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Surendran J, HS R, Kumari N, M Prasanth R, Fotedar N. A prospective study on health seeking behaviour and post exposure prophylaxis received by animal bite victims at the anti-rabies clinic in a tertiary care centre of urban Bangalore. F1000Res 2024; 13:175. [PMID: 39015143 PMCID: PMC11249507 DOI: 10.12688/f1000research.145673.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/15/2024] [Indexed: 07/18/2024] Open
Abstract
Background Rabies is 100% preventable by administering early and complete post exposure prophylaxis (PEP). Animal bite victims must have the knowledge and attitude necessary to seek appropriate medical care at the earliest to receive the required PEP. Objectives The present study sought to ascertain the health-seeking behavior of animal bite victims, their knowledge and attitude regarding rabies prophylaxis, the PEP they received, and their level of compliance with the full course of anti-rabies vaccination. Methods The study included animal bite cases that presented to the anti-rabies clinic and matched the eligibility criteria. All the required details were recorded using an internally validated structured questionnaire. All participants were followed up for six months to ensure their health conditions and compliance with the vaccination schedule. Results Out of 1058 respondents, 57.9% were adults, with 46.6% belonging to middle socioeconomic class. 91.1% of them were informed biting animals as dogs. Before arriving at the anti-rabies clinic, 93.3% of the study subjects washed their wounds, and 62.4% visited to another health facility. Rabies knowledge was inadequate among the study participants, only 54.8% being mindful about the disease and its prevention. The compliance with the full course of antirabies vaccination was found to be 77.9%. All subjects were healthy, confirming that PEP is safe and effective. Conclusion Regular social and behavioral change communication (SBCC) needs to be implemented with regard to health-seeking behavior.
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Affiliation(s)
- Jithin Surendran
- Department of Community Medicine, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ravish HS
- Department of Community Medicine, Kempegowda Institute of Medical Sciences, Bangalore, Karnataka, 560002, India
| | - Nitu Kumari
- Department of Community Medicine, University College of Medical Sciences, New Delhi, 110095, India
| | - Ramya M Prasanth
- Department of Community Medicine, Sri Siddhartha Institute of Medical Sciences & Research Centre, Karnataka, 527107, India
| | - Nidhi Fotedar
- Department of Community Medicine, Kempegowda Institute of Medical Sciences, Bangalore, Karnataka, 560002, India
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2
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Lacy M, Phasuk N, Scholand SJ. Human Rabies Treatment-From Palliation to Promise. Viruses 2024; 16:160. [PMID: 38275970 PMCID: PMC10819634 DOI: 10.3390/v16010160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/19/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
Rabies encephalitis has plagued humankind for thousands of years. In developed countries, access to preventive care, both pre-exposure and post-exposure, has significantly reduced the burden of suffering and disease. However, around the world, rabies remains a neglected tropical disease, largely due to uncontrolled dog rabies, and tens of thousands perish each year. Currently, the standard of care for management of rabies encephalitis is palliation. Heroic attempts to treat human rabies patients over the last few decades have yielded glimpses into our understanding of pathophysiology, opening the door to the development of new antiviral therapies and modalities of treatment. Researchers continue to investigate new compounds and approaches to therapy, yet there remain real challenges given the complexity of the disease. We explore and review some of the promising therapies on the horizon in pursuit of a salvage treatment for rabies.
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Affiliation(s)
- Marian Lacy
- College of Medicine, University of Arizona, Tucson, AZ 85721, USA;
| | - Nonthapan Phasuk
- School of Medicine, Walailak University, Nakhon Si Thammarat 80160, Thailand;
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3
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Khairullah AR, Kurniawan SC, Hasib A, Silaen OSM, Widodo A, Effendi MH, Ramandinianto SC, Moses IB, Riwu KHP, Yanestria SM. Tracking lethal threat: in-depth review of rabies. Open Vet J 2023; 13:1385-1399. [PMID: 38107233 PMCID: PMC10725282 DOI: 10.5455/ovj.2023.v13.i11.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/10/2023] [Indexed: 12/19/2023] Open
Abstract
An infectious disease known as rabies (family Rhabdoviridae, genus Lyssavirus) causes severe damage to mammals' central nervous systems (CNS). This illness has been around for a very long time. The majority of human cases of rabies take place in underdeveloped regions of Africa and Asia. Following viral transmission, the Rhabdovirus enters the peripheral nervous system and proceeds to the CNS, where it targets the encephalon and produces encephalomyelitis. Postbite prophylaxis requires laboratory confirmation of rabies in both people and animals. All warm-blooded animals can transmit the Lyssavirus infection, while the virus can also develop in the cells of cold-blooded animals. In the 21st century, more than 3 billion people are in danger of contracting the rabies virus in more than 100 different nations, resulting in an annual death toll of 50,000-59,000. There are three important elements in handling rabies disease in post exposure prophylaxis (PEP), namely wound care, administration of anti-rabies serum, and anti-rabies vaccine. Social costs include death, lost productivity as a result of early death, illness as a result of vaccination side effects, and the psychological toll that exposure to these deadly diseases has on people. Humans are most frequently exposed to canine rabies, especially youngsters and the poor, and there are few resources available to treat or prevent exposure, making prevention of human rabies challenging.
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Affiliation(s)
- Aswin Rafif Khairullah
- Division of Animal Husbandry, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Shendy Canadya Kurniawan
- Master Program of Animal Sciences, Department of Animal Sciences, Specialisation in Molecule, Cell and Organ Functioning, Wageningen University and Research, Wageningen, Netherlands
| | - Abdullah Hasib
- School of Agriculture and Food Sustainability, The University of Queensland, Gatton, Australia
| | - Otto Sahat Martua Silaen
- Doctoral Program in Biomedical Science, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Agus Widodo
- Department of Health, Faculty of Vocational Studies, Universitas Airlangga, Surabaya, Indonesia
| | - Mustofa Helmi Effendi
- Division of Veterinary Public Health, Faculty of Veterinary Medicine, Universitas Airlangga, Surabaya, Indonesia
| | | | - Ikechukwu Benjamin Moses
- Department of Applied Microbiology, Faculty of Science, Ebonyi State University, Abakaliki, Nigeria
| | - Katty Hendriana Priscilia Riwu
- Department of Veterinary Public Health, Faculty of Veterinary Medicine, Universitas Pendidikan Mandalika, Mataram, Indonesia
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4
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Bastos V, Pacheco V, Rodrigues ÉDL, Moraes CNS, Nóbile AL, Fonseca DLM, Souza KBS, do Vale FYN, Filgueiras IS, Schimke LF, Giil LM, Moll G, Cabral-Miranda G, Ochs HD, Vasconcelos PFDC, de Melo GD, Bourhy H, Casseb LMN, Cabral-Marques O. Neuroimmunology of rabies: New insights into an ancient disease. J Med Virol 2023; 95:e29042. [PMID: 37885152 DOI: 10.1002/jmv.29042] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 09/28/2023] [Accepted: 09/30/2023] [Indexed: 10/28/2023]
Abstract
Rabies is an ancient neuroinvasive viral (genus Lyssavirus, family Rhabdoviridae) disease affecting approximately 59,000 people worldwide. The central nervous system (CNS) is targeted, and rabies has a case fatality rate of almost 100% in humans and animals. Rabies is entirely preventable through proper vaccination, and thus, the highest incidence is typically observed in developing countries, mainly in Africa and Asia. However, there are still cases in European countries and the United States. Recently, demographic, increasing income levels, and the coronavirus disease 2019 (COVID-19) pandemic have caused a massive raising in the animal population, enhancing the need for preventive measures (e.g., vaccination, surveillance, and animal control programs), postexposure prophylaxis, and a better understanding of rabies pathophysiology to identify therapeutic targets, since there is no effective treatment after the onset of clinical manifestations. Here, we review the neuroimmune biology and mechanisms of rabies. Its pathogenesis involves a complex and poorly understood modulation of immune and brain functions associated with metabolic, synaptic, and neuronal impairments, resulting in fatal outcomes without significant histopathological lesions in the CNS. In this context, the neuroimmunological and neurochemical aspects of excitatory/inhibitory signaling (e.g., GABA/glutamate crosstalk) are likely related to the clinical manifestations of rabies infection. Uncovering new links between immunopathological mechanisms and neurochemical imbalance will be essential to identify novel potential therapeutic targets to reduce rabies morbidity and mortality.
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Affiliation(s)
- Victor Bastos
- Department of Pharmaceutical Sciences, Postgraduate Program of Physiopathology and Toxicology, University of São Paulo, São Paulo, Brazil
- Department of Arbovirology and Hemorrhagic Fevers, PAHO Collaborating Centre for Emerging and Reemerging Arboviruses and other Zoonotic Viruses, Evandro Chagas Institute, Ananindeua, Brazil
| | - Vinicius Pacheco
- Department of Arbovirology and Hemorrhagic Fevers, PAHO Collaborating Centre for Emerging and Reemerging Arboviruses and other Zoonotic Viruses, Evandro Chagas Institute, Ananindeua, Brazil
| | - Érika D L Rodrigues
- Department of Arbovirology and Hemorrhagic Fevers, PAHO Collaborating Centre for Emerging and Reemerging Arboviruses and other Zoonotic Viruses, Evandro Chagas Institute, Ananindeua, Brazil
| | - Cássia N S Moraes
- Department of Arbovirology and Hemorrhagic Fevers, PAHO Collaborating Centre for Emerging and Reemerging Arboviruses and other Zoonotic Viruses, Evandro Chagas Institute, Ananindeua, Brazil
| | - Adriel L Nóbile
- Department of Pharmaceutical Sciences, Postgraduate Program of Physiopathology and Toxicology, University of São Paulo, São Paulo, Brazil
| | - Dennyson Leandro M Fonseca
- Interunit Postgraduate Program on Bioinformatics, Institute of Mathematics and Statistics (IME), University of São Paulo, São Paulo, Brazil
| | - Kamilla B S Souza
- Department of Immunology, University of São Paulo, São Paulo, Brazil
| | - Fernando Y N do Vale
- Department of Pharmaceutical Sciences, Postgraduate Program of Physiopathology and Toxicology, University of São Paulo, São Paulo, Brazil
| | - Igor S Filgueiras
- Department of Immunology, University of São Paulo, São Paulo, Brazil
| | - Lena F Schimke
- Department of Immunology, University of São Paulo, São Paulo, Brazil
| | - Lasse M Giil
- Department of Internal Medicine, Haraldsplass Deaconess Hospital, Bergen, Norway
| | - Guido Moll
- Department of Nephrology and Internal Intensive Care Medicine, Charité University Hospital, Berlin, Germany
| | | | - Hans D Ochs
- School of Medicine and Seattle Children's Research Institute, University of Washington, Seattle, Washington, USA
| | - Pedro F da Costa Vasconcelos
- Department of Arbovirology and Hemorrhagic Fevers, PAHO Collaborating Centre for Emerging and Reemerging Arboviruses and other Zoonotic Viruses, Evandro Chagas Institute, Ananindeua, Brazil
- Department of Pathology, University of the State of Pará, Belem, Brazil
| | - Guilherme D de Melo
- Lyssavirus Epidemiology and Neuropathology Unit, WHO Collaborating Centre for Reference and Research on Rabies, Institut Pasteur, Université Paris Cité, Paris, France
| | - Hervé Bourhy
- Lyssavirus Epidemiology and Neuropathology Unit, WHO Collaborating Centre for Reference and Research on Rabies, Institut Pasteur, Université Paris Cité, Paris, France
| | - Livia M N Casseb
- Department of Arbovirology and Hemorrhagic Fevers, PAHO Collaborating Centre for Emerging and Reemerging Arboviruses and other Zoonotic Viruses, Evandro Chagas Institute, Ananindeua, Brazil
| | - Otavio Cabral-Marques
- Department of Pharmaceutical Sciences, Postgraduate Program of Physiopathology and Toxicology, University of São Paulo, São Paulo, Brazil
- Department of Immunology, University of São Paulo, São Paulo, Brazil
- Network of Immunity in Infection, Malignancy, Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), São Paulo, Brazil
- Department of Medicine, Division of Molecular Medicine, University of São Paulo School of Medicine, São Paulo, Brazil
- Laboratory of Medical Investigation 29, School of Medicine, University of São Paulo, São Paulo, Brazil
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5
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Podgoreanu P, Petre A, Tănasă RI, Dinu S, Oprea M, Marandiuc IM, Vlase E. Sequencing and Partial Molecular Characterization of BAB-TMP, the Babeș Strain of the Fixed Rabies Virus Adapted for Multiplication in Cell Lines. Viruses 2023; 15:1851. [PMID: 37766258 PMCID: PMC10536377 DOI: 10.3390/v15091851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 08/10/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
The rabies virus is a major zoonosis that causes severe nervous disease in humans, leading to paralysis and death. The world's second anti-rabies center was established in 1888 by Victor Babeș, in Bucharest, where an eponymous strain of rabies was isolated and used to develop a method for immunization. The Babeș strain of the rabies virus was used for over 100 years in Romania to produce a rabies vaccine for human use, based on animal nerve tissue, thus having a proven history of prophylactic use. The present study aimed to sequence the whole genome of the Babeș strain and to explore its genetic relationships with other vaccine strains as well as to characterize its relevant molecular traits. After being adapted for multiplication in cell lines and designated BAB-TMP, 99% of the viral genome was sequenced. The overall organization of the genome is similar to that of other rabies vaccine strains. Phylogenetic analysis indicated that the BAB-TMP strain is closely related to the Russian RV-97 vaccine strain, and both seem to have a common ancestor. The nucleoprotein gene of the investigated genome was the most conserved, and the glycoprotein showed several unique amino acid substitutions within the major antigenic sites and linear epitopes.
