Rabies Immunoglobulin

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Holly Murphy - One of the best experts on this subject based on the ideXlab platform.

Philippe Gautret - One of the best experts on this subject based on the ideXlab platform.

  • Rabies post-exposure prophylaxis started during or after travel: A GeoSentinel analysis
    PLoS Neglected Tropical Diseases, 2018
    Co-Authors: Philippe Gautret, Marc Shaw, Kristina M. Angelo, Hilmir Asgeirsson, David G. Lalloo, Eli Schwartz, Michael Libman, Kevin C. Kain, Watcharapong Piyaphanee, Holly Murphy
    Abstract:

    Background: Recent studies demonstrate that Rabies post-exposure prophylaxis (RPEP) in international travelers is suboptimal, with only 5–20% of travelers receiving Rabies immune globulin (RIG) in the country of exposure when indicated. We hypothesized that travelers may not be receiving RIG appropriately, and practices may vary between countries. We aim to describe the characteristics of travelers who received RIG and/or RPEP during travel. Methodology/Principal findings: We conducted a multi-center review of international travelers exposed to potentially rabid animals, collecting information on RPEP administration. Travelers who started RPEP before (Group A) and at (Group B) presentation to a GeoSentinel clinic during September 2014–July 2017 were included. We included 920 travelers who started RPEP. About two-thirds of Group A travelers with an indication for Rabies Immunoglobulin (RIG) did not receive it. Travelers exposed in Indonesia were less likely to receive RIG in the country of exposure (relative risk: 0.30; 95% confidence interval: 0.12–0.73; P = 0.01). Travelers exposed in Thailand [Relative risk (RR) 1.38, 95% Confidence Interval (95% CI): 1.0–1.8; P = 0.02], Sri Lanka (RR 3.99, 95% CI: 3.99–11.9; P = 0.013), and the Philippines (RR 19.95, 95% CI: 2.5–157.2; P = 0.01), were more likely to receive RIG in the country of exposure. Conclusions/Significance: This analysis highlights gaps in early delivery of RIG to travelers and identifies specific countries where travelers may be more or less likely to receive RIG. More detailed country-level information helps inform risk education of international travelers regarding appropriate Rabies prevention.

  • Summary of studies showing proportion of patients with indication for Rabies Immunoglobulin who received Rabies Immunoglobulin in the country of exposure.
    2018
    Co-Authors: Philippe Gautret, Marc Shaw, Kristina M. Angelo, Hilmir Asgeirsson, David G. Lalloo, Eli Schwartz, Michael Libman, Kevin C. Kain, Watcharapong Piyaphanee, Holly Murphy
    Abstract:

    Summary of studies showing proportion of patients with indication for Rabies Immunoglobulin who received Rabies Immunoglobulin in the country of exposure.

  • Number of international travelers receiving RPEP reported to GeoSentinel, September 2014–July 2017 (RIG: Rabies Immunoglobulin; RPEP: Rabies post-exposure prophylaxis).
    2018
    Co-Authors: Philippe Gautret, Marc Shaw, Kristina M. Angelo, Hilmir Asgeirsson, David G. Lalloo, Eli Schwartz, Michael Libman, Kevin C. Kain, Watcharapong Piyaphanee, Holly Murphy
    Abstract:

    Number of international travelers receiving RPEP reported to GeoSentinel, September 2014–July 2017 (RIG: Rabies Immunoglobulin; RPEP: Rabies post-exposure prophylaxis).

  • Relative risk of receiving Rabies Immunoglobulin in the country of exposure when indicated, by traveler and exposure characteristics, September 2014–July 2017 (N = 304).
    2018
    Co-Authors: Philippe Gautret, Marc Shaw, Kristina M. Angelo, Hilmir Asgeirsson, David G. Lalloo, Eli Schwartz, Michael Libman, Kevin C. Kain, Watcharapong Piyaphanee, Holly Murphy
    Abstract:

    Relative risk of receiving Rabies Immunoglobulin in the country of exposure when indicated, by traveler and exposure characteristics, September 2014–July 2017 (N = 304).

