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

Conclusion & Future Perspective

Crimean–Congo hemorrhagic fever often appears to be a neglected disease, as it usually occurs in remote areas in developing countries. CCHF is one of the viral hemorrhagic fevers with a high CFR and is tick-borne; therefore, its eradication is impossible. The number of patients with CCHF in Turkey has dramatically increased since 2002, in which the first patient with CCHF in Turkey was identified. These facts indicate the urgent need of therapeutics for CCHF.

Ribavirin has been used as a treatment for patients with CCHF. Unfortunately, the efficacy of ribavirin in the treatment of CCHF has not yet been established conclusively. Owing to the high CFR and relatively small number of patients with CCHF, it is quite difficult to conduct a sophisticated randomized trial to assess the efficacy of ribavirin. Therefore, ribavirin should be used as a treatment of CCHF, if available, and the treatment should be initiated in the early stage of the disease.

The intravenous passive transfer of immunoglobulin active against CCHFV is expected to be an effective treatment. Immunoglobulin products, which are prepared from sera collected from survivors and are qualified for use, are expected to become available in the near future. Further studies, however, are still necessary.

Owing to the recent increase in the number of patients with CCHF in Turkey, many clinical and virological insights into CCHF have been revealed. For instance, VAHPS has been found to contribute to the exacerbation of CCHF in some patients, and the administration of high-dose methylprednisolone has been undertaken. CCHFV seems to be a neglected infectious disease. It is expected that clarification of the pathophysiology of CCHF will facilitate the further development of specific therapeutics against CCHF. The effort for the development of vaccines for CCHF is still limited. One reason might be the lack of a suitable animal model for CCHFV infection. Development of an efficacious vaccine against CCHF is expected.

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