Nososcomial transmission of viral haemorrhagic fever in South Africa

Richards, Guy A.

doi:10.7196/samjnew.8168

Cited by 6 publications

(7 citation statements)

References 19 publications

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“…[11,21] Seroconversion may be expected from day 5 onwards, although this may be delayed in severe CCHF and may be a useful marker of prognosis. [19] Anti-CCHF antibodies may be measured by indirect immunofluorescence assays or enzymelinked immunofluorescence assays for IgG and IgM.…”

Section: The Bunyavirusesmentioning

confidence: 99%

“…[7,9] It is noteworthy that appropriate management limited the outbreaks to single secondary cases (see 'Clinical Alert' [11] ). Management of both diseases is supportive, involving active resuscitation and haemodynamic support.…”

Section: The Filovirusesmentioning

confidence: 99%

“…Interestingly, human cases remain relatively rare in SA, despite remarkably high seroprevalence rates in cattle and other ruminants. [14,15] Cases of nosocomial and laboratory transmission [8,16,17] have been noted on four occasions (data source: National Institute for Communicable Diseases) (see 'Clinical Alert' [11] ). An outbreak was reported in 1996 in which a total of 17 laboratory-confirmed cases occurred involving slaughterhouse workers following contact with infected ostriches.…”

Section: The Bunyavirusesmentioning

confidence: 99%

“…Lusaka-Johannesburg virus) (see 'Clinical Alert' [11] ). [10,59,60] The Lujo virus appears to have a particularly aggressive course [59] in that among the five reported cases there has been only one survivor.…”

Section: The Filovirusesmentioning

confidence: 99%

“…in 1984, EVD in Johannesburg in 1996, and the Lujo virus, a newly identified arenavirus, in Johannesburg in 2008 [7][8][9][10] (these are dealt with in detail in the 'Clinical Alert' article in this issue of SAMJ [11] ). Here we provide a concise account of VHFs, endemic and nonendemic, of perceived importance to SA.…”

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confidence: 99%

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Viral haemorrhagic fevers in South Africa

Richards

Weyer

Blumberg³

2015

S Afr Med J

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Section: The Bunyavirusesmentioning

confidence: 99%

Section: The Filovirusesmentioning

confidence: 99%

Section: The Bunyavirusesmentioning

confidence: 99%

Section: The Filovirusesmentioning

confidence: 99%

mentioning

confidence: 99%

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Viral haemorrhagic fevers in South Africa

Richards

Weyer

Blumberg³

2015

S Afr Med J

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Ribavirin for treating Crimean Congo haemorrhagic fever

Johnson

Maayan

Mills

et al. 2018

Cochrane Database of Systematic Reviews

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BackgroundCrimean Congo haemorrhagic fever (CCHF) is a tick-borne disease that occurs in parts of Asia, Europe and Africa. Since 2000 the infection has caused epidemics in Turkey, Iran, Russia, Uganda and Pakistan. Good-quality general supportive medical care helps reduce mortality. There is uncertainty and controversy about treating CCHF with the antiviral drug ribavirin.ObjectivesTo assess the effects of ribavirin for treating people with Crimean Congo haemorrhagic fever.Search methodsWe searched the Cochrane Infectious Diseases Group Specialized Register; the Central Register of Controlled Trials (CENTRAL); MEDLINE (PubMed); Embase (OVID); Science Citation Index-Expanded, Social Sciences Citation index, conference proceedings (Web of Science); and CINAHL (EBSCOHost). We also searched the WHO International Clinical Trials Registry Platform (ICTRP) and ClinicalTrials.gov for trials in progress. We conducted all searches up to 16 October 2017. We also contacted experts in the field and obtained further studies from these sources.Selection criteriaWe evaluated studies assessing the use of ribavirin in people with suspected or confirmed Crimean Congo haemorrhagic fever. We included randomised control trials (RCTs); non-randomised studies (NRSs) that included more than 10 participants designed as cohort studies with comparators; and case-control studies.Data collection and analysisTwo review authors assessed eligibility, risk of bias, and extracted data. For non-randomized studies we used the ROBINS-I tool to assess risk of bias. The main effects analysis included all studies where we judged the risk of bias to be low, moderate or high. We summarized dichotomous outcomes using risk ratios (RRs) and continuous outcomes using mean differences (MDs), and used meta-analyses where appropriate. We carried out a subsidiary appraisal and analysis of studies with critical risk of bias for the primary outcome, as these are often cited to support using ribavirin.Main resultsFor the main effects analysis, five studies met our inclusion criteria: one RCT with 136 participants and four non-randomized studies with 612 participants. We excluded 18 non-randomized studies with critical risk of bias, where none had attempted to control for confounding.We do not know if ribavirin reduces mortality (1 RCT; RR 1.13, 95% confidence interval (CI) 0.29 to 4.32; 136 participants; very low-certainty evidence; 3 non-randomized studies; RR 0.72, 95% CI 0.41 to 1.28; 549 participants; very low-certainty evidence). We do not know if ribavirin reduces the length of stay in hospital (1 RCT: mean difference (MD) 0.70 days, 95% CI -0.39 to 1.79; 136 participants; and 1 non-randomized study: MD -0.80, 95% CI -2.70 to 1.10; 50 participants; very low-certainty evidence). We do not know if it reduces the risk of patients needing platelet transfusions (1 RCT: RR 1.23, 95% CI 0.77 to 1.96; 136 participants; very low-certainty evidence). For adverse effects (including haemolytic anaemia and a need to discontinue treatment), we do not know whether there is a...

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