Crimean-Congo Hemorrhagic Fever-Treatment and Preventive Strategies

Abstract

Crimean-Congo hemorrhagic fever is a tick-borne viral disease reported from more than 30 countries in Africa, Asia, South-East Europe, and the Middle East. The majority of human cases are workers in livestock industry, agriculture, slaughterhouses, and veterinary practice. The current mortality rate in endemic areas varies between 5 to 20 percent depending on the geographic location and medical supportive treatment. Unfortunately, there is currently no FDA-approved vaccine for prevention or specific antiviral drug for the treatment of CCHF. Ribavirin, effective against CCHFV in vitro, is one of the few options for treatment of CCHFV, but its efficacy is still questionable due to contradictory clinical studies. The efficacy of other options including Intravenous Immuneglobulin (IVIG), steroids, CCHF hyperimmuneglobulin, and CCHF monoclonal antibodies is still controversial.

A Systematic Review of Treatment Strategies Including Future Novel Therapies in Crimean-Congo Hemorrhagic Fever

“…High dose of methylprednisolone accelerated improving the platelet and WBC count and Ddimer level in patients with hemophagohistiocytosis. So, these data supported the prescription of high-dose steroid in severe disease, but further studies are required to determine the steroid effect (25).…”

The efficacy of oral ribavirin on clinical and laboratory parameters inCrimean–Congo hemorrhagic fever: an observational study from Turkey*

“…However, Soares-Weiser et al (22) suggested that ribavirin treatment could reduce mortality by 44% according to the results of selected observational studies. In a review about the treatment of CCHF, ribavirin is recommended in suspected cases until new data are provided, even though its efficacy has not been fully confirmed (25).…”

Report of a Family with Crimean-Congo Hemorrhagic Fever Following Contact with Frozen Meat: A Case Seires Study

“…Many reports have been shown that contact with infected animal tissue and blood have transmitted the virus to humans. Also, consumption of uncooked meat can also transmit the infection to humans (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Five years ago, we reported 4 patients with CrimeanCongo hemorrhagic fever, who acquired the illness following consumption of uncooked sheep liver (2).…”

“…Death mainly occurs in the second week of disease and in patients who have survived, improvement begins about 10 days after the onset of illness (2,3,6). CCHF virus infection can be diagnosed by several different laboratory tests such as enzyme-linked immunosorbent assay (ELISA), serum neutralization (SN), reverse transcriptase polymerase chain reaction (RT-PCR) assay, and by cell culture to isolate the virus (12)(13)(14).Treatment is supportive, but ribavirin (an anti viral drug, both oral and intravenous formulations) has been used to treat CCHF infection with apparent benefit in previous reports (15)(16)(17)(18)(19)(20)(21)(22). Prevention of the virus in animals is difficult because infection in animals is usually not symptomatic.…”