Recent Progress in the Treatment of Crimean–Congo Hemorrhagic Fever and Future Perspectives

Masayuki Saijo; Shigeru Morikawa; Ichiro Kurane

Disclosures

Future Virology. 2010;5(6):801-809. 

In This Article

Abstract and Introduction

Abstract

Crimean–Congo hemorrhagic fever (CCHF) caused by the CCHF virus, a member of the family Bunyaviridae, genus Nairovirus, is a tick-borne acute viral hemorrhagic fever with a high case–fatality rate. Ribavirin has been used as a treatment for patients with CCHF. Although the efficacy of ribavirin in the treatment of CCHF has not yet been proven conclusively, its use in the early stage of the disease is recommended. A number of clinical and virological insights into CCHF have been revealed. Virus-associated hemophagocytic syndrome has been found to contribute to the exacerbation of CCHF in some patients, and the administration of methylprednisolone at high doses was observationally undertaken in patients with CCHF and virus-associated hemophagocytic syndrome, with promising results. It is expected that effective therapeutics and preventive measures will be developed in the future.

Introduction

Crimean–Congo hemorrhagic fever (CCHF) virus (CCHFV) is a member of the family Bunyaviridae, genus Nairovirus.[1] CCHFV was first definitively recognized in Crimea at the end of World War II, when Russian troops returned to assist in the cultivation of tick-infested land, left fallow during the war. The agent was named Crimean hemorrhagic fever virus. It was subsequently found to be indistinguishable from a virus isolated in 1956 from a febrile child in Stanleyville (now Kisangani), Democratic Republic of Congo.[2] Therefore, this virus is named CCHFV. CCHF is an acute viral hemorrhagic fever with a high case–fatality rate (CFR).[1] The CFR has varied from 10% to more than 50%, with most deaths occurring 5–14 days after onset.[3] This disease is also one of the most important tick-borne zoonotic viral diseases. Owing to the high CFR, and the increase in the number of patients with CCHF, an effective treatment for CCHF is urgently required. The development of the diagnostic systems for CCHF, such as quantitative real-time reverse-transcription (RT)-PCR is necessary for its proper treatment. In this article, recent progress in the field of epidemiology, diagnosis and treatment of CCHF, in both adults and in children, is reviewed.

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