One clinic visit for pre-exposure rabies vaccination (a preliminary one year study). Vaccine
ABSTRACT We performed an abbreviated prospective study of rabies pre-exposure (PREP) vaccination in 109 volunteers. Group 1, the control group, received the conventional 3 intradermal injections on days 0, 7 and 21. Group 2 received one rabies vaccine injection (0.1 ml intradermally) at 2 sites on a single day. Group 3 was given one full ampule intramuscularly. One year later, all 3 groups received booster injections (0.1 ml at 4 sites) intradermally at one time or 2 injections intramuscularly on days 0 and 3. All subjects achieved a vigorous anamnestic antibody response 7 days after the boosters. These data suggest that one time immunization of one full dose intramuscularly or 2 site injections of 0.1 intradermally on a single day are adequate to prime immune memory and obtain an accelerated immune response one year later.
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ABSTRACT: Using the principle of immunochromatography, we previously developed a method called RAPINA (Rapid Neutralizing Antibody detection test) that can measure the level of rabies virus -neutralizing antibody (VNA) in serum samples [Shiota S, Mannen K, Matsumoto T, Yamada K, Yasui T, Takayama K, et al. Development and evaluation of a rapid neutralizing antibody test for rabies. J Virol Methods 2009;161:58-62]. RAPINA is faster, simpler, and easier to perform compared with a virus-neutralizing test or enzyme-linked immunosorbent assay (ELISA). The improved version of RAPINA has greater positive and negative predictive values corresponding to a VNA level of 0.5 IU/mL, as recommended by the World Health Organization and the World Organization for Animal Health. To verify the efficacy of this improved method, serum samples were collected from humans and dogs before and after immunization against rabies and were tested in Japan, Sri Lanka, and Thailand. The results were compared between RAPINA and the true VNA levels measured by the Rapid Fluorescent Focus Inhibition Test (RFFIT). The improved RAPINA accurately predicted seropositivity for 182 of 183 seropositive human samples as assessed by RFFIT (99.5%) and for 138 of 140 RFFIT-negative human samples (98.6%). In dog serum samples, the positive and negative predictive values were 99.7% (345/355) and 95.6% (174/182), respectively. RAPINA was also used to estimate VNA levels in a semiquantitative manner by using serial dilution of serum samples. Our results show that RAPINA is an easy and rapid method for measuring VNA levels before and after immunization with the rabies vaccine and does not need a high skill level or sophisticated equipment. RAPINA can be used to monitor the success of preexposure prophylaxis in at-risk persons, vaccine coverage, and animal control. It can also be used in laboratories with modest facilities and where a large number of samples are screened.Vaccine 04/2012; 30(26):3891-6. DOI:10.1016/j.vaccine.2012.04.003 · 3.62 Impact Factor
- Travel Medicine and Infectious Disease 05/2012; 10(3):162-3. DOI:10.1016/j.tmaid.2012.03.004 · 1.67 Impact Factor
Article: Rabies pretravel vaccination[Show abstract] [Hide abstract]
ABSTRACT: This review sought to describe the recent findings on the epidemiology of rabies exposure and rabies cases in travelers and to discuss possible cost-saving measures that could be used to increase pretravel vaccination coverage in travelers. On the basis of global data, most cases of rabies in travelers are associated with dog bites, occur in adults who are commonly migrants, and are not necessarily associated with long-term travel. The incidence of injuries to travelers caused by potentially rabid animals is approximately 0.4% per month of stay. Dogs account for 51% of cases, and the remaining animals, notably monkeys, carry a lower risk of rabies transmission. Travel to Southeast Asia, India, and north Africa, young age, and traveling for tourism are risk factors for potential exposure; the duration of travel is not a risk factor. More than 70% of travelers are not immunized prior to departing and do not receive adequate care when injured. The intradermal vaccination route has been proven economical, safe, and immunogenic in the population of rabies-endemic areas, and this route of administration has been recently used in travelers from developed countries. The immunity provided by the three-dose series is long-lasting and should be considered an investment for future travel. Abbreviated schedules have been tested for last-minute travelers.Current Opinion in Infectious Diseases 07/2012; 25(5):500-6. DOI:10.1097/QCO.0b013e3283567b35 · 5.01 Impact Factor