We performed a systematic review and meta-analysis on the effectiveness of ribavirin use for the prevention of infection and death of healthcare workers exposed to patients with Crimean-Congo hemorrhagic fever virus (CCHFV) infection. Splashes with blood or bodily fluids (odds ratio [OR] 4.2), being a nurse or physician (OR 2.1), and treating patients who died from CCHFV infection (OR 3.8) were associated with healthcare workers acquiring CCHFV infection; 7% of the workers who received postexposure prophylaxis (PEP) with ribavirin and 89% of those who did not became infected. PEP with ribavirin reduced the odds of infection (OR 0.01, 95% CI 0-0.03), and ribavirin use <48 hours after symptom onset reduced the odds of death (OR 0.03, 95% CI 0-0.58). The odds of death increased 2.4-fold every day without ribavirin treatment. Ribavirin should be recommended as PEP and early treatment for workers at medium-to-high risk for CCHFV infection.
Keywords: Albania; Arabic Emirates; CCHF; CCHFV; Crimean-Congo hemorrhagic fever; Crimean-Congo hemorrhagic fever virus; Germany; India; Iran; Kazakhstan; Mauritania; PRISMA; Pakistan; Russia; South Africa; Sudan; Tajikistan; Turkey; and Spain; early treatment; healthcare workers; meta-analysis; postexposure prophylaxis; ribavirin; systematic review; vector-borne infections; viral hemorrhagic fever; viruses; zoonoses.