A nosocomial outbreak of Crimean-Congo haemorrhagic fever at Tygerberg Hospital. Part IV. Preventive and prophylactic measures.
A nosocomial outbreak of Crimean-Congo haemorrhagic fever at Tygerberg Hospital. Part IV. Preventive and prophylactic measures.
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泰格伯格医院爆发了克里米亚-刚果出血热的院内疫情。
DOI：
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发表时间：
1985
期刊：
影响因子：
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通讯作者：
J. B. King
中科院分区：
文献类型：
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作者：
B. Van de Wal;J. Joubert;P. V. van Eeden;J. B. King
在克里米亚-刚果出血热（CCHF）爆发期间，泰格伯格医院存在一个特殊的问题：同时发生的流感流行使接触者的筛查变得复杂，因为其临床表现与早期CCHF非常相似。描述了识别和筛选接触的方法。在459名列出的CCHF接触者中，7人（1.5%）发病; 6人是指示病例的接触者，只有1人是继发病例的接触者。7例CCHF患者中有2例与指示病例没有直接接触;尽管采取了充分的保护措施，但这引起了对传播的极大关注。46名血液接触者中有4人（8.7%）和9名针头接触者中有3人（33%）患上了这种疾病。预防性干扰素治疗由于副作用模仿CCHF的症状而不得不停止。在9次接种接触中的6次中，病毒唑被用于预防性治疗。其中一名服用利巴韦林的患者临床病程较轻，而另外5名服用该药的患者既没有出现临床CCHF，也没有出现病毒抗体。未接受利巴韦林治疗的3例针头接触者中有2例出现严重临床病程。一名接触针接种者和42名经证实未接受利巴韦林的血液接触者未被感染。因此，不能对预防性利巴韦林的保护价值得出确切的结论。
During the Crimean-Congo haemorrhagic fever (CCHF) outbreak at Tygerberg Hospital a particular problem existed: a simultaneous influenza epidemic complicated the screening of contacts because of its very similar clinical picture to that of early CCHF. The methods of identifying and screening contacts are described. Of 459 listed CCHF contacts, 7 (1,5%) developed the disease; 6 were contacts of the index case and only 1 a contact of a secondary case. Two of the 7 CCHF patients had no direct contact with the index case; this caused great concern about the dissemination, despite the otherwise full protective measures. Four of 46 blood contacts (8,7%) and 3 of 9 needle contacts (33%) developed the disease. Prophylactic interferon therapy had to be discontinued because of side-effects mimicking the symptoms of CCHF. Ribavirin was used prophylactically in 6 of the 9 inoculation contacts. One of the patients on ribavirin had a mild clinical course while 5 others who received the drug developed neither clinical CCHF nor antibodies to the virus. Two of the 3 needle contacts not treated with ribavirin had a severe clinical course. One contact with needle inoculation and 42 proven blood contacts who had not received ribavirin did not become infected. No firm conclusion can therefore be made about the protective value of prophylactic ribavirin.