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Tolentino Júnior DS, Vasconcelos Marques MS, de Oliveira RC. Rabies vaccination of the Maxakali indigenous population. Vaccine 2024; 42:2495-2498. [PMID: 38413279 DOI: 10.1016/j.vaccine.2023.12.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/29/2023] [Accepted: 12/30/2023] [Indexed: 02/29/2024]
Affiliation(s)
- Dilceu Silveira Tolentino Júnior
- Oswaldo Cruz Foundation, René Rachou Institute, Postgraduate Program in Collective Health, Belo Horizonte, Minas Gerais, Brazil; Special Indigenous Health District of Minas Gerais and Espírito Santo, Ministry of Health, Governador Valadares, Minas Gerais, Brazil; Vale do Rio Doce University. Postgraduate Program in Integrated Territory Management, Governador Valadares, Minas Gerais, Brazil.
| | - Maryana Santos Vasconcelos Marques
- Oswaldo Cruz Foundation, René Rachou Institute, Postgraduate Program in Collective Health, Belo Horizonte, Minas Gerais, Brazil; Special Indigenous Health District of Minas Gerais and Espírito Santo, Ministry of Health, Governador Valadares, Minas Gerais, Brazil; Vale do Rio Doce University. Postgraduate Program in Integrated Territory Management, Governador Valadares, Minas Gerais, Brazil
| | - Roberto Carlos de Oliveira
- Oswaldo Cruz Foundation, René Rachou Institute, Postgraduate Program in Collective Health, Belo Horizonte, Minas Gerais, Brazil; Special Indigenous Health District of Minas Gerais and Espírito Santo, Ministry of Health, Governador Valadares, Minas Gerais, Brazil; Vale do Rio Doce University. Postgraduate Program in Integrated Territory Management, Governador Valadares, Minas Gerais, Brazil
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Ciconello FN, Katz ISS, Fernandes ER, Guedes F, Silva SR. A comparative review of serological assays for the detection of rabies virus-specific antibodies. Acta Trop 2022; 226:106254. [PMID: 34808119 DOI: 10.1016/j.actatropica.2021.106254] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 12/25/2022]
Abstract
Rabies is a major public health problem with a fatality rate close to 100%, caused by a virus of the Lyssavirus genus, of which rabies virus (RABV) is the prototype. Nonetheless, the complete prevention can be achieved by the induction of neutralizing antibodies by pre- or post-exposure prophylaxis. According to the world health organization (WHO) and World Organization for animal health (OIE), serum titers of rabies virus neutralizing antibodies (RVNA) that are higher or equal to 0.5 international units (IU)/ml indicate adequate immune response after vaccination against rabies. Currently, RFFIT and FAVN are the gold standard tests recommended by both WHO and OIE for detecting and quantitating RVNA in biological samples from individuals or animals previously vaccinated and/or subjects suspected of having been infected by RABV. Although the tests RFFIT and FAVN are efficient, they are time-consuming, labor-intensive manual tests and not cost-effective for routine use. Following the previously mentioned, approaches with alternative methods have been developed to detect RVNA or rabies-specific antibodies in human or animal serum, but with variable success. This work summarizes the advances in the serological assays for the detection of neutralizing antibodies or rabies antibodies and assesses the individual immune status after vaccination against rabies, as well as the mechanisms of RABV neutralization mediated by antibodies. Therefore, the main alternative methods for the determination of RABV or rabies-specific antibodies are exposed, with promising results, besides being easy to execute, of low cost, and representing a possibility of being applied, according to the proposal of each test to the network of Rabies Surveillance Laboratories.