  • cost effectiveness of Rabies post exposure prophylaxis in the context of very low Rabies risk a decision tree model based on the experience of france
    Research Papers in Economics, 2015
    Co-Authors: Philippe Gautret, Florence Ribadeau Dumas, Dieynaba S Ndiaye, Juliette Paireau, Herve Bourhy, Claude Le Pen, Yazdan Yazdanpanah
    Abstract:

    Introduction : Benefit-risk of different anti-Rabies post-exposure prophylaxis (PEP) strategies after scratches or bites from dogs with unknown Rabies status is unknown in very low Rabies risk settings. Design and setting : A cost-effectiveness analysis in metropolitan France using a decision-tree model and input data from 2001 to 2011. Population : A cohort of 2807 patients, based on the mean annual number of patients exposed to category CII (minor scratches) or CIII (transdermal bite) dog attacks in metropolitan France between 2001 and 2011. Interventions : Five PEP strategies: (A) no PEP for CII and CIII; (B) vaccine only for CIII; (C) vaccine for CII and CIII; (D) vaccine+ Rabies Immunoglobulin (RIG) only for CIII; and (E) vaccine for CII and vaccine+ RIG for CIII. Main outcomes measures : The number of deaths related to Rabies and to traffic accidents on the way to anti-Rabies centers (ARC), effectiveness in terms of years of life gained by reducing Rabies cases and avoiding traffic accidents, costs, and incremental cost-effectiveness ratios (ICER) associated with each strategy. Results : Strategy E led to the fewest Rabies cases (3.6 × 10−8) and the highest costs (€1,606,000) but also to 1.7 × 10−3 lethal traffic accidents. Strategy A was associated with the most Rabies cases (4.8 × 10−6), but the risk of traffic accidents and costs were null; therefore, strategy A was the most effective and the least costly. The sensitivity analysis showed that, when the probability that a given dog is rabid a given day (PA) was >1.4 × 10−6, strategy D was more effective than strategy A; strategy B became cost-effective (i.e. ICER vs strategy A 1.4 × 10−4. Conclusions : In the metropolitan France's very low Rabies prevalence context, PEP with Rabies vaccine, administered alone or with RIG, is associated with significant and unnecessary costs and unfavourable benefit-risk ratios regardless to exposure category.

Stephen B. Lambert - One of the best experts on this subject based on the ideXlab platform.

  • Using Serology to Assist with Complicated Post-Exposure Prophylaxis for Rabies and Australian Bat Lyssavirus
    2016
    Co-Authors: Niall Conroy, Susan Vlack, John J. Patten, Robert L. Horvath, Julian M. Williams, Stephen B. Lambert
    Abstract:

    Background: Australia uses a protocol combining human Rabies Immunoglobulin (HRIG) and Rabies vaccine for post-exposure prophylaxis (PEP) of Rabies and Australian bat lyssavirus (ABLV), with the aim of achieving an antibody titre of $0.5 IU/ml, as per World Health Organization (WHO) guidelines, as soon as possible. Methodology/Principal Findings: We present the course of PEP administration and serological testing for four men with complex requirements. Following dog bites in Thailand, two men (62 years old, 25 years old) received no HRIG and had delayed vaccine courses: 23 days between dose two and three, and 18 days between dose one and two, respectively. Both seroconverted following dose four. Another 62-year-old male, who was HIV-positive (normal CD4 count), also suffered a dog bite and had delayed care receiving IM Rabies vaccine on days six and nine in Thailand. Back in Australia, he received three single and one double dose IM vaccines followed by another double dose of vaccine, delivered intradermally and subcutaneously, before seroconverting. A 23-year-old male with a history of allergies received simultaneous HRIG and vaccine following potential ABLV exposure, and developed rash, facial oedema and throat tingling, which was treated with a parenteral antihistamine and tapering dose of steroids. Serology showed he seroconverted following dose four. Conclusions/Significance: These cases show that PEP can be complicated by exposures in tourist settings where reliabl

