2491. Post-exposure prophylaxis with ribavirin plus lopinavir/ritonavir for Middle East respiratory syndrome in Healthcare workers
Session: Poster Abstract Session: Virology Potpourri
Saturday, October 6, 2018
Room: S Poster Hall
Background:

In 2015, an outbreak of Middle East Respiratory Syndrome coronavirus (MERS-CoV) infection occurred in South Korea involving 186 patients, 39 of whom were healthcare workers (HCWs) exposed to the infection. An effective post-exposure prophylaxis (PEP) strategy may limit the spread of infection; however, there is no consensus regarding PEP for MERS-CoV infection. In this study, we assessed 1) the efficacy of oral ribavirin and lopinavir/ritonavir as PEP for HCWs exposed to patients with severe MERS-CoV pre-isolation pneumonia, and 2) safety of the PEP regimen.

Methods:

We retrospectively enrolled 43 HCWs with high-risk exposure to MERS-CoV from 5 hospitals affected during this outbreak in South Korea. The rate of MERS-CoV infection was compared between 22 workers at 1 hospital who received PEP consisting of oral ribavirin and lopinavir/ritonavir after exposure to patients with severe MERS-CoV pre-isolation pneumonia and 21 workers at other hospitals who did not receive PEP.

Results:

Six workers (14%) developed MERS-CoV infection; all of these subjects belonged to the non-PEP group. The attack rate was lower in the PEP group compared to the non-PEP group (0% vs. 28.6%; Odds ratio= 0.405, 95% confidence interval = 0.274–0.599; P = 0.009). The most commonly reported side effects of PEP therapy were nausea and diarrhea, but there were no severe adverse effects associated with PEP therapy.

Conclusion: PEP with a combination of oral ribavirin and lopinavir/ritonavir appears to be effective and generally safe for preventing MERS-CoV infection after high-risk exposure in healthcare workers.

So Yeon Park, MD, PhD, Infectious Diseases, Kangdong Sacred Heart Hospital Hallym University School of Medicine, Seoul, Korea, Republic of (South), Jin Seo Lee, M.D., Kangdong Sacred Heart Hospital, Hallym medical school, SEOUL, Korea, Republic of (South), Jungok Kim, MD, PhD, Chungnam National University Hospital, Daejeon, Korea, Republic of (South), Eun-Jeong Joo, MD, PhD, Division of Infectious Diseases, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of (South), Joong Sik Eom, M.D., Infectious Diseases, Gachon University Gil Medical Center, Seoul, Korea, Republic of (South) and Kyong Ran Peck, MD, Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea, Republic of (South)

Disclosures:

S. Y. Park, None

J. S. Lee, None

J. Kim, None

E. J. Joo, None

J. S. Eom, None

K. R. Peck, None

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