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Meske M, Fanelli A, Rocha F, Awada L, Soto PC, Mapitse N, Tizzani P. Evolution of Rabies in South America and Inter-Species Dynamics (2009-2018). Trop Med Infect Dis 2021; 6:98. [PMID: 34207822 PMCID: PMC8293400 DOI: 10.3390/tropicalmed6020098] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/30/2021] [Accepted: 06/01/2021] [Indexed: 11/26/2022] Open
Abstract
Rabies is listed as one of the World Health Organisation's (WHO) Neglected Tropical Diseases Worldwide, with a significant impact in South America. This paper explores the dynamics of rabies cases in humans, pets (dogs and cats), livestock and wildlife (bats in particular) in South America during the period 2009-2018. The data used in this study were derived from the two main databases for rabies in South America: the OIE-WAHIS from the World Organisation for Animal Health (OIE) and PANAFTOSA's Regional Information System for the Epidemiological Surveillance of Rabies (SIRVERA). Being a neglected disease with possible underreporting in some areas, the reported rabies cases may not always represent the real disease burden. The analysis focuses on the evolution of the number of cases in time and their spatial distribution, as well as on the main source of infections in humans, determined by laboratory assays of the antigenic variant or through epidemiological investigations. Additionally, Generalised Linear Mixed Models (GLMM) were used to evaluate the risk factors associated with the occurrence of human cases. Our results show that the highest impact of the disease in terms of number of cases was reported on livestock, while the overall number of cases (in animals and humans) progressively decreased along the study period. The spatial distribution of rabies in livestock showed two main clusters in the north-western (mainly Colombia) and in the south-eastern part of the affected area (Brazil), and a third smaller cluster in Peru. A cluster in dogs was observed in Bolivia. Out of the 192 human cases reported during the study period, 70% of them were transmitted by bats. The number of human cases reported during the study period were significantly associated with the number of rabies cases reported in livestock, pets and wildlife. Despite the overall decreasing case report rate, the disease still represents a major animal and public health concern in South America, and new strategies for compiling systematic information, networking and education are needed, as well as the education and training of veterinary staff.
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Affiliation(s)
- Mauro Meske
- OIE—World Organisation for Animal Health, 75017 Paris, France; (M.M.); (L.A.); (P.C.S.); (N.M.)
| | - Angela Fanelli
- Department of Veterinary Medicine, University of Bari, 70121 Bari, Italy;
| | - Felipe Rocha
- PAHO-WHO-PANAFTOSA-Centro Panamericano de Fiebre Aftosa y Salud Pública Veterinaria, Regional Information System for the Epidemiological Surveillance of Rabies (SIRVERA), 25045-002 Duque de Caixas, Brazil;
| | - Lina Awada
- OIE—World Organisation for Animal Health, 75017 Paris, France; (M.M.); (L.A.); (P.C.S.); (N.M.)
| | - Paula Caceres Soto
- OIE—World Organisation for Animal Health, 75017 Paris, France; (M.M.); (L.A.); (P.C.S.); (N.M.)
| | - Neo Mapitse
- OIE—World Organisation for Animal Health, 75017 Paris, France; (M.M.); (L.A.); (P.C.S.); (N.M.)
| | - Paolo Tizzani
- OIE—World Organisation for Animal Health, 75017 Paris, France; (M.M.); (L.A.); (P.C.S.); (N.M.)
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Parize P, Sommé J, Schaeffer L, Ribadeau-Dumas F, Benabdelkader S, Durand A, Tarantola A, Cailhol J, Goesch J, Kergoat L, Le Guern AS, Mousel ML, Dacheux L, Consigny PH, Fontanet A, Francuz B, Bourhy H. Systematic Booster after Rabies Pre-Exposure Prophylaxis to Alleviate Rabies Antibody Monitoring in Individuals at Risk of Occupational Exposure. Vaccines (Basel) 2021; 9:309. [PMID: 33805019 PMCID: PMC8063951 DOI: 10.3390/vaccines9040309] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/05/2021] [Accepted: 03/17/2021] [Indexed: 12/26/2022] Open
Abstract
Pre-exposure rabies prophylaxis (PrEP) is recommended for people at frequent or increased risk of professional exposure to lyssavirus (including rabies virus). PrEP provides protection against unrecognized exposure. After the primary vaccination, one's immune response against rabies may decline over time. We aimed to evaluate the immune response to rabies in individuals immunized for occupational reasons before and after a booster dose of the rabies vaccine. With this aim, we retrospectively documented factors associated with an inadequate response in individuals vaccinated for occupational purposes. Our findings analyzed data from 498 vaccinated individuals and found that 17.2% of participants had an inadequate antibody titration documented after their primary vaccination without the booster, while inadequate response after an additional booster of the vaccine was evidenced in 0.5% of tested participants. This study showed that a single booster dose of vaccine after PrEP conferred a high and long-term immune response in nearly all individuals except for rare, low responders. A systematic rabies booster after primary vaccination may result in alleviating the monitoring strategy of post-PrEP antibody titers among exposed professionals.