  • Using Serology to Assist with Complicated Post-Exposure Prophylaxis for Rabies and Australian Bat Lyssavirus
    PLOS Neglected Tropical Diseases, 2013
    Co-Authors: Niall Conroy, Susan Vlack, Julian Williams, John J. Patten, Robert L. Horvath, Stephen B. Lambert
    Abstract:

    Background: Australia uses a protocol combining human Rabies Immunoglobulin (HRIG) and Rabies vaccine for post-exposure prophylaxis (PEP) of Rabies and Australian bat lyssavirus (ABLV), with the aim of achieving an antibody titre of >= 0.5 IU/ml, as per World Health Organization (WHO) guidelines, as soon as possible.

  • Timing of treatment and serological testing following exposure to Rabies virus or Australian Bat Lyssavirus.
    2013
    Co-Authors: Niall Conroy, Susan Vlack, John J. Patten, Robert L. Horvath, Julian M. Williams, Stephen B. Lambert
    Abstract:

    *Treatment abbreviations.v = single dose of Rabies vaccine; vaccine given intramuscularly unless otherwise indicated.vv = double dose of Rabies vaccine.HRIG = human Rabies Immunoglobulin.†Anti-Rabies antibody titre EU/mL.‡Relative volume of vaccine given intradermally and subcutaneously not available in patient's notes.

  • Using serology to assist with complicated post-exposure prophylaxis for Rabies and Australian bat lyssavirus.
    Public Library of Science (PLoS), 2024
    Co-Authors: Niall Conroy, Susan Vlack, John J. Patten, Robert L. Horvath, Julian M. Williams, Stephen B. Lambert
    Abstract:

    BACKGROUND: Australia uses a protocol combining human Rabies Immunoglobulin (HRIG) and Rabies vaccine for post-exposure prophylaxis (PEP) of Rabies and Australian bat lyssavirus (ABLV), with the aim of achieving an antibody titre of ≥0.5 IU/ml, as per World Health Organization (WHO) guidelines, as soon as possible. METHODOLOGY/PRINCIPAL FINDINGS: We present the course of PEP administration and serological testing for four men with complex requirements. Following dog bites in Thailand, two men (62 years old, 25 years old) received no HRIG and had delayed vaccine courses: 23 days between dose two and three, and 18 days between dose one and two, respectively. Both seroconverted following dose four. Another 62-year-old male, who was HIV-positive (normal CD4 count), also suffered a dog bite and had delayed care receiving i.m. Rabies vaccine on days six and nine in Thailand. Back in Australia, he received three single and one double dose i.m. vaccines followed by another double dose of vaccine, delivered intradermally and subcutaneously, before seroconverting. A 23-year-old male with a history of allergies received simultaneous HRIG and vaccine following potential ABLV exposure, and developed rash, facial oedema and throat tingling, which was treated with a parenteral antihistamine and tapering dose of steroids. Serology showed he seroconverted following dose four. CONCLUSIONS/SIGNIFICANCE: These cases show that PEP can be complicated by exposures in tourist settings where reliable prophylaxis may not be available, where treatment is delayed or deviates from World Health Organization recommendations. Due to the potentially short incubation time of Rabies/ABLV, timely prophylaxis after a potential exposure is needed to ensure a prompt and adequate immune response, particularly in patients who are immune-suppressed or who have not received HRIG. Serology should be used to confirm an adequate response to PEP when treatment is delayed or where a concurrent immunosuppressing medical condition or therapy exists

Qing Tang - One of the best experts on this subject based on the ideXlab platform.

  • The establishment of a rapid fluorescent focus inhibition test for testing Rabies virus neutralizing antibody
    Chinese journal of epidemiology, 2010
    Co-Authors: Peng-cheng Yu, Xinjun Lv, Xinxin Shen, Xin-xiong Zheng, Hu Shan, Qing Tang
    Abstract:

    Objective To establish a rapid fluorescent inhibition test (RFFIT) for testing Rabies virus neutralizing antibody and the titer of Rabies virus neutralizing antibody.CVS-11 was used as the standard challenge virus,and three generations prepared for the establishment of the virus library.Methods International standard for Rabies Immunoglobulin was used as the reference serum.RFFIT test was established under consulting the protocol of Institute of Pasteur,and its specificity,stability and reproducibility were validated.Results We established the RFFIT which showed both good specificity ( 100% ) and reproducibility (P＞0.5).Conclusion The establishment of RFFIT test perfected the Rabies laboratory techniques and would enhance the overall ability in detecting Rabies in China. Key words: Rabies virus; Neutralizing antibody; Fluorescent inhibition test; Titer

Shengjie Lai - One of the best experts on this subject based on the ideXlab platform.

