Experience with Ribavirin for Treatment and Postexposure Prophylaxis of Hemorrhagic Fever Viruses: Crimean Congo Hemorrhagic Fever,Lassa Fever,and Hantaviruses
Free accessResearch articleFirst published online June, 2011
Experience with Ribavirin for Treatment and Postexposure Prophylaxis of Hemorrhagic Fever Viruses: Crimean Congo Hemorrhagic Fever,Lassa Fever,and Hantaviruses
The increase in research laboratories with biosafety level-4 (BSL-4) capabilities may be
associated with increased research with hemorrhagic fever (HF) viruses. The yellow fever
vaccine and an investigational formalin-inactivated Rift Valley fever vaccine are the only
vaccines for at-risk laboratory workers available in the United States against HF viruses.
Ribavirin is a nucleoside analogue that has been demonstrated to have antiviral activity
against a wide range of viruses, including many HF viruses. While intravenous (IV)
ribavirin is not FDA-approved and oral ribavirin is approved only for treatment of
hepatitis C in the United States, ribavirin has been used for treatment and postexposure
prophylaxis for Crimean Congo hemorrhagic fever (CCHF), Lassa fever (LF), and
hantaviruses, based mainly on in vitro sensitivity testing and efficacy
studies in animals, but only on a limited number of studies and/or anecdotal experience in
humans. The literature on both IV and oral ribavirin for treatment and postexposure
prophylaxis for CCHF, LF, and hantaviruses is reviewed to aid occupational healthcare
providers in the evaluation and recommendation of ribavirin to laboratory workers with
exposures or illness from these HF viruses, which are associated with a significant
morbidity and mortality.
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