Primary prevention
At present there is no licensed vaccine for human use; however, vaccines are in development.[56][57][58]
The following preventative measures are recommended for people in a CCHF-endemic area.
The US Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) recommend the following tick-bite prevention measures:[51][59]
Wear clothes that cover as much of the body as possible (e.g., long-sleeved shirts and long trousers); clothes may be treated with permethrin or other approved acaricides (chemicals intended to kill ticks)
Check entire body daily and remove attached ticks promptly; light-colour clothes allow for easy detection of ticks
Use approved repellent on skin (if >2 months of age); DEET (N,N-diethyl-3-methylbenzamide), picaridin, and IR3535 can be used in pregnant and breastfeeding women when used as directed
Where possible control tick infestations; avoid areas where there are large numbers of ticks and seasons when they are most active.
Animal husbandry procedures and slaughtering practices are considered high risk, and may increase likelihood for exposure to CCHF virus. When working with animals, especially in areas with a history of CCHF virus outbreaks, it is recommended that:[51][53][60]
Individuals wear protective equipment (including gloves and masks with eye protection) to avoid any exposure to potentially infected blood or tissues
Acaricides are used in livestock production facilities to reduce risk of transmission to workers
Slaughtering sick animals for consumption is avoided, especially during an outbreak.
A consensus report of preventative measures has been published to prevent transmission associated with animal sacrifice during Eid al-Adha.[53]
Healthcare workers who may be exposed to infected patients should:
Wear protective clothing
Practise proper infection-control and sterilisation measures
Isolate suspected patients from each other if possible, and confirmed patients from suspected patients
Notify health officials if you have direct contact with the body fluids of an infected patient.
Most human-to-human transmission of CCHF virus is via direct contact with infected blood and body fluids. Therefore, it is recommended that in caring for any patient with suspected or documented CCHF virus infection, specific barrier precautions (including use of gloves, gowns, face shields, and masks) should be implemented immediately. For procedures that may generate an aerosol, healthcare workers should consider wearing an N95 or FFP2 respirator (European Norm [EN] 61010-1).[40][61] To minimise risk of needlestick injuries, sharps containers should be available at all times and the use of safety-engineered devices should also be considered.[40][61]
The WHO produce detailed guidance on PPE:
WHO: steps to put on personal protective equipment Opens in new window
WHO: steps to remove personal protective equipment Opens in new window
The WHO has also produced guidance on collecting and shipping samples from patients with suspected CCHF:
Secondary prevention
CCHF is a notifiable disease. If infection is suspected, the patient should be put in isolation and all healthcare workers in contact with the patient should wear personal protective equipment.
Oral ribavirin has been used for post-exposure prophylaxis in CCHF.[80][97] It is generally well tolerated, and should be considered for healthcare workers who have had high-risk exposures such as needlestick injuries.[61][99][100] The WHO supports this recommendation.[81]
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