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

Ergönül, Önder; Keske, Şiran; Celdir, Melis G.; Kara, İlayda Arjen; Pshenichnaya, N.; Abuova, G.; Blumberg, Lucille; Gönen, Mehmet

doi:10.3201/eid2409.171709

Cited by 31 publications

(20 citation statements)

References 44 publications

(54 reference statements)

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“…KKKA hastalığında temel tedavi seçeneği destek tedavisidir. Ancak ribavirin, profilakside veya tedavinin erken dönemlerinde kullanılabilecek bir antiviral ilaçtır [4,18]. İncelediğimiz çalışmalarda özellikle profilakside ribavirin kullanılmasının etkili olduğu gözlenmiştir.…”

Section: Discussionunclassified

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Evaluation of nosocomial Crimean Congo hemorrhagic fever patients reported from Turkey

Öztürk¹

2019

Ortadogu Tıp Derg

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ÖZAmaç: Kırım Kongo kanamalı ateşi (KKKA) ülkemizde 2002 yılından beri düzenli bildirimi yapılan, kanamalarla seyreden, ölümlere sebep olabilen önemli bir hastalıktır. Genel olarak hastalık endemik bölgede yaşayan çiftçilik ve/veya hayvancılıkla uğraşan insanlarda kene teması sonrası bulaşmaktadır. Ancak özellikle sağlık çalışanlarına nozokomiyal olarak bulaş olabilmektedir. Bu çalışmada, ülkemizden bildirilen nozokomiyal kaynaklı KKKA olgularının irdelenmesi amaçlandı. Gereç veYöntem: Yayınlar ulusal (http://uvt.ulakbim.gov.tr, http://www.turkmedline.net) ve uluslararası veri tabanları (www.ncbi.nlm.nih.gov, google scholar) kullanılarak tarandı. Tespit edilen olgular bulaş yolu, proflaksi veya tedavi verilip verilmediği ve hastalığın seyri yönlerinden, havuz analizi yapılarak değerlendirildi. Bulgular: Kriterlere uygun olan 6 çalışma dahil edildi. Bu çalışmalarda, 5 merkezde, toplam 12 dönemde, 49 kişide nozokomiyal bulaş olduğu bildirilmiştir. Olguların büyük çoğunluğunu hasta bakımıyla ilgili sağlık çalışanları oluştururken, iki kişi hasta yakını, bir kişi ise KKKA tanılı bir hastayla aynı odayı paylaşan başka bir hastaydı. Bulaş şekilleri irdelendiğinde; genellikle bulaşın KKKA hastalarının sekresyonlarına yakın temas veya kesici delici alet yaralanmaları sonucunda olduğu gözlenmiştir. Bu 49 hastanın 23'ünde temas sonrası ribavirin proflaksisi verilmiş ve bunların hiçbirinde klinik olarak KKKA gelişmemiştir, yalnızca bir hastada seroloji pozitifliği olmuştur. Sonuçlar: KKKA ülkemizde halen önemini koruyan endemik bir hastalıktır. Özellikle endemik bölgede yaşayan hastaları muayene ederken veya tıbbi müdahalede bulunurken standart korunma önlemlerinin doğru bir şekilde uygulanması önemlidir. Temas sonrası hastayı yakından izlenmeli ve ribavirin proflaksisinin faydalı olabileceğinden profilaksi yönünden de değerlendirilmelidir. Anahtar kelimeler: Kırım Kongo kanamalı ateş, nozokomiyal bulaş, havuz analizi Ortadoğu Tıp Dergisi / Ortadogu Medical Journal ORTADOGU MEDICAL JOURNAL 2019; 11(3): 322-325 323ABSTRACT Aim: Crimean Congo Hemorrhagic Fever (CCHF) is an important disease that can lead to hemorrhages and deaths and has been seen in our country since the year 2002. The disease generally spreads to farmers and/or people occupied in animal husbandry after tick bite in the endemic regions. But nosocomial contagion can be seen especially in health care workers (HCWs). In this study the nosocomial contagions from CCHF patients were evaluated. Material and Method:The studies were screened by using national (http://uvt.ulakbim.gov.tr, http://www.turkmedline.net) and international (www.ncbi.nlm.nih.gov, google scholar) data bases. The detected cases were evaluated for contagion route, presence of prophylactic therapy and disease course by using pool analysis method.Results: Six studies were included in this study. In these studies, totally 49 nosocomial contagion were reported in 5 different centers and in 12 different periods. The majority of these were HCWs, two of them were relatives of the patients and one of th...