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Affiliation(s)
| | | | - Radu Iulian Tănasă
- Cantacuzino National Military Medical Institute for Research and Development, 050096 Bucharest, Romania; (P.P.); (A.P.)
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6
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Capin JBG, Sanque AJC, Eng MNJ, Lagare A, Sepulveda MCB, Murao LAE. Emerging Genomic Trends on Rabies Virus in Davao Region, Philippines, 2018-2021. Viruses 2023; 15:1658. [PMID: 37632001 PMCID: PMC10459148 DOI: 10.3390/v15081658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/10/2023] [Accepted: 07/19/2023] [Indexed: 08/27/2023] Open
Abstract
Rabies, caused by the rabies virus (RABV), remains a significant public health issue in the Philippines despite efforts to control it. To eliminate rabies by 2030, effective surveillance strategies are crucial. In this study, we examined RABV evolution and phylodynamics in the Davao Region using genome sequences from Davao City and nearby provinces. We adapted the RABV ARTIC Protocol for Oxford Nanopore High-Throughput Sequencing to optimize workflow efficiency under limited resources. Comparing new virus samples collected from June 2019 to June 2021 (n = 38) with baseline samples from June 2018 to May 2019 (n = 49), new sub-clades were observed in the phylogenetic tree, suggesting divergence from older variants that were previously undetected. Most of the new viruses belonged to the Asian SEA4_A1.1.1 lineage, but new (SEA4_B1 and SEA4_B1.1) and emerging (SEA4_B1.1_E1) lineages that have never been reported in the Philippines were also identified. The baseline study reported phylogeographic clustering of RABV isolates from the same areas. However, this pattern was disrupted in the current biosurveillance, with variants detected in areas outside the original cluster. Furthermore, our findings revealed significant transmission routes between Davao City and neighboring provinces, contrasting with the predominantly intra-city transmission observed in the baseline study. These results underscore the need for ongoing and timely genomic surveillance to monitor genetic diversity changes and the emergence of novel strains, as well as to track alterations in transmission pathways. Implementing cost-effective next-generation sequencing workflows will facilitate the integration of genomic surveillance into rabies control programs, particularly in resource-limited settings. Collaborations between different sectors can empower local laboratories and experts in genomic technologies and analysis.
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Affiliation(s)
- Jessel Babe G. Capin
- Department of Biological Science and Environmental Studies, College of Science and Mathematics, University of the Philippines Mindanao, Davao City 8000, Philippines; (J.B.G.C.); (A.J.C.S.)
| | - Angela Jahn C. Sanque
- Department of Biological Science and Environmental Studies, College of Science and Mathematics, University of the Philippines Mindanao, Davao City 8000, Philippines; (J.B.G.C.); (A.J.C.S.)
| | - Maria Noreen J. Eng
- Davao City Veterinarian’s Office, Davao City 8000, Philippines; (M.N.J.E.); (A.L.); (M.C.B.S.)
| | - Arlene Lagare
- Davao City Veterinarian’s Office, Davao City 8000, Philippines; (M.N.J.E.); (A.L.); (M.C.B.S.)
| | | | - Lyre Anni E. Murao
- Department of Biological Science and Environmental Studies, College of Science and Mathematics, University of the Philippines Mindanao, Davao City 8000, Philippines; (J.B.G.C.); (A.J.C.S.)
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7
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Salahuddin N, Gohar MA, Jamali S, Qureshi MA, Baig-Ansari N. Analysis of human rabies deaths reported at two hospitals in Karachi, Pakistan: a call to save lives by reforming rabies prevention facilities. Trans R Soc Trop Med Hyg 2023; 117:479-484. [PMID: 36857513 DOI: 10.1093/trstmh/trad004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/27/2023] [Accepted: 02/10/2023] [Indexed: 03/03/2023] Open
Abstract
BACKGROUND Rabies is endemic in low- and middle-income countries. It is caused mainly by the bite of a rabid dog and is fatal if not treated effectively and in a timely manner with quality post-exposure prophylaxis. Despite a profusion of private and public healthcare centres in Sindh province, most are ill-equipped to treat dog bites. METHODS We analysed 129 human deaths from rabies who presented at the emergency departments of two tertiary care hospitals in Karachi over 10 y. Demographic data, time, location of the bite and distance travelled to report symptoms of rabies were recorded. RESULTS Most victims were male, and children were more often affected; almost none had received post-exposure prophylaxis. A total of 12% of bites were on the face, head or neck. The mean incubation period was 56 d. Most (60%) of the rabies victims travelled long distances, hoping to receive treatment. CONCLUSIONS Rabies deaths were either due to a lack of awareness or the non-availability of rabies immunobiologicals within easy reach. Public health services must raise awareness, conduct surveillance and provide appropriately spaced centres for free treatment of dog bites. This lethal disease must be prevented at all costs.
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Affiliation(s)
- N Salahuddin
- Department of Infectious Diseases, Indus Hospital and Health Network, Karachi, Pakistan
| | - M A Gohar
- Rabies Prevention Clinic, Indus Hospital and Health Network, Karachi, Pakistan
| | - S Jamali
- Emergency Department, Jinnah Postgraduate Medical Center, Karachi, Pakistan
| | - M A Qureshi
- Research Assistant, Indus Hospital and Health Network, Karachi, Pakistan
| | - N Baig-Ansari
- Indus Hospital Research Center, Indus Hospital and Health Network, Karachi, Pakistan
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8
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Rupprecht CE, Mshelbwala PP, Reeves RG, Kuzmin IV. Rabies in a postpandemic world: resilient reservoirs, redoubtable riposte, recurrent roadblocks, and resolute recidivism. ANIMAL DISEASES 2023; 3:15. [PMID: 37252063 PMCID: PMC10195671 DOI: 10.1186/s44149-023-00078-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 04/02/2023] [Indexed: 05/31/2023] Open
Abstract
Rabies is an ancient disease. Two centuries since Pasteur, fundamental progress occurred in virology, vaccinology, and diagnostics-and an understanding of pathobiology and epizootiology of rabies in testament to One Health-before common terminological coinage. Prevention, control, selective elimination, and even the unthinkable-occasional treatment-of this zoonosis dawned by the twenty-first century. However, in contrast to smallpox and rinderpest, eradication is a wishful misnomer applied to rabies, particularly post-COVID-19 pandemic. Reasons are minion. Polyhostality encompasses bats and mesocarnivores, but other mammals represent a diverse spectrum of potential hosts. While rabies virus is the classical member of the genus, other species of lyssaviruses also cause the disease. Some reservoirs remain cryptic. Although global, this viral encephalitis is untreatable and often ignored. As with other neglected diseases, laboratory-based surveillance falls short of the notifiable ideal, especially in lower- and middle-income countries. Calculation of actual burden defaults to a flux within broad health economic models. Competing priorities, lack of defined, long-term international donors, and shrinking local champions challenge human prophylaxis and mass dog vaccination toward targets of 2030 for even canine rabies impacts. For prevention, all licensed vaccines are delivered to the individual, whether parenteral or oral-essentially 'one and done'. Exploiting mammalian social behaviors, future 'spreadable vaccines' might increase the proportion of immunized hosts per unit effort. However, the release of replication-competent, genetically modified organisms selectively engineered to spread intentionally throughout a population raises significant biological, ethical, and regulatory issues in need of broader, transdisciplinary discourse. How this rather curious idea will evolve toward actual unconventional prevention, control, or elimination in the near term remains debatable. In the interim, more precise terminology and realistic expectations serve as the norm for diverse, collective constituents to maintain progress in the field.
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Affiliation(s)
- Charles E. Rupprecht
- College of Forestry, Wildlife & Environment, College of Veterinary Medicine, Auburn University, Auburn, AL 36849 USA
| | - Philip P. Mshelbwala
- School of Veterinary Science, University of Queensland, Gatton, Australia
- Department of Veterinary Medicine, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | - R. Guy Reeves
- Max Planck Institut Für Evolutionsbiologie, 24306 Plön, Germany
| | - Ivan V. Kuzmin
- Department of Pathology, University of Texas Medical Branch, Galveston, TX 77555 USA
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Prakash Rao VC, Ramakrishnaiah S, Isloor S, Doddamane R, Lakshman D, Maralavadi MSSR, Bhat A, Chandrashekar B, Natesan K, Kondabattula G, Hegde NR. Assessment of Immune Responses to Rabies Vaccination in Free-Ranging Dogs in Bengaluru, India. Vaccines (Basel) 2023; 11:vaccines11050888. [PMID: 37242992 DOI: 10.3390/vaccines11050888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 04/03/2023] [Accepted: 04/06/2023] [Indexed: 05/28/2023] Open
Abstract
Rabies is a fatal encephalomyelitis mainly transmitted to humans and other animals by rabid dog bites. Hence, vaccination programs are being instituted for the control of rabies in dogs. Though stray dogs have been vaccinated for years under various programs initiated for control of the disease, the effectiveness of these programs can be ascertained only by assessing the immunity of these dogs. With this in view, a study was conducted to assess the effectiveness of the ongoing mass dog vaccination (MDV) program by the Bengaluru City Municipal Corporation, Bengaluru, India. Whole blood and serum samples (n = 260) from vaccinated stray dogs in 26 wards of 8 corporation zones were tested by rapid fluorescent focus inhibition test (RFFIT) as well as an in-house quantitative indirect enzyme-linked immunosorbent assay (iELISA) for a humoral response and by interferon-gamma (IFN-γ) ELISA for a cellular response. As determined by the cut-off value of 0.5 IU/mL of serum, 71% and 87% of the samples from vaccinated dogs revealed adequate levels of antibodies presumed to confer protection by RFFIT and iELISA, respectively. The sensitivity and specificity of the iELISA were 100% and 63.3%, respectively. The IFN-γ ELISA revealed adequate cellular response in 50% of the samples. The quantitative iELISA was found to be useful in large-scale seromonitoring of MDV programs to aid in the elimination of dog-mediated rabies.