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Affiliation(s)
- Perrine Parize
- Institut Pasteur, Unit Lyssavirus Epidemiology and Neuropathology, National Reference Center for Rabies and WHO Collaborating Centre for Reference and Research on Rabies, 75015 Paris, France; (F.R.-D.); (S.B.); (A.T.); (L.K.); (L.D.); (H.B.)
| | - Jérémie Sommé
- Institut Pasteur, Occupational Health Department, 75015 Paris, France; (J.S.); (M.-L.M.); (B.F.)
| | - Laura Schaeffer
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Centre for Global Health Research and Education, 75015 Paris, France; (L.S.); (A.F.)
| | - Florence Ribadeau-Dumas
- Institut Pasteur, Unit Lyssavirus Epidemiology and Neuropathology, National Reference Center for Rabies and WHO Collaborating Centre for Reference and Research on Rabies, 75015 Paris, France; (F.R.-D.); (S.B.); (A.T.); (L.K.); (L.D.); (H.B.)
| | - Sheherazade Benabdelkader
- Institut Pasteur, Unit Lyssavirus Epidemiology and Neuropathology, National Reference Center for Rabies and WHO Collaborating Centre for Reference and Research on Rabies, 75015 Paris, France; (F.R.-D.); (S.B.); (A.T.); (L.K.); (L.D.); (H.B.)
| | | | - Arnaud Tarantola
- Institut Pasteur, Unit Lyssavirus Epidemiology and Neuropathology, National Reference Center for Rabies and WHO Collaborating Centre for Reference and Research on Rabies, 75015 Paris, France; (F.R.-D.); (S.B.); (A.T.); (L.K.); (L.D.); (H.B.)
| | - Johann Cailhol
- Institut Pasteur, Centre Médical, Centre d’Infectiologie Necker-Pasteur, 75015 Paris, France; (J.C.); (J.G.); (P.-H.C.)
| | - Julia Goesch
- Institut Pasteur, Centre Médical, Centre d’Infectiologie Necker-Pasteur, 75015 Paris, France; (J.C.); (J.G.); (P.-H.C.)
| | - Lauriane Kergoat
- Institut Pasteur, Unit Lyssavirus Epidemiology and Neuropathology, National Reference Center for Rabies and WHO Collaborating Centre for Reference and Research on Rabies, 75015 Paris, France; (F.R.-D.); (S.B.); (A.T.); (L.K.); (L.D.); (H.B.)
| | | | - Marie-Laurence Mousel
- Institut Pasteur, Occupational Health Department, 75015 Paris, France; (J.S.); (M.-L.M.); (B.F.)
| | - Laurent Dacheux
- Institut Pasteur, Unit Lyssavirus Epidemiology and Neuropathology, National Reference Center for Rabies and WHO Collaborating Centre for Reference and Research on Rabies, 75015 Paris, France; (F.R.-D.); (S.B.); (A.T.); (L.K.); (L.D.); (H.B.)
| | - Paul-Henri Consigny
- Institut Pasteur, Centre Médical, Centre d’Infectiologie Necker-Pasteur, 75015 Paris, France; (J.C.); (J.G.); (P.-H.C.)
| | - Arnaud Fontanet
- Institut Pasteur, Emerging Diseases Epidemiology Unit, Centre for Global Health Research and Education, 75015 Paris, France; (L.S.); (A.F.)
- Conservatoire National des Arts et Métiers, 75003 Paris, France
| | - Beata Francuz
- Institut Pasteur, Occupational Health Department, 75015 Paris, France; (J.S.); (M.-L.M.); (B.F.)
| | - Hervé Bourhy
- Institut Pasteur, Unit Lyssavirus Epidemiology and Neuropathology, National Reference Center for Rabies and WHO Collaborating Centre for Reference and Research on Rabies, 75015 Paris, France; (F.R.-D.); (S.B.); (A.T.); (L.K.); (L.D.); (H.B.)
