Use of ribavirin for treatment of viral hemorrhagic fever in the context of bioterrorism

A bioterrorist attack using hemorrhagic fever viruses (HFVs) against civilian populations is a potential threat in the current era. This could result in a major outbreak of a highly fatal disease with symptoms of fever, rash, hemorrhage and shock. The purpose of this study was to review and evaluate current knowledge on the use of ribavirin and propose recommendations regarding its potential use as a therapeutic during such an attack. All relevant articles, found from a careful PUBMED/MEDLINE search from the period January 1966 to June 2003, were reviewed. The findings of key studies were summarized in a matrix form. Additionally, with the help of study advisors, several experts in the field of bio-terrorism (some specifically in the field of viral hemorrhagic fever) were consulted regarding their assessments on the use of ribavirin. A questionnaire was developed and provided to these experts, to obtain their opinion regarding the use, future research and cost effectiveness of ribavirin therapy during a bio-terrorist attack. (Abstract shortened by UMI.)...