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Affiliation(s)
- Vinay Chavan Prakash Rao
- KVAFSU-CVA Rabies Diagnostic Laboratory, WOAH Reference Laboratory for Rabies, Department of Veterinary Microbiology, Veterinary College, KarnatakaVeterinary, Animal and Fisheries Sciences University (KVAFSU), Bengaluru 560024, India
| | - Sharada Ramakrishnaiah
- KVAFSU-CVA Rabies Diagnostic Laboratory, WOAH Reference Laboratory for Rabies, Department of Veterinary Microbiology, Veterinary College, KarnatakaVeterinary, Animal and Fisheries Sciences University (KVAFSU), Bengaluru 560024, India
| | - Shrikrishna Isloor
- KVAFSU-CVA Rabies Diagnostic Laboratory, WOAH Reference Laboratory for Rabies, Department of Veterinary Microbiology, Veterinary College, KarnatakaVeterinary, Animal and Fisheries Sciences University (KVAFSU), Bengaluru 560024, India
| | - Rathnamma Doddamane
- KVAFSU-CVA Rabies Diagnostic Laboratory, WOAH Reference Laboratory for Rabies, Department of Veterinary Microbiology, Veterinary College, KarnatakaVeterinary, Animal and Fisheries Sciences University (KVAFSU), Bengaluru 560024, India
| | - Dilip Lakshman
- KVAFSU-CVA Rabies Diagnostic Laboratory, WOAH Reference Laboratory for Rabies, Department of Veterinary Microbiology, Veterinary College, KarnatakaVeterinary, Animal and Fisheries Sciences University (KVAFSU), Bengaluru 560024, India
| | | | - Avinash Bhat
- Trouw Nutrition India Pvt. Ltd., Hyderabad 500032, India
| | | | - Krithiga Natesan
- KVAFSU-CVA Rabies Diagnostic Laboratory, WOAH Reference Laboratory for Rabies, Department of Veterinary Microbiology, Veterinary College, KarnatakaVeterinary, Animal and Fisheries Sciences University (KVAFSU), Bengaluru 560024, India
| | | | - Nagendra R Hegde
- National Institute of Animal Biotechnology, Hyderabad 500032, India
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10
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Shen T, Welburn SC, Sun L, Yang GJ. Progress towards dog-mediated rabies elimination in PR China: a scoping review. Infect Dis Poverty 2023; 12:30. [PMID: 37024944 PMCID: PMC10077633 DOI: 10.1186/s40249-023-01082-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 03/14/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Rabies continues to be a serious threat to global public health endangering people's health and public health safety. In the People's Republic of China, multi-sectoral and comprehensive prevention and control strategies have aimed to extensively curb human rabies transmission. Here, we examine the current state of rabies infection in China, explore strategic interventions put in place in response to WHO's ambition of "Zero rabies deaths by 2030" and critically assess the constraints and feasibility of dog-mediated rabies elimination in China. METHODS This study analyzed and evaluated the process towards dog-mediated rabies elimination in China from five perspectives: namely, human, dog, policy, challenge, and prospects. Evidence-based data on progress of dog-mediated rabies elimination in China was derived from a number of sources; a literature search was undertaken using PubMed, Web of Science and CNKI databases, distribution data for human rabies cases as derived from the Data-center of the China Public Health Science and policy and document data were obtained from official websites of the relevant China ministries and commissions. RESULTS The incidence of human rabies cases in China have shown a downward trend year-on-year since 2007. Implementation of a government-led, multi-sectoral "One Health" approach to combating rabies has driven down the total number of rabies deaths nationwide to around 200 in 2020. The number of provincial-level administrative divisions (PLADs) reporting human cases of rabies has also decreased to 21 in 2020, 13 of which reported less than 10 cases. Furthermore, the number of outpatient visits seeking rabies post-exposure prophylaxis has risen dramatically over the past two decades, with demand being 15 times higher than it was initially. There remain however, significant gaps in rabies elimination outcomes across the different regions of China. To date the target of achieving a canine rabies vaccination rate of > 75% has not been met. The challenges of rabies immunization of dogs and dog management in underdeveloped cities and rural areas need to be addressed together with more effective animal surveillance and rabies risk from and too wildlife and livestock. CONCLUSIONS The Chinese government-led, multi-sectoral "One Health" approach to combating rabies and has made significant progress over the past decade. Development and adoption of more cost-effective One Health strategies can achieve more nationally beneficial rabies elimination outcomes. The ambitious target of "Zero rabies deaths by 2030" can be met through establishment of long-lasting herd immunity in dogs by means of dog mass vaccination campaigns, dog population management, epidemiological surveillance and the application of large-scale oral rabies vaccine to eliminate rabies in wild animals coupled with deployment of cost-effective human post-exposure prophylaxis, and community education.
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Affiliation(s)
- Tianren Shen
- Zhejiang University-University of Edinburgh Joint Institute, Zhejiang University, International Campus, 718 East Haizhou Road, Haining, 314400, People's Republic of China
- Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, 1 George Square, Edinburgh, EH8 9JZ, Scotland, UK
| | - Susan Christina Welburn
- Zhejiang University-University of Edinburgh Joint Institute, Zhejiang University, International Campus, 718 East Haizhou Road, Haining, 314400, People's Republic of China
- Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, 1 George Square, Edinburgh, EH8 9JZ, Scotland, UK
| | - Long Sun
- Department of Infectious Diseases, The First Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, People's Republic of China
| | - Guo-Jing Yang
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, The School of Tropical Medicine, The First Affiliated Hospital, Hainan Medical University, Haikou, 571199, Hainan, People's Republic of China.
- Infection Medicine, Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine and Veterinary Medicine, The University of Edinburgh, 1 George Square, Edinburgh, EH8 9JZ, Scotland, UK.
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11
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Rathnadiwakara H, Gunatilake M, Cliquet F, Wasniewski M, Thammitiyagodage M, Karunakaran R, Thibault JC, Ijas M. Detection of immunity in sheep following anti-rabies vaccination. Clin Exp Vaccine Res 2023; 12:97-106. [PMID: 37214148 PMCID: PMC10193110 DOI: 10.7774/cevr.2023.12.2.97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/12/2023] [Accepted: 01/30/2023] [Indexed: 05/24/2023] Open
Abstract
Purpose Rabies is a fatal but preventable disease with proper pre-exposure anti-rabies vaccination (ARV). Dogs, as household pets and strays, are the reservoir and vector of the disease, and dog bites have been associated with human rabies cases in Sri Lanka over the past few years. However, other susceptible species having frequent contact with humans may be a source of infection. One such species is sheep and immunity following ARV has never been tested in sheep reared in Sri Lanka. Materials and Methods We have tested serum samples from sheep reared in the Animal Centre, Medical Research Institute of Sri Lanka for the presence of anti-rabies antibodies following ARV. Sheep serum samples were tested with Bio-Pro Rabies enzyme-linked immunosorbent assay (ELISA) antibody kits used for the first time in Sri Lanka and our results were verified by a seroneutralization method on cells (fluorescent antibody virus neutralization, FAVN test) currently recommended by World Organization for Animal Health and World Health Organization. Results Sheep received annual ARV and maintained high neutralizing antibody titers in their serum. No maternal antibodies were detected in lamb around 6 months of age. Agreement between the ELISA and FAVN test, i.e., coefficient concordance was 83.87%. Conclusion Annual vaccination in sheep has an effect on maintaining adequate protection against rabies by measurements of anti-rabies antibody response. Lambs need to be vaccinated earlier than 6 months of age to achieve protective levels of neutralizing antibodies in their serum. Introducing this ELISA in Sri Lanka will be a good opportunity to determine the level of anti-rabies antibodies in animal serum samples.
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Affiliation(s)
| | - Mangala Gunatilake
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Florence Cliquet
- EU/WOAH/WHO Reference Laboratory for Rabies, OMCL for rabies vaccines, French Agency for Food, Environmental and Occupational Health Safety, Nancy, France
| | - Marine Wasniewski
- EU/WOAH/WHO Reference Laboratory for Rabies, OMCL for rabies vaccines, French Agency for Food, Environmental and Occupational Health Safety, Nancy, France
| | | | | | | | - Mohamed Ijas
- Municipal Veterinary Department, Colombo Municipal Council, Colombo, Sri Lanka
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12
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Miao L, Wang X, Zhao C, Li Y, He W, Li Y, Zhang J, Xu X, Feng X. A New Antibody Binding Test for Potency Assessment of the Human Rabies Vaccine. Viral Immunol 2023; 36:122-126. [PMID: 36827324 DOI: 10.1089/vim.2022.0161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
This study established a new protocol of the antibody binding test to evaluate the potency of the rabies vaccine containing the final bulk and the product. The principle of this experiment is to combine rabies vaccine with quantitative anti-rabies virus neutralizing antibody. After combination, the remaining rabies vaccine is combined with the quantitative fluorescent labeled rabies virus. After this, observe the remaining fluorescent labeled rabies virus, calculate the fluorescence area with fluorescence observation equipment, then calculate the potency of rabies vaccine by Reed and Muench method. The test results of many batches of rabies vaccine final bulk and finished products showed that the potency detected by this method was consistent with that of National Institute of Health method.
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Affiliation(s)
- Li Miao
- Department of Vaccine Research, Changchun Zhuoyi Biological Co., Ltd., Changchun, China
| | - Xiaoli Wang
- Department of Vaccine Research, Changchun Zhuoyi Biological Co., Ltd., Changchun, China
| | - Chengshuang Zhao
- Department of Vaccine Research, Changchun Zhuoyi Biological Co., Ltd., Changchun, China
| | - Yanyu Li
- Department of Vaccine Research, Changchun Zhuoyi Biological Co., Ltd., Changchun, China
| | - Wei He
- Department of Vaccine Research, Changchun Zhuoyi Biological Co., Ltd., Changchun, China
| | - Yue Li
- Department of Vaccine Research, Changchun Zhuoyi Biological Co., Ltd., Changchun, China
| | - Jingzhi Zhang
- Department of Vaccine Research, Changchun Zhuoyi Biological Co., Ltd., Changchun, China
| | - Xiuzhi Xu
- Department of Vaccine Research, Changchun Zhuoyi Biological Co., Ltd., Changchun, China
| | - Xingfu Feng
- Department of Vaccine Research, Changchun Zhuoyi Biological Co., Ltd., Changchun, China
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13
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Shi C, Tian L, Zheng W, Zhu Y, Sun P, Liu L, Liu W, Song Y, Xia X, Xue X, Zheng X. Recombinant adeno-associated virus serotype 9 AAV-RABVG expressing a Rabies Virus G protein confers long-lasting immune responses in mice and non-human primates. Emerg Microbes Infect 2022; 11:1439-1451. [PMID: 35579916 PMCID: PMC9154782 DOI: 10.1080/22221751.2022.2078226] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Three or four intramuscular doses of the inactivated human rabies virus vaccines are needed for pre- or post-exposure prophylaxis in humans. This procedure has made a great contribution to prevent human rabies deaths, which bring huge economic burdens in developing countries. Herein, a recombinant adeno-associated virus serotype 9, AAV9-RABVG, harbouring a RABV G gene, was generated to serve as a single dose rabies vaccine candidate. The RABV G protein was stably expressed in the 293T cells infected with AAV9-RABVG. A single dose of 2 × 1011 v.p. of AAV9-RABVG induced robust and long-term positive seroconversions in BALB/c mice with a 100% survival from a lethal RABV challenge. In Cynomolgus Macaques vaccinated with a single dose of 1 × 1013 v.p. of AAV9-RABVG, the titres of rabies VNAs increased remarkably from 2 weeks after immunity, and maintained over 31.525 IU/ml at 52 weeks. More DCs were activated significantly for efficient antigen presentations of RABV G protein, and more B cells were activated to be responsible for antibody responses. Significantly more RABV G specific IFN-γ-secreting CD4+ and CD8+ T cells, and IL-4-secreting CD4+ T cells were activated, and significantly higher levels of IL-2, IFN-γ, IL-4, and IL-10 were secreted to aid immune responses. Overall, the AAV9-RABVG was a single dose rabies vaccine candidate with great promising by inducing robust, long-term humoral responses and both Th1 and Th2 cell-mediated immune responses in mice and non-human primates.
