Pediatric Viral Hemorrhagic Fevers Medication

Updated: Aug 17, 2021
  • Author: Martha L Muller, MD, MPH; Chief Editor: Russell W Steele, MD  more...
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Medication

Medication Summary

Ribavirin is effective for treating patients with Lassa fever and markedly reduces the mortality rate if used within the first week of illness. Oral ribavirin may be of benefit for postexposure prophylaxis in high-risk Lassa fever exposures. [45] Its use is under investigation for the treatment of patients with South American hemorrhagic fever (HF) but it is recommended for infection with all arenaviruses until a more effective alternative treatment becomes available. Widespread clinical trials have not established the efficacy of ribavirin in Crimean-Congo hemorrhagic fever (CCHF). [46] No evidence suggests any benefit of antiviral agents, passive antibodies, or interferon in the treatment for Ebola or Marburg virus infection. Other agents are being sought. [47, 48]

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Antiviral agents

Class Summary

Some evidence suggests that ribavirin may be effective in the viral hemorrhagic fevers (VHFs) (in addition to Lassa fever, for which it is effective), particularly among the other arenaviruses and possibly in CCHF. [49] Treatment must be initiated promptly at the onset of the infection to effectively inhibit the replicating virus.

Ribavirin (Virazole)

DOC for VHF caused by arenaviruses, until other more effective drugs are identified and made available. Inhibits viral replication by inhibiting DNA and RNA synthesis.

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Monoclonal Antibodies

Class Summary

Consider available information on drug susceptibility patterns for circulating Zaire ebolavirus strains when considering use.

Atoltivimab/maftivimab/odesivimab (Ebola monoclonal antibodies, Inmazeb)

Indicated for treatment of Zaire ebolavirus (Ebola virus) infection in adult and pediatric patients, including neonates born to a mother who is reverse-transcriptase polymerase chain reaction (RT-PCR) positive for Zaire ebolavirus infection.

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Vaccines

Class Summary

Several vaccines are available in the United States for individuals traveling to endemic areas or those working at biomedical facilities. 

Ebola Zaire vaccine (Ebola vaccine, Ervebo)

Indicated for prevention of disease caused by Zaire ebolavirus.

Tick borne encephalitis vaccine (TicoVac)

Indicated in adults and children aged 1 year and older for prevention tick-borne encephalitis caused by Flaviviridae, including European or Western tick-borne encephalitis virus (transmitted by Ixodes ricinus), Siberian tick borne encephalitis virus (transmitted by I persulcatus), and Far-Eastern tick borne encephalitis virus, formerly known as Russian spring summer encephalitis virus (transmitted by I persulcatus). 

Japanese encephalitis virus vaccine (Ixiaro)

Indicated for adults and children aged 2 months and older at increased risk of Japanese encephalitis virus (JEV) during travel to Asia.

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