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Factors influencing the immune response after a single-dose 3-visit pre-exposure rabies intradermal vaccination schedule: A retrospective multivariate analysis. Travel Med Infect Dis 2020; 37:101867. [PMID: 32871278 DOI: 10.1016/j.tmaid.2020.101867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND The World Health Organization (WHO) recommends intradermal (ID) rabies vaccination as a safe and immunogenic alternative to intramuscular administration. The aim of this study is to determine which factors influence the levels of rabies virus neutralizing antibodies (RVNA) after a 3-visit ID rabies vaccination. METHODS This is a retrospective secondary data analysis study based on electronic health record vaccination data of Belgian military subjects who received ID rabies Pre-exposure prophylaxis (PrEP) with a single-dose 3-visit regimen during the period 2014-2017. Logistic regression was performed to identify predictive factors of RVNA level ≥3.0 IU/mL and >10 IU/mL. RESULTS The second analysis performed on the 2025 subjects (100% seroconverted with a RVNA ≥ 0.5 IU/mL) shows a significantly better immune response in subjects younger than 30 years compared to all other age-groups, a gender-difference to predict RVNA ≥ 3.0 IU/mL (OR 2.30 [1.26-4.22] comparing "female" to "male") and the influence of the vaccination schedule (OR 2.28 [1.15-4.53] comparing "late - very variable" to "correct" schedule) to predict > 10 IU/ml. Multivariate analysis also demonstrates that a postponed serology control significantly influences the Rapid Fluorescent Focus Inhibition Test (RFFIT). CONCLUSION Gender and age significantly influence the response to ID rabies vaccine. Timing of RVNA determination is important to correctly assess the response to vaccination. A single-dose 3-visit ID rabies PrEP schedule is a dose-sparing effective alternative to the double-dose 2-visit ID schedule. When the minimum time interval between doses is respected, RVNA determination is not necessary.
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Parize P, Poujol P, Morineau Le Houssine P, Goesch J, Lucet C, Basuyau L, Cailhol J, Dacheux L, Bourhy H, Consigny PH. Immune response to rabies post-exposure prophylaxis in patients with non-HIV secondary immunodeficiencies. Vaccine 2020; 38:5091-5094. [PMID: 32586759 DOI: 10.1016/j.vaccine.2020.06.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 06/10/2020] [Accepted: 06/12/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND This study sought to determine the proportion of individuals with non-HIV secondary immunodeficiencies presenting inadequate antibody titers after rabies post-exposure prophylaxis (PEP) and to identify variables associated with inadequate response. METHODS A retrospective review of the records of immunocompromised patients having received a full course of PEP after a rabies exposure and having been tested for post-PPE antibody titers in two French Antirabies Clinics, between 2013 and 2018, was conducted. Antibody titers < 0.5 EU/ml (ELISA) were classified as inadequate. RESULTS A total of 28 individuals were included, 6 had inadequate post-PPE titers. None of the tested variable was independently associated with inadequate titers. CONCLUSIONS Inadequate response was unpredictable and not explained either by the characteristics of patients or by the PEP regimen they received. These findings support the WHO recommendation to systematically assess post-PEP response in immunocompromised patients to detect non-responders, who might require an additional dose.
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Affiliation(s)
- Perrine Parize
- Institut Pasteur, Unit Lyssavirus Epidemiology and Neuropathology, National Reference Centre for Rabies, WHO Collaborating Centre for Research on Rabies, Paris, France.