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Affiliation(s)
- Chenjuan Shi
- Department of Virology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China
| | - Li Tian
- Department of Virology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China
| | - Wenwen Zheng
- Department of Virology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China
| | - Yelei Zhu
- Department of Virology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China.,Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, People's Republic of China
| | - Peilu Sun
- Institute of Materia Medical, Shandong Academy of Medical Sciences, Jinan, People's Republic of China
| | - Lele Liu
- Department of Virology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China
| | - Wenkai Liu
- Department of Virology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China
| | - Yanyan Song
- Department of Virology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China
| | - Xianzhu Xia
- Institute of Military Veterinary Medicine, Academy of Military Medical Science, Changchun, People's Republic of China
| | - Xianghong Xue
- Divisions of Infectious Diseases of Special Animal, Institute of Special Animal and Plant Sciences, Chinese Academy of Agricultural Sciences, Changchun, People's Republic of China
| | - Xuexing Zheng
- Department of Virology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China
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14
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Nadal D, Abela-Ridder B, Beeching S, Cleaveland S, Cronin K, Steenson R, Hampson K. The Impact of the First Year of the COVID-19 Pandemic on Canine Rabies Control Efforts: A Mixed-Methods Study of Observations About the Present and Lessons for the Future. FRONTIERS IN TROPICAL DISEASES 2022. [DOI: 10.3389/fitd.2022.866811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Achieving zero human deaths from dog-mediated rabies has been set as a global target for 2030. However, the COVID-19 pandemic has disrupted essential health services across the world, with disproportionate impacts on Neglected Tropical Diseases. Through a mixed-method study using stakeholder questionnaires and in-depth interviews, we examined the scale and nature of disruption from the first year of the pandemic to rabies control programs, and reflected on lessons for the future. Study participants included practitioners and policymakers working in government, academia, international organizations, and the pharmaceutical industry across 48 countries, mainly in Africa and Asia. Mass dog vaccination, essential to rabies control, was most heavily impacted and in 2020, was carried out as planned in just 5% of surveyed countries. Access to post-exposure prophylaxis (PEP) also decreased due to fear of COVID-19 infection and difficulties in reaching health care centers. Dog vaccination and PEP delivery suffered from disruptions to the importation and distribution of vaccines. School closures affected rabies awareness activities and, when public events moved online, they could not reach the most disadvantaged groups. Surveillance, already weak, was severely disrupted by movement restrictions which, together with reduced demand for PEP, exacerbated under-reporting. Participants reported growing complaints around free-roaming dogs, with numbers likely to have increased in some settings. In some countries, dog rabies outbreaks and human rabies cases were already ascribed to the pandemic, but further impacts are likely still to be realized. Meanwhile, decreased demand for PEP from COVID-19 constraints could lead to reduced procurement in future. In the wake of post-COVID-19 demands on health services, there is an opportunity for veterinary services to show leadership in progressing the Zero by 30 agenda, particularly in scaling up mass dog vaccination within and across countries, as well as potential to make better use of community-based vaccinators. Countries must further secure stable procurement of dog and human vaccines, classifying them as essential goods prioritized for import and where needed, through sharing of stocks. Dedicated telemedicine services also show promise, for example through fostering participatory disease surveillance, including Integrated Bite Case Management, and delivering up-to-date instructions on the closest sources of PEP.
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15
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Haradanhalli RS, Fotedar N, Kumari N, Narayana DHA. Safety and clinical efficacy of human rabies immunoglobulin in post exposure prophylaxis for category III animal exposures. Hum Vaccin Immunother 2022; 18:2081024. [PMID: 35687876 PMCID: PMC9621008 DOI: 10.1080/21645515.2022.2081024] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The human rabies immunoglobulin (HRIG) is a life-saving immune biological essential for all category III animal exposures. It provides neutralizing antibodies at the site of exposure until the body can produce vaccine-mediated antibodies. We conducted this study to determine the safety and clinical efficacy of an HRIG being used presently for post-exposure prophylaxis (PEP) and to strengthen the existing evidence for its further usage. We conducted a prospective cohort study in 123 subjects with category III animal exposures at the KIMS Hospital and Research Center, Bangalore, India. Post-exposure prophylaxis (PEP) with wound toilet, a single application of HRIG, and a full course of anti-rabies vaccination were provided to all the study subjects. The volume of HRIG was calculated according to the body weight, and all the wounds were infiltrated as was anatomically feasible. All the study subjects were followed up for immediate and delayed adverse events (AE), both local and systemic. Subsequently, all the subjects were followed up for 6 months to demonstrate the clinical efficacy of PEP. The incidence of AEs was 11.4% including local pain, erythema, itching, headache, body ache, fever, and malaise. All AEs were mild and subsided without any complications. All the study subjects were healthy and alive after 6 months following the administration of HRIG, along with a full course of anti-rabies vaccine. Our study provides evidence of safety and clinical efficacy of HRIG for category III animal exposures and supports its continued usage.
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Affiliation(s)
- Ravish S Haradanhalli
- Department of Community Medicine, Kempegowda Institute of Medical Sciences, Bangalore, India
| | - Nidhi Fotedar
- Department of Community Medicine, Kempegowda Institute of Medical Sciences, Bangalore, India
| | - Nitu Kumari
- Department of Community Medicine, Bangalore Medical College & Research Institute, Bangalore, India
| | - D H Ashwath Narayana
- Department of Community Medicine, Kempegowda Institute of Medical Sciences, Bangalore, India
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16
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Knobel DL, Jackson AC, Bingham J, Ertl HCJ, Gibson AD, Hughes D, Joubert K, Mani RS, Mohr BJ, Moore SM, Rivett-Carnac H, Tordo N, Yeates JW, Zambelli AB, Rupprecht CE. A One Medicine Mission for an Effective Rabies Therapy. Front Vet Sci 2022; 9:867382. [PMID: 35372555 PMCID: PMC8967983 DOI: 10.3389/fvets.2022.867382] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
Despite the disease's long history, little progress has been made toward a treatment for rabies. The prognosis for patient recovery remains dire. For any prospect of survival, patients require aggressive critical care, which physicians in rabies endemic areas may be reluctant or unable to provide given the cost, clinical expertise required, and uncertain outcome. Systematic clinical research into combination therapies is further hampered by sporadic occurrence of cases. In this Perspective, we examine the case for a One Medicine approach to accelerate development of an effective therapy for rabies through the veterinary care and investigational treatment of naturally infected dogs in appropriate circumstances. We review the pathogenesis of rabies virus in humans and dogs, including recent advances in our understanding of the molecular basis for the severe neurological dysfunction. We propose that four categories of disease process need to be managed in patients: viral propagation, neuronal degeneration, inflammation and systemic compromise. Compassionate critical care and investigational treatment of naturally infected dogs receiving supportive therapy that mimics the human clinical scenario could increase opportunities to study combination therapies that address these processes, and to identify biomarkers for prognosis and therapeutic response. We discuss the safety and ethics of this approach, and introduce the Canine Rabies Treatment Initiative, a non-profit organization with the mission to apply a One Medicine approach to the investigation of diagnostic, prognostic, and therapeutic options for rabies in naturally infected dogs, to accelerate transformation of rabies into a treatable disease for all patients.
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Affiliation(s)
- Darryn L. Knobel
- Department of Biomedical Sciences, Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
- Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
- Canine Rabies Treatment Initiative, Salt Rock, South Africa
| | - Alan C. Jackson
- Department of Medicine, Northern Consultation Centre, Thompson General Hospital, Thompson, MB, Canada
- Department of Medicine, Lake of the Woods District Hospital, Kenora, ON, Canada
| | - John Bingham
- Commonwealth Scientific and Industrial Research Organisation (CSIRO) Australian Animal Health Laboratory at the Australian Centre for Disease Preparedness, Geelong, VIC, Australia
| | | | - Andrew D. Gibson
- Division of Genetics and Genomics, Easter Bush Veterinary Centre, The Roslin Institute and the Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Roslin, United Kingdom
| | - Daniela Hughes
- Canine Rabies Treatment Initiative, Salt Rock, South Africa
| | - Kenneth Joubert
- Veterinary Anaesthesia, Analgesia and Critical Care Services, Lonehill, South Africa
| | - Reeta S. Mani
- Department of Neurovirology, WHO Collaborating Centre for Reference and Research in Rabies, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Bert J. Mohr
- Canine Rabies Treatment Initiative, Salt Rock, South Africa
- Centre for Animal Research, Faculty of Health Sciences, University of Cape Town, Observatory, South Africa
| | - Susan M. Moore
- Veterinary Medical Diagnostic Laboratory, University of Missouri, Columbia, MO, United States
| | | | - Noël Tordo
- Institut Pasteur de Guinée, Conakry, Guinea
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17
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van Heuvel Y, Schatz S, Rosengarten JF, Stitz J. Infectious RNA: Human Immunodeficiency Virus (HIV) Biology, Therapeutic Intervention, and the Quest for a Vaccine. Toxins (Basel) 2022; 14:toxins14020138. [PMID: 35202165 PMCID: PMC8876946 DOI: 10.3390/toxins14020138] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/02/2022] [Accepted: 02/09/2022] [Indexed: 11/16/2022] Open
Abstract
Different mechanisms mediate the toxicity of RNA. Genomic retroviral mRNA hijacks infected host cell factors to enable virus replication. The viral genomic RNA of the human immunodeficiency virus (HIV) encompasses nine genes encoding in less than 10 kb all proteins needed for replication in susceptible host cells. To do so, the genomic RNA undergoes complex alternative splicing to facilitate the synthesis of the structural, accessory, and regulatory proteins. However, HIV strongly relies on the host cell machinery recruiting cellular factors to complete its replication cycle. Antiretroviral therapy (ART) targets different steps in the cycle, preventing disease progression to the acquired immunodeficiency syndrome (AIDS). The comprehension of the host immune system interaction with the virus has fostered the development of a variety of vaccine platforms. Despite encouraging provisional results in vaccine trials, no effective vaccine has been developed, yet. However, novel promising vaccine platforms are currently under investigation.
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Affiliation(s)
- Yasemin van Heuvel
- Research Group Pharmaceutical Biotechnology, Faculty of Applied Natural Sciences, TH Köln—University of Applied Sciences, Chempark Leverkusen, Kaiser-Wilhelm-Allee, 51368 Leverkusen, Germany; (Y.v.H.); (S.S.); (J.F.R.)