  • exposure history post exposure prophylaxis use and clinical characteristics of human Rabies cases in china 2006 2012
    Scientific Reports, 2018
    Co-Authors: Chun Guo, Yang Huai, Carol Y Rao, Shengjie Lai, Wenwu Yin, Shaofa Nie
    Abstract:

    Rabies is still a public health threat in China. Evaluating the exposure history, clinical characteristics, and post-exposure prophylaxis (PEP) of the cases could help in identifying approaches to reducing the number of these preventable deaths. We analysed data collected from 10,971 case-investigations conducted in China from 2006 to 2012. Most cases (n = 7,947; 92.0%) were caused by animal bites; 5,800 (55.8%) and 2,974 (28.6%) exposures were from domestic and free-roaming dogs, respectively. Only 278 (4.8%) of these domestic dogs had previously received Rabies vaccination. Among all cases, 5,927 (59.7%) cases had category III wounds, 1,187 (11.7%) cases initiated the Rabies PEP vaccination and 234 (3.9%) cases with category III wounds received Rabies Immunoglobulin. In our adjusted logistic regression model, male cases (adjusted odds ratio [aOR] = 1.25, 95% confidence interval [CI]: 1.09–1.44) and farmers (aOR = 1.39, 95% CI: 1.10–1.77) and person older than 55 years (aOR = 1.48, 95% CI: 1.01–2.17) were less likely than females and persons in other occupations or younger than 15 years to initiate PEP vaccination. The median incubation period was 66 days (interquartile range (IQR): 33–167 days). To reduce the number of human deaths due to Rabies, Rabies prevention campaigns targeting males and farmers and older people should be conducted. Increasing routine Rabies vaccination among domestic dogs will be essential in the long term.

  • Exposure history, post-exposure prophylaxis use, and clinical characteristics of human Rabies cases in China, 2006–2012
    Nature Publishing Group, 2018
    Co-Authors: Chun Guo, Yang Huai, Carol Y Rao, Shengjie Lai, Wenwu Yin, Shaofa Nie
    Abstract:

    Abstract Rabies is still a public health threat in China. Evaluating the exposure history, clinical characteristics, and post-exposure prophylaxis (PEP) of the cases could help in identifying approaches to reducing the number of these preventable deaths. We analysed data collected from 10,971 case-investigations conducted in China from 2006 to 2012. Most cases (n = 7,947; 92.0%) were caused by animal bites; 5,800 (55.8%) and 2,974 (28.6%) exposures were from domestic and free-roaming dogs, respectively. Only 278 (4.8%) of these domestic dogs had previously received Rabies vaccination. Among all cases, 5,927 (59.7%) cases had category III wounds, 1,187 (11.7%) cases initiated the Rabies PEP vaccination and 234 (3.9%) cases with category III wounds received Rabies Immunoglobulin. In our adjusted logistic regression model, male cases (adjusted odds ratio [aOR] = 1.25, 95% confidence interval [CI]: 1.09–1.44) and farmers (aOR = 1.39, 95% CI: 1.10–1.77) and person older than 55 years (aOR = 1.48, 95% CI: 1.01–2.17) were less likely than females and persons in other occupations or younger than 15 years to initiate PEP vaccination. The median incubation period was 66 days (interquartile range (IQR): 33–167 days). To reduce the number of human deaths due to Rabies, Rabies prevention campaigns targeting males and farmers and older people should be conducted. Increasing routine Rabies vaccination among domestic dogs will be essential in the long term

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