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Section: Discussionunclassified

“…Tedavide erken evrede ribavirin antiviral ilaç olarak kullanılabilir. Ribavirinin proflakside de etkili olduğuna dair çalışmalar mevcuttur [4]. Hastalığın mortalitesi %5-55 arasında değişmekle birlikte [1, [5][6][7], nozokomiyal bulaş gelişen hastalarda mortalite oranının daha yüksek olduğu bildirilmiştir [8][9][10].…”

Section: Introductionunclassified

Evaluation of nosocomial Crimean Congo hemorrhagic fever patients reported from Turkey

Öztürk¹

2019

Ortadogu Tıp Derg

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“…It is an open-ring analog of guanosine nucleoside ( Figure 3 ) that was approved by the U.S. FDA in 1985 for the treatment of respiratory syncytial virus [ 48 ]. It is also used systemically for chronic hepatitis C virus (HCV) infection [ 49 ] and viral hemorrhagic fever [ 50 ]. The drug possesses broad-spectrum antiviral activity against both RNA and DNA viruses.…”

Section: Viral Polymerase Inhibitorsmentioning

confidence: 99%

Potential Anti-SARS-CoV-2 Therapeutics That Target the Post-Entry Stages of the Viral Life Cycle: A Comprehensive Review

Al‐Horani

Kar

2020

Viruses

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The coronavirus disease-2019 (COVID-19) pandemic continues to challenge health care systems around the world. Scientists and pharmaceutical companies have promptly responded by advancing potential therapeutics into clinical trials at an exponential rate. Initial encouraging results have been realized using remdesivir and dexamethasone. Yet, the research continues so as to identify better clinically relevant therapeutics that act either as prophylactics to prevent the infection or as treatments to limit the severity of COVID-19 and substantially decrease the mortality rate. Previously, we reviewed the potential therapeutics in clinical trials that block the early stage of the viral life cycle. In this review, we summarize potential anti-COVID-19 therapeutics that block/inhibit the post-entry stages of the viral life cycle. The review presents not only the chemical structures and mechanisms of the potential therapeutics under clinical investigation, i.e., listed in clinicaltrials.gov, but it also describes the relevant results of clinical trials. Their anti-inflammatory/immune-modulatory effects are also described. The reviewed therapeutics include small molecules, polypeptides, and monoclonal antibodies. At the molecular level, the therapeutics target viral proteins or processes that facilitate the post-entry stages of the viral infection. Frequent targets are the viral RNA-dependent RNA polymerase (RdRp) and the viral proteases such as papain-like protease (PLpro) and main protease (Mpro). Overall, we aim at presenting up-to-date details of anti-COVID-19 therapeutics so as to catalyze their potential effective use in fighting the pandemic.

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“…Notably, a placebo-controlled study failed to identify a clinical benefit of ribavirin treatment in patients with CCHF 72 . A recent meta-analysis demonstrated that ribavirin treatment needs to be started soon after symptom onset (<48 hours) to reduce odds of death 73 . In the recent emergence of CCHFV in Spain, although treatment of an infected nurse with ribavirin had mutagenic effects on CCHFV in vivo and a reduction in viral titers was coincident with treatment start 74 , ultimately ribavirin treatment was discontinued because of suspected hemolytic anemia 75 , a potential complication of ribavirin treatment 76 , 77 .…”

Section: Antiviralsmentioning

confidence: 99%

Recent advances in understanding Crimean–Congo hemorrhagic fever virus

Hawman

Feldmann

2018

F1000Res

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Crimean-Congo hemorrhagic fever virus (CCHFV) is a widely distributed hemorrhagic fever virus and the cause of hemorrhagic disease in Africa, Southern and Eastern Europe, the Middle East, India and Asia. Recent emergence of CCHFV into Spain indicates that the geographic range of this virus is expanding and the presence of its tick vector in several countries without reported disease suggest that CCHFV will continue to spread. Research into CCHFV was historically limited by a lack of suitable animal models and tools to study viral pathogenesis. However, in the past few years the toolset for studying CCHFV has expanded with small animal and non-human primate models for CCHFV being developed along with a reverse genetics system that allows for investigation of viral determinants of disease. These tools have been utilized to understand how CCHFV antagonizes host restriction factors and to develop novel vaccine candidates that may help limit the substantial morbidity and mortality in humans caused by CCHFV.

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

Cited by 31 publications

References 44 publications

Evaluation of nosocomial Crimean Congo hemorrhagic fever patients reported from Turkey

Evaluation of nosocomial Crimean Congo hemorrhagic fever patients reported from Turkey

Potential Anti-SARS-CoV-2 Therapeutics That Target the Post-Entry Stages of the Viral Life Cycle: A Comprehensive Review

Recent advances in understanding Crimean–Congo hemorrhagic fever virus

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