- Institute of Technical Chemistry, Leibniz University Hannover, Callinstraße 3-9, 30167 Hannover, Germany
| | - Stefanie Schatz
- Research Group Pharmaceutical Biotechnology, Faculty of Applied Natural Sciences, TH Köln—University of Applied Sciences, Chempark Leverkusen, Kaiser-Wilhelm-Allee, 51368 Leverkusen, Germany; (Y.v.H.); (S.S.); (J.F.R.)
- Institute of Technical Chemistry, Leibniz University Hannover, Callinstraße 3-9, 30167 Hannover, Germany
| | - Jamila Franca Rosengarten
- Research Group Pharmaceutical Biotechnology, Faculty of Applied Natural Sciences, TH Köln—University of Applied Sciences, Chempark Leverkusen, Kaiser-Wilhelm-Allee, 51368 Leverkusen, Germany; (Y.v.H.); (S.S.); (J.F.R.)
- Institute of Technical Chemistry, Leibniz University Hannover, Callinstraße 3-9, 30167 Hannover, Germany
| | - Jörn Stitz
- Research Group Pharmaceutical Biotechnology, Faculty of Applied Natural Sciences, TH Köln—University of Applied Sciences, Chempark Leverkusen, Kaiser-Wilhelm-Allee, 51368 Leverkusen, Germany; (Y.v.H.); (S.S.); (J.F.R.)
- Correspondence:
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Kamble B, Jethani S, Singh S, Anshumali, Dobhal V, Singh S, Jha D, Ahlawat P. Epidemiological pattern and trend analysis of animal bite cases of anti-rabies clinic of tertiary care hospital of Delhi. J Family Med Prim Care 2022; 11:728-732. [PMID: 35360778 PMCID: PMC8963589 DOI: 10.4103/jfmpc.jfmpc_1395_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 12/08/2021] [Accepted: 12/16/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Animal bites to humans are a public health problem. Rabies is caused by rhabdovirus which is present in the saliva of rabid animals like dogs, cats, monkeys, and wild animals like fox and jackals. Objective: To find the epidemiological pattern and trend analysis of animal bite cases registered in Anti-rabies clinic of tertiary care hospital of Delhi. Materials and Methods: A retrospective cross-sectional study was planned in Anti-rabies clinic of Hindu Rao Hospital, Delhi, and data from January 2010 to December 2018 was taken. Data were analyzed by SPSS software version 21.0. Results: After interpretation of data from 2010 to 2018, it was found that maximum number of animal bite cases belonged to category 3 (91.0%) and majority (93.6%) were due to dog bite. On analysis of year and season wise trend, it was found that the frequency of cases showed a rising trend from the year 2010, with highest number of cases in the year 2014, while animal bite cases were maximum with arrival of spring season (month of April). Conclusion: This study concludes that animal bite cases are rising over the years and dog bites are most common animal bite cases in Delhi. Most of the animal bite cases occurred during spring season followed by autumn season of the year. So, there is dire need of strengthening the preventive measures for controlling animal bites in the study area.
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AI and Immunoinformatics. Artif Intell Med 2022. [DOI: 10.1007/978-3-030-64573-1_113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Haradanhalli RS, Kumari N, Sudarshan MK, Narayana DHA, Prashanth RM, Surendran J. Defining the volume of rabies immunoglobulins/ rabies monoclonal antibodies requirement for wound infiltration of category III animal exposures - an exploratory study. Hum Vaccin Immunother 2021; 17:5355-5360. [PMID: 35061550 PMCID: PMC8903922 DOI: 10.1080/21645515.2021.2013079] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
WHO recommends infiltration of rabies immunoglobulins/rabies monoclonal antibodies as anatomically possible, into or close to all category III animal bite wound(s)/exposures for post exposure prophylaxis. The volume required for wound infiltration depending upon the site/size/severity of wound is yet to be defined for guiding the treating physicians. This study aimed to determine the volume of rabies immunoglobulin/rabies monoclonal antibody required for wound infiltration depending upon the site, size, and severity. A prospective cohort study was conducted including category III animal exposures at the anti-rabies clinic, KIMS hospital and Research Center, Bangalore, India. The volume of rabies immunoglobulins/rabies monoclonal antibodies required for wound infiltration, depending on site, severity, and size was determined. All the subjects were followed for 6 months to demonstrate the safety and clinical efficacy of post exposure prophylaxis. The present study included 717 subjects having 1428 bite wounds. There was a significant difference in the median volume required for wound infiltration based on site, size, and severity of bite wounds. However, on pairwise comparison; the median volume among all the pairs for only wound size was found to be statistically significant. Supportively, a strong positive correlation was seen with the size of wound and volume infiltrated. The volume of rabies immunoglobulin/rabies monoclonal antibodies required for wound infiltration shall be determined according to size of wounds, i.e. 1 ml for <1 cm wound, 3 ml for 1-5 cm wound, and 5 ml for >5 cm wound.
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Affiliation(s)
- Ravish S. Haradanhalli
- Department of Community Medicine, Kempegowda Institute of Medical Sciences, Bangalore, India
| | - Nitu Kumari
- Department of Community Medicine, Bangalore Medical College & Research Institute, Bangalore, India,CONTACT Nitu Kumari Bangalore Medical College & Research Institute, Bangalore, Karnataka, India
| | - Mysore K. Sudarshan
- Department of Community Medicine, Kempegowda Institute of Medical Sciences, Bangalore, India
| | - D. H. Ashwath Narayana
- Department of Community Medicine, Kempegowda Institute of Medical Sciences, Bangalore, India
| | - Ramya M. Prashanth
- Department of Community Medicine, Sri Siddhartha Institute of Medical Sciences & Research Centre, Nelamangala, India
| | - Jithin Surendran
- Department of Community Medicine, Kempegowda Institute of Medical Sciences, Bangalore, India
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21
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Quinlan LM. The Puppy in the Pit: Osteobiography of an Eighteenth-Century Dog at the Three Cranes Tavern, Massachusetts. INTERNATIONAL JOURNAL OF HISTORICAL ARCHAEOLOGY 2021; 27:363-392. [PMID: 34785878 PMCID: PMC8581961 DOI: 10.1007/s10761-021-00636-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 10/07/2021] [Indexed: 05/29/2023]
Abstract
Boston's "Big Dig" construction project resulted in the excavation of multiple archaeological sites dating from the seventeenth to nineteenth centuries, including the Great House/Three Cranes Tavern in Charlestown, Massachusetts (USA). An otherwise unremarkable pit below the tavern foundation contained bones originally identified as a cat skeleton, which has subsequently been reidentified as a dog. This paper discusses site context, osteological evidence for the dog's reclassification, and the shifts in cultural meaning this may indicate. Employing an osteobiographical approach, it draws together points of connection between the modern skeletal assessment, a series of 1980s excavations, and the motivations of eighteenth-century tavern inhabitants.
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Affiliation(s)
- Liz M. Quinlan
- Archaeology, University of York, Environment Building, Wentworth Way, York, YO10 5NG UK
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22
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H S R, Khobragade A, Satapathy D, Gupta M, Kumar S, Bhomia V, V R, Desai M, Agrawal AD. Safety and Immunogenicity of a novel three-dose recombinant nanoparticle rabies G protein vaccine administered as simulated post exposure immunization: A randomized, comparator controlled, multicenter, phase III clinical study. Hum Vaccin Immunother 2021; 17:4239-4245. [PMID: 34499574 PMCID: PMC8828110 DOI: 10.1080/21645515.2021.1957413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/12/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Rabies vaccines are lifesaving in human post animal exposure. However, the compliance to the complete course of vaccine is found to be only 60%. Hence, there is a need for safe and immunogenic, shorter course vaccine that can enhance the compliance and effectively prevent the disease. OBJECTIVES To establish a noninferiority of a novel three-dose recombinant rabies G protein vaccine to be administered as simulated postexposure prophylaxis when compared to five-dose WHO prequalified vaccine for better safety and immunogenicity. METHODS A multi-centric, open label, assessor blind, center-specific block randomized, parallel design, phase III clinical study was conducted among 800 subjects. The eligible subjects were randomized in 2:1 ratio for recombinant rabies G protein vaccine and the reference vaccine. Subjects in recombinant rabies G protein vaccine arm received three doses of vaccine on days 0, 3, and 7, while subjects in reference vaccine arm received five doses of WHO prequalified vaccine on days 0, 3, 7, 14, and 28. RESULTS The socio-demographic characteristics of the two arms were comparable. About 9.9% subjects in recombinant rabies G protein vaccine arm and 17.2% subjects in reference arm reported adverse events. The sero-protection on day 14 was found to be 99.24% and 97.72% in recombinant rabies G protein vaccine arm and reference vaccine arm respectively and the difference was statistically nonsignificant. CONCLUSION The novel three-dose recombinant rabies G protein vaccine administered as simulated postexposure prophylaxis was noninferior to five dose WHO prequalified vaccine in terms of safety and immunogenicity.
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Affiliation(s)
- Ravish H S
- Department of Community Medicine, Kempegowda Institute of Medical Science, Bengaluru, India
| | | | - Durga Satapathy
- Department of Community Medicine, VSS Institute of Medical Science and Research, Sambalpur, India
| | - Monica Gupta
- Consultant Physician, Samvedna Hospital, Varanasi, India
| | - Surendra Kumar
- Department of Community Medicine, S P Medical College and A.G Hospitals, Bikaner, India
| | - Vinay Bhomia
- Consultant Physician, Sanjivani Superspeciality Hospital Pvt. Ltd, Ahmedabad, India
| | - Ramasubramanian V
- Senior Consultant, Infectious Diseases and Tropical Medicine, Apollo Hospital, Chennai, India
| | - Maharshi Desai
- Senior Consultant, Infectious Diseases, Apollo Hospitals International Ltd, Gandhinagar, India
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23
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Rabies in a Sand Cat (Felis margarita) in Saudi Arabia: One Health Implications. J Wildl Dis 2021; 57:977-979. [PMID: 34320648 DOI: 10.7589/jwd-d-20-00233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 04/15/2021] [Indexed: 11/20/2022]
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24
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Piewbang C, Wardhani SW, Chaiyasak S, Yostawonkul J, Kasantikul T, Techangamsuwan S. Japanese encephalitis virus infection in meerkats (Suricata suricatta). Zoonoses Public Health 2021; 69:55-60. [PMID: 34254456 DOI: 10.1111/zph.12882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/14/2021] [Accepted: 07/03/2021] [Indexed: 11/30/2022]
Abstract
Japanese encephalitis virus (JEV) infection has been recognized as a serious disease in humans. Wildlife animal infections due to JEV have not been well described. This study identified JEV infection in two deceased meerkats in Thailand, with clinical signs of neurological disease. Histopathology of brains revealed severe lymphoplasmacytic necrotizing meningoencephalitis, while similar inflammation was observed in the lung and liver. Partial JEV sequences were identified from the formalin-fixed paraffin-embedded-derived brain sections of two meerkats and were found to be genetically similar to a JEV strain detected in China but not from a local strain. Using immunohistochemistry, the virus was identified in neurons and glial cells, and also found in bronchial glands, Kupffer's cells in liver, lymphocytes in the spleen and pancreatic acini, which suggests extraneural infection. Transmission electron microscopy confirmed the presence of spheroid viral particles in the lungs. These findings may suggest that infection of extraneural organs in meerkats is similar to that described in JEV-infected humans. In conclusion, this study identified the first JEV infection in meerkats as an interesting case study. The JEV should be considered as an important differential diagnosis in meerkats with encephalitis. Further surveillance on JEV infection in meerkats and other wildlife species in a large cohort is needed in the future study.
