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Volume: 23S1 - January 1997 Canadian Contingency Plan for Viral Hemorrhagic Fevers and Other Related Diseases IDENTIFICATION, SURVEILLANCE AND MANAGEMENT OF PATIENT CONTACTSA contact is defined as a person who has been exposed to an infected person or to an infected person's secretions, excretions, or tissues within 3 weeks of the patient's onset of illness. Contacts may be subdivided into three levels of risk.
Any close or high-risk contact who develops a temperature of >=38.3° C or any other symptoms of illness should be immediately isolated and treated as a VHF patient (see "Management of the Patient"). Convalescent patients and their contacts should be warned that some of the causative agents of VHF may continue to be excreted for many weeks in semen, as demonstrated with filoviruses (e.g., Marburg and Ebola) and arenaviruses (e.g., Junin), and in urine, as occurs sometimes with Lassa virus. Collection of both seminal fluid and urine for virus isolation from male patients and urine from female patients in the convalescent period is encouraged (see "Transportation of Specimens for Diagnostic Tests"). Weekly evaluation for viral excretion is recommended. Convalescent patients must be meticulous about personal hygiene. While data are limited concerning infectivity in the convalescent period, abstinence from sexual intercourse is advised until genital fluids have been shown to be free of the virus. If the patient does engage in sexual intercourse before tests are done, the use of condoms is advised. The use of ribavirin for post-exposure prophylaxis for high-risk contacts of patients with Lassa fever has not been studied. Although experience is more limited, post-exposure prophylaxis with ribavirin may be considered for high-risk contacts of patients with Crimean-Congo hemorrhagic fever. The prophylactic regimen is ribavirin 500 mg by mouth every 6 hours for 7 days. Ribavirin is not licensed for oral use in Canada, and one must request authorization from the Emergency Drug Release Program, Bureau of Pharmaceutical Assessment, Drugs Directorate (613-941-2108) during regular business hours (0830-1630 EST) and (613-941-3061) after hours. Authorized supplies of ribavirin will be supplied by the National Defence Medical Centre, Ottawa.
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Last Updated: 2002-11-08 | ![]() |