Pre-Exposure and Post-Exposure Prophylaxis of Crimean-Congo Hemorrhagic Fever



Context: Crimean-Congo hemorrhagic fever (CCHF) is a tick-borne viral disease with a mortality rate of 30% to 80% and reported from more than 30 countries in Asia, Africa, South-Eastern Europe, and the Middle East. It is a zoonotic viral disease and an important health problem. In endemic areas, livestock handlers, livestock market workers, skin processors, veterinary staff, farmers, and healthcare personnel are at risk. Clinical manifestations are non-specific. Diagnosis is based on clinical manifestations, epidemiologic factors, and laboratory tests. Here, we reviewed the routes of transmission, pre-exposure, and post-exposure prophylaxis to help the public health authorities for decreasing rate of the disease in the community.

Evidence Acquisition: Medical databases (PubMed, Scopus, and Embase) were searched from June 1985 to June 2014. Keywords, including CCHF, epidemiology, transmission, control, prophylaxis, and prevention routes were searched.

Results: CCHF is widely distributed in many countries of the world, including our country, Iran which is an endemic region. Infection has a wide distribution that correlates with a global distribution of Hyalomma tick (the vector responsible for viral transmission). Preventive measures are very important in lowering the incidence rate. Post-exposure prophylaxis should be considered for people exposed to CCHF virus, such as those who have mucous membrane contact or a percutaneous injury in contact with the secretions or blood of infected animal or patients.

Conclusions: CCHF is a fatal viral disease. Therefore, pre-exposure and post-exposure prophylaxis should be considered to decrease the infection rate. All strategies should be centralized on raising surveillance using standardized case finding and proper case management, reduction of infection in animals, and increasing laboratory capacity in at risk regions for CCHF.