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Affiliation(s)
- Chutchai Piewbang
- Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand.,Animal Virome and Diagnostic Development Research Group, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | - Sabrina Wahyu Wardhani
- Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand.,Animal Virome and Diagnostic Development Research Group, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
| | | | - Jakarwan Yostawonkul
- Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand.,National Nanotechnology Center (NANOTEC), National Science and Technology Development Agency (NSTDA), Pathumthani, Thailand
| | - Tanit Kasantikul
- Department of Preclinic and Animal Science, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand.,Clemson Veterinary Diagnostic Center, Clemson University, Columbia, South Carolina, USA
| | - Somporn Techangamsuwan
- Department of Pathology, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand.,Animal Virome and Diagnostic Development Research Group, Faculty of Veterinary Science, Chulalongkorn University, Bangkok, Thailand
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25
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Taking the Bite Out of Rabies: The Evolution of Rabies Management in Canada. J Wildl Dis 2021. [DOI: 10.7589/0090-3558-57.3.728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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26
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DA MOTA GOMES MARLEIDE. Louis Pasteur and Dom Pedro II engaged in rabies vaccine development. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E231-E236. [PMID: 34322641 PMCID: PMC8283628 DOI: 10.15167/2421-4248/jpmh2021.62.1.1631] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 12/15/2020] [Indexed: 11/16/2022]
Abstract
Louis Pasteur is the renowned chemist and microbiologist of the 19th century involved in the development of the rabies vaccine. He worked with a researchers team in the laboratory, mainly Pierre Paul Emile Roux, and also physicians in the clinical practice approach and the defense of Pasteur’s anti-rabies technique in the Académie Nationale de Médecine, Alfred Vulpian being the most notable. Pasteur’s first studies on rabies are noted in his 1881 publication. But in 1885, he revealed that he had already immunized 50 dogs against rabies. Meanwhile, he was looking for human subjects. The most polemic of this search involves the second and last Emperor of Brazil, Dom Pedro II, who was a patron of the arts and sciences and followed and supported the work of the great scientist. During the reign of Dom Pedro II, the first Pasteur’s Institute was founded in Rio de Janeiro, nine months before the Parisian, which had the financial support of Dom Pedro. This article deals with the interaction between the two outstanding characters, especially in the development of prophylactic treatment against rabies, and with the utilitarian aspects of this vaccine researches development against individual autonomy.
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Affiliation(s)
- MARLEIDE DA MOTA GOMES
- Correspondence: Marleide da Mota Gomes, Instituto de Neurologia, Universidade Federal do Rio de Janeiro, Av. Venceslau Brás 95, Botafogo, Rio de Janeiro 22290-140 - E-mail:
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27
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Bourhy H, de Melo GD, Tarantola A. [New aspects of rabies control]. BULLETIN DE L'ACADEMIE NATIONALE DE MEDECINE 2020; 204:1000-1009. [PMID: 32981935 PMCID: PMC7500396 DOI: 10.1016/j.banm.2020.09.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 09/10/2020] [Indexed: 12/25/2022]
Abstract
Rabies still causes about 60,000 human deaths per year, mainly in poor populations in Africa and Asia. However, since Louis Pasteur developed the first vaccine 130 years ago, prophylactic measures have been considerably improved and simplified. They now consist of the vaccine combined with purified rabies immunoglobulins of equine or human origin. In general, however, post-exposure prophylaxis protocols are long and expensive. Furthermore, the immunoglobulins used for associated serotherapy are costly and not widely available in developing countries. Approaches have been developed to deal with these two issues that offer hope for a paradigm shift for the benefit of exposed populations. Finally, mass rabies vaccination in dogs, which are the most cost-effective measure for preventing rabies in humans, are difficult to implement and sometimes have moderate effectiveness. The identification and analysis of the epidemiological drivers conditioning the circulation of the virus in dog populations allow a better understanding of the key control points that need to be associated with these campaigns for a better efficacy.
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Affiliation(s)
- H Bourhy
- Unité lyssavirus, épidémiologie et neuropathologie, centre collaborateur de l'Organisation mondiale de la santé de référence et de recherche sur la rage, institut Pasteur, 28, rue du Docteur Roux, 75724 Paris cedex 15, France
| | - G D de Melo
- Unité lyssavirus, épidémiologie et neuropathologie, centre collaborateur de l'Organisation mondiale de la santé de référence et de recherche sur la rage, institut Pasteur, 28, rue du Docteur Roux, 75724 Paris cedex 15, France
| | - A Tarantola
- Unité lyssavirus, épidémiologie et neuropathologie, centre collaborateur de l'Organisation mondiale de la santé de référence et de recherche sur la rage, institut Pasteur, 28, rue du Docteur Roux, 75724 Paris cedex 15, France
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28
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Bannazadeh Baghi H, Rupprecht CE. Notes on three periods of rabies focus in the Middle East: From progress during the cradle of civilization to neglected current history. Zoonoses Public Health 2020; 68:697-703. [PMID: 33230968 DOI: 10.1111/zph.12781] [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: 08/15/2019] [Revised: 07/24/2020] [Accepted: 10/18/2020] [Indexed: 11/29/2022]
Abstract
Rabies is a historical scourge as well as one of the most neglected infectious diseases. While the developed world has rolled back dog-mediated human rabies, thanks to social interventions and modern rabies vaccines, African and Asian countries still struggle with a significant burden due to this viral zoonosis. The Middle East, which includes both Asian and African countries, still has localities in which dog-mediated rabies remains endemic although it is the region that first documented rabies historically. The oldest putative record of this fatal encephalitis may date back at least 4,000 years and is believed to originate from ancient Mesopotamia. In this historical review, we describe rabies through three major time periods (ancient, the Islamic Golden Age and more recent history) of the Middle East. Inarguably, the Middle East experienced great medical development during the Islamic Golden Age. Proof of early rabies prevention, control and proposed treatment strategies existed which we only perceive anew via modern science. Such rabies strategies were neglected severely due in no small part to the influence of Middle Eastern rulers, who steered scholars away from this field to a broader toxicological focus, because they feared assassination from poisoning. Such setbacks are coupled with constant social and political unrest and continuous wars in the Middle East to modern times. This situation leads to an inconstancy in rabies surveillance and reporting of data, neglect of prevention and control strategies, and subsequently a devolvement of rabies management strategies in this unstable region of the world.
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Affiliation(s)
- Hossein Bannazadeh Baghi
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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29
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de Melo GD, Sonthonnax F, Lepousez G, Jouvion G, Minola A, Zatta F, Larrous F, Kergoat L, Mazo C, Moigneu C, Aiello R, Salomoni A, Brisebard E, De Benedictis P, Corti D, Bourhy H. A combination of two human monoclonal antibodies cures symptomatic rabies. EMBO Mol Med 2020; 12:e12628. [PMID: 32945125 PMCID: PMC7645379 DOI: 10.15252/emmm.202012628] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 12/18/2022] Open
Abstract
Rabies is a neglected disease caused by a neurotropic Lyssavirus, transmitted to humans predominantly by the bite of infected dogs. Rabies is preventable with vaccines or proper post-exposure prophylaxis (PEP), but it still causes about 60,000 deaths every year. No cure exists after the onset of clinical signs, and the case-fatality rate approaches 100% even with advanced supportive care. Here, we report that a combination of two potent neutralizing human monoclonal antibodies directed against the viral envelope glycoprotein cures symptomatic rabid mice. Treatment efficacy requires the concomitant administration of antibodies in the periphery and in the central nervous system through intracerebroventricular infusion. After such treatment, recovered mice presented good clinical condition, viral loads were undetectable, and the brain inflammatory profile was almost normal. Our findings provide the unprecedented proof of concept of an antibody-based therapeutic approach for symptomatic rabies.
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Affiliation(s)
| | - Florian Sonthonnax
- Lyssavirus Epidemiology and Neuropathology UnitInstitut PasteurParisFrance
- Sorbonne‐Paris CitéCellule PasteurUniversité Paris‐DiderotParisFrance
| | | | - Grégory Jouvion
- Experimental Neuropathology UnitInstitut PasteurParisFrance
- INSERMPathophysiology of Pediatric Genetic DiseasesSorbonne UniversitéHôpital Armand‐TrousseauUF Génétique MoléculaireAssistance Publique‐Hôpitaux de ParisParisFrance
| | - Andrea Minola
- Humabs BioMed SAa subsidiary of Vir BiotechnologyBellinzonaSwitzerland
| | - Fabrizia Zatta
- Humabs BioMed SAa subsidiary of Vir BiotechnologyBellinzonaSwitzerland
| | - Florence Larrous
- Lyssavirus Epidemiology and Neuropathology UnitInstitut PasteurParisFrance
| | - Lauriane Kergoat
- Lyssavirus Epidemiology and Neuropathology UnitInstitut PasteurParisFrance
| | - Camille Mazo
- Perception and Memory UnitInstitut PasteurParisFrance
| | | | - Roberta Aiello
- Istituto Zooprofilattico Sperimentale delle VeneziePaduaItaly
| | - Angela Salomoni
- Istituto Zooprofilattico Sperimentale delle VeneziePaduaItaly
| | - Elise Brisebard
- Experimental Neuropathology UnitInstitut PasteurParisFrance
- Laboratoire d'HistopathologieVetAgro‐SupUniversité de LyonLyonFrance
| | | | - Davide Corti
- Humabs BioMed SAa subsidiary of Vir BiotechnologyBellinzonaSwitzerland
| | - Hervé Bourhy
- Lyssavirus Epidemiology and Neuropathology UnitInstitut PasteurParisFrance
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30
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Rabies as a Public Health Concern in India-A Historical Perspective. Trop Med Infect Dis 2020; 5:tropicalmed5040162. [PMID: 33096767 PMCID: PMC7709690 DOI: 10.3390/tropicalmed5040162] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 10/09/2020] [Accepted: 10/16/2020] [Indexed: 11/26/2022] Open
Abstract
India bears the highest burden of global dog-mediated human rabies deaths. Despite this, rabies is not notifiable in India and continues to be underprioritised in public health discussions. This review examines the historical treatment of rabies in British India, a disease which has received relatively less attention in the literature on Indian medical history. Human and animal rabies was widespread in British India, and treatment of bite victims imposed a major financial burden on the colonial Government of India. It subsequently became a driver of Pasteurism in India and globally and a key component of British colonial scientific enterprise. Efforts to combat rabies led to the establishment of a wide network of research institutes in India and important breakthroughs in development of rabies vaccines. As a result of these efforts, rabies no longer posed a significant threat to the British, and it declined in administrative and public health priorities in India towards the end of colonial rule—a decline that has yet to be reversed in modern-day India. The review also highlights features of the administrative, scientific and societal approaches to dealing with this disease in British India that persist to this day.
