Rabies in China: An Update

Abstract

Human rabies cases in China have continued to increase in recent years, reaching a new peak in 2007. Parallel with an increase in human rabies deaths, a number of animal species with rabies have been reported in the majority of rabies-endemic areas. In this report, the occurrence, status, and control of rabies in both humans and animals are reviewed. Vaccines and immunoglobulin for human and animal use and postexposure prophylaxis for human are also summarized. The current strategies for rabies elimination in China are presented.

A randomized open-labeled study to demonstrate the non-inferiority of purified chick-embryo cell rabies vaccine administered in the Zagreb regimen (2-1-1) compared with the Essen regimen in Chinese adults

“…1 In China, 85%-95% of human rabies cases are dog-mediated rabies, and rabies is among the 3 leading causes of death due to infection. 2 Since 2000, a new epidemic outbreak has led to a rapid increase in the number of notified cases, 3 with over 3,300 clinically diagnosed deaths due to rabies recorded in 2007, 4 and an associated mortality rate that increased by an average of 26% per year from 1999 to 2008. [3][4][5] Since then, the incidence has started to decline, with 2,048 reported cases in 2010, a decrease of about 7.5% compared with 2009.…”

“…2 Since 2000, a new epidemic outbreak has led to a rapid increase in the number of notified cases, 3 with over 3,300 clinically diagnosed deaths due to rabies recorded in 2007, 4 and an associated mortality rate that increased by an average of 26% per year from 1999 to 2008. [3][4][5] Since then, the incidence has started to decline, with 2,048 reported cases in 2010, a decrease of about 7.5% compared with 2009. 6 After an incubation period of approximately 1-3 months, the virus leads to a progressive encephalomyelitis that almost always results in cardiorespiratory arrest and death within a few days of the onset of symptoms.…”

Immunogenicity and safety of purified chick-embryo cell rabies vaccine under Zagreb 2-1-1 or 5-dose Essen regimen in Chinese children 6 to 17 years old and adults over 50 years: A randomized open-label study

“…4 Although declining in recent years, more than 1,400 human deaths were reported in China in the year 2012. [3][4][5][6][7] Following an incubation period of approximately 1-3 months after virus inoculation, the virus travels to the central nervous system, and causes an acute progressive encephalomyelitis followed by coma and death within 1-2 weeks in almost 100% of cases. 8 Although after the onset of clinical symptoms there is no known cure for rabies, timely prophylaxis by vaccination can avert the development of the disease even after exposure to the virus.…”

“…[12][13][14][15][16][17][18][19] Moreover, a study assessing the anamnestic response following a single booster dose administered 2 years after a primary 3-dose immunization with PCECV indicated that it was potentially able to elicit long-lasting immune responses even after 14 years. 20 In China, where 12-15 million doses of rabies vaccine are estimated to be administered annually, 7,21,22 the traditional 5-dose Essen regimen recommended by the WHO has been widely adopted since years, 23 while the Zagreb regimen has been only recently approved for PCECV preparations. A previous clinical trial conducted in healthy adult Chinese subjects aged 18-50 years indicated that immunization following the Zagreb regimen with PCECV was non-inferior to that following the Essen regimen, and had an acceptable and similar if not more favorable safety profile.…”

Experimental Oral Immunization of Ferret Badgers (Melogale moschata) with a Recombinant Canine Adenovirus Vaccine CAV-2-E3Δ-RGP and an Attenuated Rabies Virus SRV9

“…Human rabies cases associated with ferret badger (FB, Melogale moschata) have been reported in southeastern China since 1994, with 17 of 22 human rabies cases in Hangzhou, and 12 of 20 in Huzhou between 1994and 2004(Zhang et al 2009). Rabies in FBs is an increasing public health threat to humans in southeastern China (including northern Jiangxi, central to western Zhejiang, and eastern Anhui provinces; Gong et al 2007;Hu et al 2009). Epidemiologic studies have suggested that FB rabies has likely formed an independent enzootic transmission cycle (Zhang et al 2009).…”