F, Bojdi  A, Khosravi  N, Mostafavi  I. Fatal nosocomial spread of Crimean-Congo hemorrhagic fever with very short incubation period. Am J Trop Med Hyg. 2013;88:46971. DOIPubMedGoogle Scholar
  35. Mardani  M, Keshtkar-Jahromi  M, Ataie  B, Adibi  P. Crimean-Congo hemorrhagic fever virus as a nosocomial pathogen in Iran. Am J Trop Med Hyg. 2009;81:6758. DOIPubMedGoogle Scholar
  36. Chinikar  S, Shayesteh  M, Khakifirouz  S, Jalali  T, Rasi Varaie  FS, Rafigh  M, et al. Nosocomial infection of Crimean-Congo haemorrhagic fever in eastern Iran: case report. Travel Med Infect Dis. 2013;11:2525. DOIPubMedGoogle Scholar
  37. Tishkova  FH, Belobrova  EA, Valikhodzhaeva  M, Atkinson  B, Hewson  R, Mullojonova  M. Crimean-Congo hemorrhagic fever in Tajikistan. Vector Borne Zoonotic Dis. 2012;12:7226. DOIPubMedGoogle Scholar
  38. Suleiman  MNEH, Muscat-Baron  JM, Harries  JR, Satti  AGO, Platt  GS, Bowen  ETW, et al. Congo/Crimean haemorrhagic fever in Dubai. An outbreak at the Rashid Hospital. Lancet. 1980;2:93941. DOIPubMedGoogle Scholar
  39. Nabeth  P, Cheikh  DO, Lo  B, Faye  O, Vall  IO, Niang  M, et al. Crimean-Congo hemorrhagic fever, Mauritania. Emerg Infect Dis. 2004;10:21439. DOIPubMedGoogle Scholar
  40. ProMED-RUS. Crimean-Congo hemorrhagic fever-Kazakhstan (South Kazakhstan). ProMed. 2009 Jul 15 [cited 2016 Feb 21]. http://www.promedmail.org/, archive no. 20090715.2529.
  41. Aradaib  IE, Erickson  BR, Mustafa  ME, Khristova  ML, Saeed  NS, Elageb  RM, et al. Nosocomial outbreak of Crimean-Congo hemorrhagic fever, Sudan. Emerg Infect Dis. 2010;16:8379. DOIPubMedGoogle Scholar
  42. Elata  AT, Karsany  MS, Elageb  RM, Hussain  MA, Eltom  KH, Elbashir  MI, et al. A nosocomial transmission of crimean-congo hemorrhagic fever to an attending physician in North Kordufan, Sudan. Virol J. 2011;8:303. DOIPubMedGoogle Scholar
  43. Bente  DA, Forrester  NL, Watts  DM, McAuley  AJ, Whitehouse  CA, Bray  M. Crimean-Congo hemorrhagic fever: history, epidemiology, pathogenesis, clinical syndrome and genetic diversity. Antiviral Res. 2013;100:15989. DOIPubMedGoogle Scholar
  44. Ince  Y, Yasa  C, Metin  M, Sonmez  M, Meram  E, Benkli  B, et al. Crimean-Congo hemorrhagic fever infections reported by ProMED. Int J Infect Dis. 2014;26:446. DOIPubMedGoogle Scholar
  45. Dokuzoguz  B, Celikbas  AK, Gök  SE, Baykam  N, Eroglu  MN, Ergönül  Ö. Severity scoring index for Crimean-Congo hemorrhagic fever and the impact of ribavirin and corticosteroids on fatality. Clin Infect Dis. 2013;57:12704. DOIPubMedGoogle Scholar
  46. Ergonul  O. Treatment of Crimean-Congo hemorrhagic fever. Antiviral Res. 2008;78:12531. DOIPubMedGoogle Scholar
  47. Ergonul  O. DEBATE (see Elaldi N et al, Efficacy of oral ribavirin treatment in Crimean-Congo haemorrhagic fever: a quasi-experimental study from Turkey. Journal of Infection 2009; 58: 238-244): Biases and misinterpretation in the assessment of the efficacy of oral ribavirin in the treatment of Crimean-Congo hemorrhagic fever. J Infect. 2009;59:2846, author reply 286–9. DOIPubMedGoogle Scholar
  48. Pourahmad  M, Raoofi  R, Chinikar  S, Ghiasi  SM, Ghalyanchi-Langeroudi  A. Nosocomial transmission of Crimean-Congo hemorrhagic fever in a health care worker, Fars Province, Iran. Iran J Clin Infect Dis. 2011;6:4750.
  49. Ergonul  O, Zeller  H, Celikbas  A, Dokuzoguz  B. The lack of Crimean-Congo hemorrhagic fever virus antibodies in healthcare workers in an endemic region. Int J Infect Dis. 2007;11:4851. DOIPubMedGoogle Scholar
  50. Mardani  M, Rahnavardi  M, Rajaeinejad  M, Naini  KH, Chinikar  S, Pourmalek  F, et al. Crimean-Congo hemorrhagic fever among health care workers in Iran: a seroprevalence study in two endemic regions. Am J Trop Med Hyg. 2007;76:4435.PubMedGoogle Scholar

Main Article

Page created: August 14, 2018
Page updated: August 14, 2018
Page reviewed: August 14, 2018
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external