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31
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Bartlett ML, Griffin DE. Acute RNA Viral Encephalomyelitis and the Role of Antibodies in the Central Nervous System. Viruses 2020; 12:v12090988. [PMID: 32899509 PMCID: PMC7551998 DOI: 10.3390/v12090988] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 09/02/2020] [Accepted: 09/02/2020] [Indexed: 12/25/2022] Open
Abstract
Acute RNA viral encephalomyelitis is a serious complication of numerous virus infections. Antibodies in the cerebral spinal fluid (CSF) are correlated to better outcomes, and there is substantive evidence of antibody secreting cells (ASCs) entering the central nervous system (CNS) and contributing to resolution of infection. Here, we review the RNA viruses known to cause acute viral encephalomyelitis with mechanisms of control that require antibody or ASCs. We compile the cytokines, chemokines, and surface receptors associated with ASC recruitment to the CNS after infection and compare known antibody-mediated mechanisms as well as potential noncytolytic mechanisms for virus control. These non-canonical functions of antibodies may be employed in the CNS to protect precious non-renewable neurons. Understanding the immune-specialized zone of the CNS is essential for the development of effective treatments for acute encephalomyelitis caused by RNA viruses.
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32
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Pantha S, Subedi D, Poudel U, Subedi S, Kaphle K, Dhakal S. Review of rabies in Nepal. One Health 2020; 10:100155. [PMID: 33117872 PMCID: PMC7582201 DOI: 10.1016/j.onehlt.2020.100155] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/05/2020] [Accepted: 07/07/2020] [Indexed: 12/25/2022] Open
Abstract
Rabies is a global problem, but the burden is higher in less developed or developing countries of Asia and Africa. In Nepal, rabies is reported to kill around 500 animals and up to 32 human beings in recent years, with possible under-reporting of cases and deaths. As a prophylactic measure, around 30,000 livestock and 300,000 humans get vaccinated each year in Nepal. This review summarizes the past, present and future perspectives of rabies control and prevention in Nepal. The global strategic plan of World Health Organization (WHO) aims to bring human deaths from dog-transmitted rabies to zero by 2030. To achieve this goal of ‘Zero by 30’, the concerned governmental and non-governmental agencies in Nepal should work together using the One Health concept. Rabies is caused by Lyssa virus that is responsible for deaths of 55,000 people annually across the world. Dogs are responsible for 95% of rabies cases around the globe and 99% in endemic regions. Asia has the highest burden of rabies and India alone accounts for around 35% of world rabies cases. In Nepal, less than 35 people have died each year due to rabies. One health approach is mandatory to end dog mediated rabies by the year 2030.
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Affiliation(s)
- Saurav Pantha
- Paklihawa Campus, Institute of Agriculture and Animal Science, Tribhuvan University, Paklihawa, Rupandehi, Nepal
| | - Deepak Subedi
- Paklihawa Campus, Institute of Agriculture and Animal Science, Tribhuvan University, Paklihawa, Rupandehi, Nepal
| | - Uddab Poudel
- Paklihawa Campus, Institute of Agriculture and Animal Science, Tribhuvan University, Paklihawa, Rupandehi, Nepal
| | - Sanju Subedi
- Bachelor of Public Health, Chitwan Medical College, Tribhuvan University, Chitwan, Nepal
| | - Krishna Kaphle
- Associate Professor and Director, Veterinary Teaching Hospital, Paklihawa Campus, Institute of Agriculture and Animal Science, Tribhuvan University, Paklihawa, Rupandehi, Nepal
| | - Santosh Dhakal
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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Mastraccio KE, Huaman C, Warrilow D, Smith GA, Craig SB, Weir DL, Laing ED, Smith IL, Broder CC, Schaefer BC. Establishment of a longitudinal pre-clinical model of lyssavirus infection. J Virol Methods 2020; 281:113882. [PMID: 32407866 PMCID: PMC8056983 DOI: 10.1016/j.jviromet.2020.113882] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 04/19/2020] [Accepted: 05/07/2020] [Indexed: 12/12/2022]
Abstract
Traditional mouse models of lyssavirus pathogenesis rely on euthanizing large groups of animals at various time points post-infection, processing infected tissues, and performing histological and molecular analyses to determine anatomical sites of infection. While powerful by some measures, this approach is limited by the inability to monitor disease progression in the same mice over time. In this study, we established a novel non-invasive mouse model of lyssavirus pathogenesis, which consists of longitudinal imaging of a luciferase-expressing Australian bat lyssavirus (ABLV) reporter virus. In vivo bioluminescence imaging (BLI) in mice revealed viral spread from a peripheral site of inoculation into the central nervous system (CNS), with kinetically and spatially distinct foci of replication in the footpad, spinal cord, and hindbrain. Detection of virus within the CNS was associated with onset of clinical disease. Quantification of virus-derived luminescent signal in the brain was found to be a reliable measure of viral replication, when compared to traditional molecular methods. Furthermore, we demonstrate that in vivo imaging of ABLV infection is not restricted to the use of albino strains of mice, but rather strong BLI signal output can be achieved by shaving the hair from the heads and spines of pigmented strains, such as C57BL/6. Overall, our data show that in vivo BLI can be used to rapidly and non-invasively identify sites of lyssavirus replication and to semi-quantitatively determine viral load without the need to sacrifice mice at multiple time points.
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Affiliation(s)
- Kate E Mastraccio
- Uniformed Services University, Department of Microbiology and Immunology, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
| | - Celeste Huaman
- Uniformed Services University, Department of Microbiology and Immunology, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
| | - David Warrilow
- Queensland Health Forensic and Scientific Services, Archerfield, Australia.
| | - Greg A Smith
- Queensland Health Forensic and Scientific Services, Archerfield, Australia.
| | - Scott B Craig
- Queensland Health Forensic and Scientific Services, Archerfield, Australia.
| | - Dawn L Weir
- Uniformed Services University, Department of Microbiology and Immunology, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
| | - Eric D Laing
- Uniformed Services University, Department of Microbiology and Immunology, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
| | - Ina L Smith
- Queensland Health Forensic and Scientific Services, Archerfield, Australia; Risk Evaluation and Preparedness Program, Health and Biosecurity, CSIRO, Black Mountain, ACT, Australia.
| | - Christopher C Broder
- Uniformed Services University, Department of Microbiology and Immunology, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
| | - Brian C Schaefer
- Uniformed Services University, Department of Microbiology and Immunology, 4301 Jones Bridge Road, Bethesda, MD, 20814, USA.
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Hadebe JM, Sibiya MN. Experiences of people affected by rabies in Ethekwini district in the province of Kwazulu-Natal, South Africa. Afr Health Sci 2020; 20:150-157. [PMID: 33402903 PMCID: PMC7750068 DOI: 10.4314/ahs.v20i1.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background South Africa is one of the countries in Africa adversely affected by rabies, a notifiable disease which can be fatal. Fatalities can be prevented if health care is sought timeously and people are educated about the disease. The Province of Kwa-Zulu-Natal, in particular, has had rabies outbreaks in the past which have led to loss of many lives and devastation of entire families. Objective The aim of the study was to explore the experiences of people affected by rabies in the eThekwini district of Kwa-Zulu-Natal, South Africa. Methods The study was guided by a qualitative, exploratory, descriptive design. The sample was purposively selected, and a semi-structured interview was used to collect data from people affected by rabies in the eThekwini district. Data saturation was reached after 12 participants were interviewed. Data was analysed by using Tesch's eight steps of thematic analysis. Results The themes included family stability and support structures, exposure to risk factors and risky practices, factors that hindered participants from seeking health care assistance, limited knowledge about rabies and the effects of rabies. Conclusion It was evident that participants experienced many challenges during their rabies exposure. Individuals, who were directly affected by rabies through contact with rabid animals, were expected to take responsibility for their own lives.
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36
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Ghosh S, Rana MS, Islam MK, Chowdhury S, Haider N, Kafi MAH, Ullah SM, Shah MRA, Jahan AA, Mursalin HS, Marma ASP, Ali SME, Hossain S, Bhowmik R, Debnath NC, Shamsuzzaman AKM, Ahmed BN, Siddiqi UR, Jhora ST. Trends and clinico-epidemiological features of human rabies cases in Bangladesh 2006-2018. Sci Rep 2020; 10:2410. [PMID: 32051481 PMCID: PMC7016137 DOI: 10.1038/s41598-020-59109-w] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 01/24/2020] [Indexed: 11/23/2022] Open
Abstract
Vaccinating dogs against rabies is an effective means of reducing human rabies. We subjected 1327 clinically diagnosed human rabies death and mass dog vaccination (MDV) data during 2006-2018 to quantify the impacts of MDV on human rabies incidence in Bangladesh and a subset of rabies death data (422) for clinico-epidemiological analysis. A positive and increasing trend of MDV (p = 0.01 and tau = 0.71) and a negative and declining trend (p < 0.001 and tau = -0.88) of human rabies cases (Correlation coefficient: -0.82) have been observed. Among 422 deaths, the majority (78%) of the victims sought treatment from traditional healers, and 12% received post-exposure prophylaxis (PEP). The mean incubation period of rabies in cases with exposure sites on the head & neck (35 days) was shorter than the upper limb (mean = 64 days, p = 0.02) and lower limb (mean = 89 days, p < 0.01). MDV has been found to be effective for reducing human rabies cases in Bangladesh. Creating awareness among the animal bite victims to stop reliance on traditional healers rather seeking PEP, addressing the role of traditional healers through awareness education programme with respect to the treatment of dog bites, ensuring availability of PEP, and continuing to scale up MDV may help to prevent human rabies deaths.
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Affiliation(s)
- Sumon Ghosh
- Disease Control Unit, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh.
| | - Md Sohel Rana
- Disease Control Unit, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
- Department of Livestock Services, Ministry of Fisheries and Livestock, Dhaka, Bangladesh
| | - Md Kamrul Islam
- Disease Control Unit, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Sukanta Chowdhury
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Najmul Haider
- Technical University of Denmark, Section for Epidemiology, National Veterinary Institutes, Copenhagen, Denmark
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, London, UK
| | | | - Sayed Mohammed Ullah
- Disease Control Unit, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Md Rashed Ali Shah
- Disease Control Unit, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Afsana Akter Jahan
- Disease Control Unit, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
- Faculty of Veterinary and Animal Sciences, Gono University, Savar, Dhaka, Bangladesh
| | - Hasan Sayedul Mursalin
- Disease Control Unit, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Aung Swi Prue Marma
- Disease Control Unit, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - S M Emran Ali
- Infectious Disease Hospital, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | | | - Rajub Bhowmik
- John Jay College of the City University of New York, 445 W 59th St-10019, New York, USA
| | - Nitish C Debnath
- Food and Agriculture Organization of the United Nation, Dhaka, Bangladesh
| | - Abul Khair Mohammad Shamsuzzaman
- Disease Control Unit, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Be-Nazir Ahmed
- Disease Control Unit, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Umme Ruman Siddiqi
- Disease Control Unit, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | - Sanya Tahmina Jhora
- Disease Control Unit, Communicable Disease Control, Directorate General of Health Services, Ministry of Health and Family Welfare, Dhaka, Bangladesh
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Abstract
The selection of papers included in this issue of Microbiology Australia present a broad brush of zoonotic diseases, from those known or described in ancient times such as rabies, first described in the Eshnunna cuneiform law tablets from ancient Mesopotamia dating back to the 18th–19th centuries BC, and glanders, thought to be first described in donkeys by Aristotle in Ancient Greece in 420–450 BC and subsequently by the Romans, to some discovered or recognised as zoonotic within the past 30 years, such as the recently described zoonotic bat-borne pathogens in Australia, and Clostridium difficile, only recently recognised as a zoonotic pathogen. The selection of papers also demonstrates the wide range of zoonotic origins, including arthropod-borne viruses and potentially seafood-borne parasites.
