van de Wal B W, Joubert J R, van Eeden P J, King J B
S Afr Med J. 1985 Nov 9;68(10):729-32.
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.
在泰格堡医院发生克里米亚-刚果出血热（CCHF）疫情期间，出现了一个特殊问题：同时爆发的流感疫情使接触者筛查变得复杂，因为其临床症状与早期CCHF非常相似。本文描述了识别和筛查接触者的方法。在列出的459名CCHF接触者中，7人（1.5%）发病；6人是首例病例的接触者，只有1人是二代病例的接触者。7名CCHF患者中有2人与首例病例无直接接触；尽管采取了全面的防护措施，但这引起了对传播问题的极大关注。46名血液接触者中有4人（8.7%）发病，9名针头接触者中有3人（33%）发病。预防性干扰素治疗因出现类似CCHF症状的副作用而不得不中断。9名接种接触者中有6人接受了利巴韦林预防性治疗。接受利巴韦林治疗的患者中有1人临床病程较轻，而其他5名接受该药物治疗的患者既未出现临床CCHF，也未产生病毒抗体。3名未接受利巴韦林治疗的针头接触者中有两人临床病程严重。1名针头接种接触者和42名未接受利巴韦林治疗的经证实的血液接触者未被感染。因此，关于预防性利巴韦林的保护价值无法得出确切结论。