| | - Philippe Poujol
- Institut Pasteur, Centre Médical, Centre d'Infectiologie Necker-Pasteur, Paris, France
| | | | - Julia Goesch
- Institut Pasteur, Centre Médical, Centre d'Infectiologie Necker-Pasteur, Paris, France
| | - Cora Lucet
- Institut Pasteur, Centre Médical, Centre d'Infectiologie Necker-Pasteur, Paris, France
| | - Laura Basuyau
- Institut Pasteur, Centre Médical, Centre d'Infectiologie Necker-Pasteur, Paris, France
| | - Johann Cailhol
- Institut Pasteur, Centre Médical, Centre d'Infectiologie Necker-Pasteur, Paris, France
| | - Laurent Dacheux
- Institut Pasteur, Unit Lyssavirus Epidemiology and Neuropathology, National Reference Centre for Rabies, WHO Collaborating Centre for Research on Rabies, Paris, France
| | - Hervé Bourhy
- Institut Pasteur, Unit Lyssavirus Epidemiology and Neuropathology, National Reference Centre for Rabies, WHO Collaborating Centre for Research on Rabies, Paris, France
| | - Paul-Henri Consigny
- Institut Pasteur, Centre Médical, Centre d'Infectiologie Necker-Pasteur, Paris, France
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Quiambao BP, Ambas C, Diego S, Bosch Castells V, Korejwo J, Petit C, Rasuli A, Houillon G. Single-visit, 4-site intradermal (ID) rabies vaccination induces robust immune responses 5 years after 1-week, 4-site ID primary post-exposure prophylaxis in the Philippines. Vaccine 2020; 38:3740-3746. [PMID: 32280042 DOI: 10.1016/j.vaccine.2020.03.043] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/20/2020] [Accepted: 03/23/2020] [Indexed: 01/14/2023]
Abstract
BACKGROUND In a randomized controlled study (NCT01622062) a 1-week, 4-site intradermal (ID, 4-4-4-0-0) post-exposure prophylaxis (PEP) rabies vaccination regimen with purified Vero cell rabies vaccine (PVRV, Verorab®, Sanofi Pasteur), either without (Group 1) or with (Group 2) purified equine rabies immunoglobulin (ERIG), patients in the Philippines achieved seroconversion rates at Day 14 that were non-inferior to that of the updated Thai Red Cross (TRC) 28-day, 2-site (2-2-2-0-2) ID regimen with ERIG (Group 3). Presented here are the annual immunogenicity data up to five years after the last primary dose, and the immunogenicity and safety data following simulated PEP with single-visit, 4-site ID regimen. METHODS Rabies virus neutralizing antibodies (RVNA) were determined by rapid fluorescent focus inhibition test (RFFIT). Participants (n = 397) received simulated PEP vaccination ID at Year 5 and RVNAs were assessed at Day 11 post-vaccination. RESULTS Seroconversion rates (RVNA titres ≥ 0.5 IU/mL) during annual follow-up remained >95% in Group 1 and were relatively stable at 80-90% in Group 2, but decreased from 80% to 64% in Group 3. RVNA geometric mean titres (GMTs) in Group 1 were consistently higher than in the other two groups, and those in Group 3 were generally lower than in the other two groups. There was a clear anamnestic response to vaccination in all groups, with all participants achieving RVNA titres ≥ 0.5 IU/mL at Day 11 post-simulated PEP booster vaccination. There were no safety concerns raised during annual follow-up and with simulated post-exposure vaccination with PVRV. CONCLUSION The shortened, 1-week, 4-site ID regimen with PVRV achieved persistently higher RVNA titres than the updated 2-site TRC regimen, and more participants remained seroprotected up to five years after the last dose of primary immunization. Simulated post-exposure with 4-site ID rapidly induced an anamnestic response indicative of robust protection.
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Affiliation(s)
- Beatriz P Quiambao
- Research Institute for Tropical Medicine, Alabang, Muntinlupa City, Philippines
| | - Cristina Ambas
- Research Institute for Tropical Medicine, Alabang, Muntinlupa City, Philippines
| | - Sherylle Diego
- Research Institute for Tropical Medicine, Alabang, Muntinlupa City, Philippines
| | | | - Joanna Korejwo
- Sanofi Pasteur, 14 Espace Henry Vallée, 69007 Lyon, France
| | - Céline Petit
- Sanofi Pasteur, 14 Espace Henry Vallée, 69007 Lyon, France
| | - Anvar Rasuli
- Sanofi Pasteur, 14 Espace Henry Vallée, 69007 Lyon, France
| | - Guy Houillon
- Sanofi Pasteur, 14 Espace Henry Vallée, 69007 Lyon, France.