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Rupprecht CE, Kuzmin IV, Yale G, Nagarajan T, Meslin FX. Priorities in applied research to ensure programmatic success in the global elimination of canine rabies. Vaccine 2019; 37 Suppl 1:A77-A84. [PMID: 30685249 DOI: 10.1016/j.vaccine.2019.01.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 12/14/2018] [Accepted: 01/10/2019] [Indexed: 01/19/2023]
Abstract
The elimination of human rabies mediated by dogs is attainable in concept, based upon current sensitive and specific diagnostic methods, existing safe and effective human and veterinary vaccines and a sound virological, pathological and epidemiological understanding of the disease. Globally, all developed countries achieved this goal. Regionally, major progress occurred throughout the Americas. However, less advancement is evident in Africa and Asia. Our objective was to concentrate upon those salient improvements to extant tools and methods over the next five years which could assist and simplify the task for both those developing countries that have already begun the process, as well as other localities in the earlier stages of consideration. We considered several categories of applied research which could be accomplished in the short term, based upon the available scientific evidence and recent recommendations from subject matter experts and key opinion leaders, focused upon perceived major limitations to prior program success. Areas of concentration included: laboratory-based surveillance, pathogen detection and characterization; human rabies prophylaxis; veterinary biologics; implementation of canine vaccination; and oral vaccination of free-ranging community dogs. Further real-time application in these core areas with proven techniques and technology would simplify attaining not only the global goal focused subtly upon human mortality, but the actual elimination of canine rabies as well.
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Affiliation(s)
| | | | - Gowri Yale
- Mission Rabies, Panaji, Goa 403002, India
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Evaluating new rabies post-exposure prophylaxis (PEP) regimens or vaccines. Vaccine 2018; 37 Suppl 1:A88-A93. [PMID: 30471958 DOI: 10.1016/j.vaccine.2018.10.103] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 10/12/2018] [Accepted: 10/31/2018] [Indexed: 12/25/2022]
Abstract
The development of human rabies vaccines has evolved dramatically from the first crude nerve tissue vaccine produced then administered in the presence of Louis Pasteur in 1885. New cell culture technology has enabled highly potent and well-tolerated rabies vaccines to be produced that have reduced the volume and number of doses required to save human lives after exposure. However, these highly potent vaccines are still unaffordable to many patients living at risk of exposure on a daily basis. The cost of post-exposure prophylaxis (PEP) is not only related to the direct cost of rabies biologicals and equipment but is also associated with indirect costs that patients incur as a result of travel, loss of work time (income loss), and accommodation over the period of time that a PEP regimen requires to be completed. This paper summarizes the particular criteria that the SAGE Working Group and WHO personnel reviewed as part of the evaluation process for recommending the new one-week intradermal vaccination regimen (2-2-2-0-0) for rabies post-exposure prophylaxis. These criteria included: Cost-effectiveness; evaluation of number of doses; seroconversion after vaccination; efficacy; safety; and patient follow-up.
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Tarantola A, Ly S, Chan M, In S, Peng Y, Hing C, Taing CN, Phoen C, Ly S, Cauchemez S, Buchy P, Dussart P, Bourhy H, Mary JY. Intradermal rabies post-exposure prophylaxis can be abridged with no measurable impact on clinical outcome in Cambodia, 2003-2014. Vaccine 2018; 37 Suppl 1:A118-A127. [PMID: 30454946 DOI: 10.1016/j.vaccine.2018.10.054] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 10/03/2018] [Accepted: 10/15/2018] [Indexed: 12/12/2022]
Abstract
Rabies causes 60,000 deaths worldwide annually. Rabies post-exposure prophylaxis is highly effective but often geographically and financially beyond reach in endemic developing countries. We conducted a retrospective study on clinical outcome at ≥6 months in 3318 Cambodians who received intradermal Vero cell vaccine post-exposure prophylaxis after a bite by a rabid or sick-looking but untested dog in 2003-2014. An external expert panel examined verbal autopsy reports to identify rabies deaths. 1739 (93.65%) persons bitten by rabid- and 1066 (72.96%) bitten by sick-looking but untested dogs were traced and 513 were lost to follow-up. Among the former, 1591 (91.49%) and 129 (7.42%) patients referred for 4+ and 3 post-exposure prophylaxis sessions, respectively. Three persons died of probable rabies so that the overall percentage of survival was 99.83% (95% exact confidence interval: 99.49-99.96%) in post-exposure prophylaxis recipients bitten by confirmed rabid dogs. No significant difference was found in survival among patients who received 3 vs. 4+ sessions (with or without rabies immunoglobin). The power of the study, however, was limited. The current four sessions/one month intradermal regimen can be reduced to a three sessions/one week at no detectable added risk to patients, with the limitation of study power at 49%. A clinical follow-up system should be adopted by rabies prevention centers, especially to monitor implementation of an abridged course. The Institut Pasteur in Cambodia regimen will improve vaccine equity by treating 33% more patients with available doses, reduce direct cost of vaccination, transportation and other indirect costs to vaccinees.
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Affiliation(s)
- Arnaud Tarantola
- Epidemiology & Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia; Epidemiology Unit, Institut Pasteur de Nouvelle-Calédonie, Nouméa, New Caledonia.
| | - Sowath Ly
- Epidemiology & Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Malen Chan
- Epidemiology & Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Sotheary In
- Epidemiology & Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Yiksing Peng
- Epidemiology & Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Chanthy Hing
- Epidemiology & Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Chun Navy Taing
- Epidemiology & Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Chandara Phoen
- Epidemiology & Public Health Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Sovann Ly
- Center for Communicable Disease Control, Ministry of Health, Phnom Penh, Cambodia
| | - Simon Cauchemez
- Mathematical Modelling of Infectious Diseases Unit, CNRS UMR2000: Génomique évolutive, modélisation et santé (GEMS), Center of Bioinformatics, Biostatistics and Integrative Biology, Institut Pasteur, Paris 75015, France
| | | | - Philippe Dussart
- Virology Unit, Institut Pasteur du Cambodge, Phnom Penh, Cambodia
| | - Hervé Bourhy
- Institut Pasteur, Lyssavirus Dynamics and Host Adaptation Unit, WHO Collaborating Centre for Reference and Research on Rabies, Paris, France
| | - Jean-Yves Mary
- Inserm UMR 1153, Centre de Recherche Epidémiologie et Statistique Sorbonne Paris Cité, Hôpital Saint-Louis, Université Paris Diderot - Paris 7, Paris, France
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Cleaveland S, Hampson K. Rabies elimination research: juxtaposing optimism, pragmatism and realism. Proc Biol Sci 2018; 284:rspb.2017.1880. [PMID: 29263285 PMCID: PMC5745407 DOI: 10.1098/rspb.2017.1880] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2017] [Accepted: 11/27/2017] [Indexed: 12/17/2022] Open
Abstract
More than 100 years of research has now been conducted into the prevention, control and elimination of rabies with safe and highly efficacious vaccines developed for use in human and animal populations. Domestic dogs are a major reservoir for rabies, and although considerable advances have been made towards the elimination and control of canine rabies in many parts of the world, the disease continues to kill tens of thousands of people every year in Africa and Asia. Policy efforts are now being directed towards a global target of zero human deaths from dog-mediated rabies by 2030 and the global elimination of canine rabies. Here we demonstrate how research provides a cause for optimism as to the feasibility of these goals through strategies based around mass dog vaccination. We summarize some of the pragmatic insights generated from rabies epidemiology and dog ecology research that can improve the design of dog vaccination strategies in low- and middle-income countries and which should encourage implementation without further delay. We also highlight the need for realism in reaching the feasible, although technically more difficult and longer-term goal of global elimination of canine rabies. Finally, we discuss how research on rabies has broader relevance to the control and elimination of a suite of diseases of current concern to human and animal health, providing an exemplar of the value of a ‘One Health’ approach.
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Affiliation(s)
- Sarah Cleaveland
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
| | - Katie Hampson
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow G12 8QQ, UK
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Fisher CR, Streicker DG, Schnell MJ. The spread and evolution of rabies virus: conquering new frontiers. Nat Rev Microbiol 2018; 16:241-255. [PMID: 29479072 PMCID: PMC6899062 DOI: 10.1038/nrmicro.2018.11] [Citation(s) in RCA: 140] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Rabies is a lethal zoonotic disease that is caused by lyssaviruses, most often rabies virus. Despite control efforts, sporadic outbreaks in wildlife populations are largely unpredictable, underscoring our incomplete knowledge of what governs viral transmission and spread in reservoir hosts. Furthermore, the evolutionary history of rabies virus and related lyssaviruses remains largely unclear. Robust surveillance efforts combined with diagnostics and disease modelling are now providing insights into the epidemiology and evolution of rabies virus. The immune status of the host, the nature of exposure and strain differences all clearly influence infection and transmission dynamics. In this Review, we focus on rabies virus infections in the wildlife and synthesize current knowledge in the rapidly advancing fields of rabies virus epidemiology and evolution, and advocate for multidisciplinary approaches to advance our understanding of this disease.
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Affiliation(s)
- Christine R. Fisher
- Department of Microbiology and Immunology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Daniel G. Streicker
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, Scotland, UK
- MRC-University of Glasgow Centre for Virus Research, Glasgow, Scotland, UK
| | - Matthias J. Schnell
- Department of Microbiology and Immunology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
- Vaccine Center at Thomas Jefferson University, Philadelphia, PA, USA
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Rupprecht CE, Dietzschold B. Special Issue: Rabies Symptoms, Diagnosis, Prophylaxis, and Treatment. Trop Med Infect Dis 2017; 2:E59. [PMID: 30270916 PMCID: PMC6082069 DOI: 10.3390/tropicalmed2040059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 11/08/2017] [Indexed: 11/17/2022] Open
Abstract
Rabies is an acute, progressive, incurable viral encephalitis found throughout the world. Despite being one of the oldest recognized pathogens, its impact remains substantial in public health, veterinary medicine, and conservation biology.[...].
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Affiliation(s)
| | - Bernhard Dietzschold
- Department of Microbiology and Immunology, Thomas Jefferson University, Philadelphia, PA 19107, USA.
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Buchy P, Preiss S, Singh V, Mukherjee P. Heterogeneity of Rabies Vaccination Recommendations across Asia. Trop Med Infect Dis 2017; 2:E23. [PMID: 30270882 PMCID: PMC6082101 DOI: 10.3390/tropicalmed2030023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 06/27/2017] [Accepted: 06/29/2017] [Indexed: 12/25/2022] Open
Abstract
Asian countries bear the greatest burden of the disease, with a majority (59%) of rabies-related deaths occurring in Asia. In order to promote best practices, we summarized national human vaccination guidelines across this region, to highlight differences and similarities and to discuss the aspects that would benefit from updates. National management guidelines for rabies were retrieved from various sources to extract information on rabies pre- and post-exposure prophylaxis (PrEP, and PEP), booster vaccination, and route of administration. Rabies guidelines recommendations for wound management and PrEP across Asia are broadly aligned to the World Health Organization (WHO) guidelines. For PEP, the 5-dose Essen, and the 4-dose Zagreb are the regimens of choice for intramuscular (IM), and the Thai Red Cross regimen for intradermal (ID), administration. Several national guidelines have yet to endorse ID vaccine administration. Most guidelines recommend rabies immunoglobulin in category III exposures. Booster recommendations are not included in all guidelines, with limited clarity on booster requirement across the spectrum of risk of rabies exposure. In conclusion, national recommendations across Asian countries differ and while some guidelines are closely aligned to the WHO recommendations, resource-saving ID administration and use of rational abbreviated schedules have yet to be endorsed.
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Affiliation(s)
| | | | - Ved Singh
- GSK, 20 Avenue Fleming, 1300 Wavre, Belgium.
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