Making rabies prophylaxis more economical

Huang, Guihua; Liu, Huazhang; Tang, Qing; Yu, Pengcheng; Shen, Xinxin; Zhang, Yibin; Liu, Xiangyi; Cao, Qing; Fu, Chuanxi; Liu, Beiyan; Wang, Ming

doi:10.4161/hv.26264

Cited by 12 publications

(7 citation statements)

References 16 publications

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“…In principle, PEP compliance could be increased by: reducing patient costs by increasing the government subsidization above the current rate of 30%; requiring animal owners to pay for PEP; reducing travel expenses with shorter vaccination schedules requiring fewer clinic visits and making vaccine more widely available; and use of intradermal (ID) vaccinations that require smaller, more cost-effective volumes [ 22 ]. For example, alternative vaccination regimens have been proposed that can be completed within 1 week with three intramuscular vaccinations in two visits [ 23 ] or four ID vaccinations in three visits [ 24 ]. Current WHO guidelines recommend such ID PEP regimens, which are effective cost- and vaccine-saving measures that require up to 80% less vaccine per dose than intramuscular administration [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Human rabies in Côte d'Ivoire 2014-2016: Results following reinforcements to rabies surveillance

et al. 2018

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In Côte d’Ivoire, rabies is endemic and remains largely uncontrolled. The numbers of human exposures and rabies cases are unknown and are probably much higher than reported. Data on human rabies cases are collected by the National Institute of Public Health (NIPH) Anti-rabies Center in Abidjan through a network of 28 NIPH local units, which cover the population of the entire country. During 2014, the NIPH initiated a program to reinforce the human rabies surveillance system in those 28 NIPH local units, with specific goals of improving the infrastructure, training, communication, and government involvement. Here, we report the progress and findings during 2014–2016. The reinforced system recorded 50 cases of human rabies (15–18 cases/year; annual incidence = 0.06−0.08 per 100,000) and more than 30,000 animal exposures (annual incidence = 41.8−48.0 per 100,000). Almost one-half of the human rabies cases were in children ≤15 years old. All were fatal and dog bites were the most common route by which rabies virus was transmitted. In the 32 cases where samples of sufficient quality for analysis were available, rabies was confirmed by reverse transcription-polymerase chain reaction RT-PCR. Post-exposure prophylaxis with rabies vaccine was administered to all animal exposure victims presenting at the NIPH local units, although only about 57% completed the full immunization schedule. All available reports were provided by the NIPH local units, indicating effective communication between them and the NIPH Anti-rabies Center. These findings indicate that the reinforcements resulted in highly specific detection of human rabies, provided detailed epidemiological data about these cases, and improved estimates of animal exposure numbers. These represent substantial advances, but further improvements to the surveillance system are needed to increase disease awareness and capture cases that are currently missed by the system. In the future, better communication between local health centers and the NIPH units, surveillance at the local health center level, and increased veterinarian engagement will help provide a more complete picture of the rabies burden in Côte d’Ivoire.

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Section: Discussionmentioning

confidence: 99%

Human rabies in Côte d'Ivoire 2014-2016: Results following reinforcements to rabies surveillance

et al. 2018

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“…The PVRV for intramuscular pre-and post-exposure rabies prophylaxis manufactured by Chengda Biotechnology has been proven to be well tolerated and immunogenic with an acceptable safety profile in China. [19][20][21][22][23] It has been approved initially by SFDA to use under the Essen regimen in 2005, and permitted to use Zagreb regimen later. Until now, the vaccine has been used 3 million under Zagreb regimen, however, it remained far below than Essen regimen.…”

Section: Discussionmentioning

confidence: 99%

Immunogenicity, safety and antibody persistence of a purified vero cell cultured rabies vaccine (Speeda) administered by the Zagreb regimen or Essen regimen in post-exposure subjects

Shi

Zhang

Zheng

et al. 2017

Human Vaccines & Immunotherapeutics

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“…In the WHO position paper, the 2-week intramuscular regimen (1-1-1-1-0; 1-site intramuscular on days 0, 3, 7 and between day 14–28) and the three-week intramuscular regimen (2-0-1-0-1; 2-sites intramuscular on days 0 and 1-site intramuscular on days 7, 21) are also recommended as the simplified post-exposure prophylaxis. The IPC regimen shows the same safety and efficacy as the Essen regimen [ 110 ]. Compared with standard intramuscular injection, the IPC regimen can produce an equivalent immune response at a lower dose, to reduce the dosage and direct cost of the vaccine by 60–80% [ 111 ].…”

Section: Resultsmentioning

confidence: 99%

Progress towards dog-mediated rabies elimination in PR China: a scoping review

et al. 2023

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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. Graphical Abstract

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Making rabies prophylaxis more economical

Cited by 12 publications

References 16 publications

Human rabies in Côte d'Ivoire 2014-2016: Results following reinforcements to rabies surveillance

Human rabies in Côte d'Ivoire 2014-2016: Results following reinforcements to rabies surveillance

Immunogenicity, safety and antibody persistence of a purified vero cell cultured rabies vaccine (Speeda) administered by the Zagreb regimen or Essen regimen in post-exposure subjects

Progress towards dog-mediated rabies elimination in PR China: a scoping review

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