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Factors influencing the immune response after a double-dose 2-visit pre-exposure rabies intradermal vaccination schedule: A retrospective study. Travel Med Infect Dis 2020; 33:101554. [PMID: 31931134 DOI: 10.1016/j.tmaid.2020.101554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 01/04/2020] [Accepted: 01/07/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Double-dose 2-visit intradermal rabies schedules (22ID) have recently been accepted by the World Health Organization (WHO) as Pre-Exposure Prophylaxis (PrEP). The aim of this study is to determine which factors influence the levels of rabies virus neutralizing antibodies (RVNA) after a 22ID rabies vaccination schedule. METHODS This is a retrospective study based on electronic health record vaccination data of subjects from the Belgian Armed Forces who received the 22ID rabies PrEP. An antibody titer ≥0.5 IU/mL, measured by rapid fluorescent focus inhibition test, is defined by the WHO as an adequate immune response after PrEP. Logistic regression was performed in order to identify predictive factors of RVNA level ≥3.0 IU/ml and >10 IU/ml. RESULTS 301 subjects were included. 297 (98,6%) seroconverted with a RVNA ≥ 0.5 IU/ml. Multivariate analysis shows a significant better immune response in the subjects where the second dose was administered later on than on day 7 (RVNA >10 IU/ml (OR: 3.01 [1.36-6.67])). Postponing the timing of the serology control also influenced significantly the rapid fluorescent focus inhibition test (RVNA ≥ 3.0 IU/ml (OR: 0.12 [0.06-0.24]) and RVNA > 10 IU/ml (OR: 0.14 [0.06-0.29])). CONCLUSION A 22ID rabies PrEP vaccination schedule is highly effective and provides an adequate immune response in most subjects in a real live setting. Timing of the second vaccine dose significantly influences the response to ID rabies vaccine. Timing of RVNA determination is important in order to correctly assess the response to vaccination.
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Dougas G, Mavrouli M, Vrioni G, Lytras T, Mellou K, Metallidis S, Istikoglou I, Mitrou K, Tzani M, Georgopoulou I, Tsalikoglou F, Garetsou E, Poulakou G, Giannitsioti E, Moschopoulos C, Baka A, Georgakopoulou T, Tsiodras S, Tsakris A. Antibody Response Following Pre-Exposure Immunization Against Rabies in High-Risk Professionals. Vector Borne Zoonotic Dis 2019; 20:303-309. [PMID: 31794689 DOI: 10.1089/vbz.2019.2526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Vaccination against rabies and routine antibody testing of subjects participating in programs for the surveillance and control of rabies in animals is strongly recommended. The scope of this study is to describe the antibody level as measured by a commercial enzyme-linked immunosorbent assay (ELISA) after primary and booster intramuscular vaccination with a purified vero-cell rabies vaccine (PVRV) in high-risk professionals and to determine the influence of an array of factors on antibody level, that is, time elapsed since primary immunization series and booster dose, sex, age, pathologic conditions, high-risk occupation, and peak antibody level after initial scheme and booster dose. A primary series of three doses of PVRV was administered and a commercial ELISA was recommended 14 days postimmunization with continuous repetition at 6 months and yearly intervals for the laboratory personnel and the rest of the professionals, respectively. The protective antibody titer was defined as a minimum of 0.5 equivalent units/mL (EU/mL) (seroconvertion) and a booster dose was applied if the titer was determined nonprotective. The seroconversion rate (SCR) after primary vaccination was 100%, with a geometric mean titer (GMT) of 2.90 EU/mL (interquartile range [IQR]: 1.85-3.45). After booster vaccination due to nonprotective titer, the SCR was 100% and the GMT increased by 678% (95% confidence interval [CI]: 514-887) reaching 4.25 EU/mL (IQR: 4.00-4.60), 2.5 times higher than the GMT elicited by the primary vaccine scheme in the respective recipients. The titer dropped by 1.20% per month (95% CI: 0.52-1.89) regardless of booster administration or any other factor. Women had 51% higher titer compared with men (95% CI: 6-116). High-risk professionals should be verified for adequate antibody titers, but routine administration of a single booster dose of PVRV 1 year after the primary series could be considered; more evidence is needed to support the benefit in terms of immunity and logistics.
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Affiliation(s)
| | - Maria Mavrouli
- Department of Microbiology, Medical School, University of Athens, Athens, Greece
| | - Georgia Vrioni
- Department of Microbiology, Medical School, University of Athens, Athens, Greece
| | | | | | - Symeon Metallidis
- Infectious Diseases Division, 1st Internal Medicine Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Istikoglou
- Infection Control Committee, "AHEPA" University Hospital, Thessaloniki, Greece
| | | | - Myrsini Tzani
- Department of Zoonoses, Animal Health Directorate, Directorate General of Veterinary Services, Ministry of Rural Development and Food, Athens, Greece
| | - Ioanna Georgopoulou
- Department of Zoonoses, Animal Health Directorate, Directorate General of Veterinary Services, Ministry of Rural Development and Food, Athens, Greece
| | | | | | - Garyfallia Poulakou
- "Attikon" Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Efthymia Giannitsioti
- "Attikon" Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Charalampos Moschopoulos
- "Attikon" Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Agoritsa Baka
- European Centre for Disease Prevention and Control, Solna, Sweden
| | | | - Sotirios Tsiodras
- National Public Health Organization, Athens, Greece.,"Attikon" Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Athanassios Tsakris
- Department of Microbiology, Medical School, University of Athens, Athens, Greece
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Rupprecht CE, Salahuddin N. Current status of human rabies prevention: remaining barriers to global biologics accessibility and disease elimination. Expert Rev Vaccines 2019; 18:629-640. [PMID: 31159618 DOI: 10.1080/14760584.2019.1627205] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Introduction: Rabies is a serious, neglected tropical disease. Zoonotic agents are RNA viruses (Genus Lyssavirus, Family Rhabdoviridae), global in distribution. As an acute, progressive, incurable encephalitis, rabies has the highest case fatality of any infectious disease. Warm-blooded vertebrates are susceptible hosts. Major mammalian reservoirs include mesocarnivores and bats. Given wildlife perpetuation, rabies is not eradicable, but is preventable and controllable, especially under newly available international guidelines. Areas covered: Literature review over the past 5 years reveals development of sensitive, specific diagnostic tests and safe and highly effective human and veterinary vaccines. Yet, tens of thousands of human fatalities occur annually, usually in Africa and Asia, primarily after canine exposure. Human and domestic animal vaccination, before or after exposure, is the single greatest preventative strategy following a rabid animal bite. Expert opinion: Significant progress occurred during the twenty-first century regarding vaccine development, doses, and schedules. Remaining barriers to widespread rabies vaccination include an inter-related set of economic, cultural, social, educational, ecological and technological factors. A basic understanding of local and regional root causes of cases historically allows for broader accessibility to vaccination in a trans-disciplinary fashion to meet the global elimination of human rabies caused via dogs (GEHRD) by 2030.
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Affiliation(s)
| | - Naseem Salahuddin
- b Infectious Disease Division, Department of Medicine , The Indus Hospital , Karachi , Pakistan
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Menachery VD, Graham RL, Baric RS. Jumping species-a mechanism for coronavirus persistence and survival. Curr Opin Virol 2017; 23:1-7. [PMID: 28214731 PMCID: PMC5474123 DOI: 10.1016/j.coviro.2017.01.002] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Revised: 01/01/2017] [Accepted: 01/16/2017] [Indexed: 12/20/2022]
Abstract
Zoonotic transmission of novel viruses represents a significant threat to global public health and is fueled by globalization, the loss of natural habitats, and exposure to new hosts. For coronaviruses (CoVs), broad diversity exists within bat populations and uniquely positions them to seed future emergence events. In this review, we explore the host and viral dynamics that shape these CoV populations for survival, amplification, and possible emergence in novel hosts.
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Affiliation(s)
- Vineet D Menachery
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Rachel L Graham
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Ralph S Baric
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.
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