Rabies trend in China (1990–2007) and post-exposure prophylaxis in the Guangdong province

Si, Han; Guo, Zhiwei; Hao, Yuantao; Liu, Yuge; Zhang, Dingmei; Rao, Shaoqi; Lu, Jiahai

doi:10.1186/1471-2334-8-113

Cited by 67 publications

(73 citation statements)

References 33 publications

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“…There was no information about rabies and the risk of animal bite in the current study population. But the findings were consistent with those of the previous studies revealing that the population may not be aware of the risks of animal bites (18,19). Khazaei et al (9) in a similar study reported that distance to the RTC was more than 30 km for 51.3% of the bitten people and 72.5% of them did not receive timely PEP.…”

Section: Discussionsupporting

confidence: 82%

Delay in Post-Exposure Prophylaxis and Associated Factors Among People Bitten by Animals in the Northeast of Iran, 2015

Khazaei

Rezaeian

Salehiniya

et al. 2016

Arch Clin Infect Dis

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Background: Despite the importance of post-exposure prophylaxis (PEP), studies conducted in Iran on PEP showed different findings and it is not well documented yet. Objectives:The current study aimed to evaluate the delayed time of PEP and associated factors in bitten people. Materials and Methods: This cross-sectional study was conducted on 397 subjects of animal bites in Khalilabad County, Northeast of Iran, from March 2012 to March 2013. The census method was employed to use the data on animal bites recorded in the rabies treatment center (RTC).Results: Overall, 93.4% of the subjects received PEP in less than 48 hours after exposure. Of the 397 subjects, 86.0% were male, 61.7% aged 0 -30 years, and 64.7% lived in rural areas. The subjects were mainly bitten by domestic dogs (79.8%), most of the subjects (91.9%) were involved with superficial wounds, and the most common sites of the animal bite were legs (48.1%) and hands (40.6%). The bite incidents happened more frequently in spring (29.2%) followed by summer (26.7%). There was only significant difference in delayed PEP with respect to the type of biting animal (x 2 = 30.8, P < 0.001). Conclusions:The rabies PEP is well monitored in the region and its delayed time depends on the type of biting animal especially domestic dogs. Considering the high proportion of stray and domestic dogs as a public health concern in the district, the educational programs and the rabies vaccinations of dogs is recommended in the community.

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Section: Discussionsupporting

confidence: 82%

Delay in Post-Exposure Prophylaxis and Associated Factors Among People Bitten by Animals in the Northeast of Iran, 2015

Khazaei

Rezaeian

Salehiniya

et al. 2016

Arch Clin Infect Dis

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“…From 1990 to 1996, numbers of cases of human rabies were extremely low due to the nationwide rabies vaccination program (11), although the numbers of rabies cases increased considerably in recent years, due largely to more relaxed dog control measures. Approximately 5,000,000 persons undergo postexposure rabies vaccination annually (11). China accounts for almost two-thirds of the total postexposure prophylaxis (PEP) used in Asia, and the locally produced tissue culture vaccine is safe and relatively inexpensive (7).…”

mentioning

confidence: 99%

“…In 1981, the Semple vaccine was completely replaced by a locally produced tissue cell vaccine (TCV) in China (15). From 1990 to 1996, numbers of cases of human rabies were extremely low due to the nationwide rabies vaccination program (11), although the numbers of rabies cases increased considerably in recent years, due largely to more relaxed dog control measures. Approximately 5,000,000 persons undergo postexposure rabies vaccination annually (11).…”

mentioning

confidence: 99%

Persistence of Rabies Antibody 5 Years after Postexposure Prophylaxis with Vero Cell Antirabies Vaccine and Antibody Response to a Single Booster Dose

Zhang

Zhu

Wang

2011

Clin. Vaccine Immunol.

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This study was done to investigate the antibody response to a Vero cell antirabies vaccine, the persistence of antibody for 5 years, and the effect of a booster dose after this interval. From August 2005 to February 2011, a total of 195 patients were enrolled into our study due to an animal bite. The Essen intramuscular (i.m.) regimen, which is recommended by the WHO for modern vaccines used in postexposure treatment, was adopted in this study. Blood samples were obtained on day 0, day 7, day 14, day 45, year 1, year 2, year 3, year 4, year 5, and year 5 plus 14 days. Immunogenicity was evaluated by the titration of neutralizing antibodies with a rapid fluorescent focus inhibition test (RFFIT). Seroconversion was expressed as the seroconversion rate (SCR). A secondary quantitative evaluation criterion, other than the seroconversion level, was the geometric mean titer (GMT). Of the 195 enrolled patients, 168 (86.4%) of them completed the whole study. No serious adverse reactions to the vaccine were reported during vaccination, the 5-year follow-up period, or revaccination. On day 14, the rabies antibody GMT value was 8.87 IU/ml in the vaccinees. During the next 5 years, the SCR in the ChengDa vaccine group gradually decreased to 34.0% at year 5, down from 90.5% at year 1. There was a significant booster effect: the GMT was 15.22 IU/ml on year 5 plus 14 days. Our findings demonstrate that the ChengDa rabies vaccine offers an alternative with a high degree of efficacy and yet limited side effects and ensures that the exposed patient will be on the safe side of the risk of rabies by the 14th day. Moreover, when followed by a booster dose 5 years later, it could boost the immunity. A further booster is effective in inducing a good neutralizing antibody response even after an interval of 5 years.Although effective vaccines for the postexposure treatment of rabies are available (4), there are still about 50,000 to 60,000 human deaths annually. Rabies is a major public health problem in most of the developing world (3, 6). China, the largest developing country in the world, has endeavored tremendously to prevent rabies and manufacture vaccines. In 1981, the Semple vaccine was completely replaced by a locally produced tissue cell vaccine (TCV) in China (15). From 1990 to 1996, numbers of cases of human rabies were extremely low due to the nationwide rabies vaccination program (11), although the numbers of rabies cases increased considerably in recent years, due largely to more relaxed dog control measures. Approximately 5,000,000 persons undergo postexposure rabies vaccination annually (11). China accounts for almost two-thirds of the total postexposure prophylaxis (PEP) used in Asia, and the locally produced tissue culture vaccine is safe and relatively inexpensive (7).Currently, the most prevalently used rabies vaccine in China is the purified Vero cell rabies vaccine (PVRV; Liaoning ChengDa Biological Co., Ltd., Shengyang, China). The Vero cell line has a long and successful history of use for the production of rabies...

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“…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.…”

Section: Introductionmentioning

confidence: 99%

“…Immunogenicity and safety of purified chickembryo 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…”

mentioning

confidence: 99%

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

Wen

et al. 2015

Human Vaccines & Immunotherapeutics

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(2015) 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 , Human Vaccines & Immunotherapeutics, 11:2, 435-442, DOI: 10.4161/21645515.2014 The aim of this Phase IIIb, open-label, randomized study was to demonstrate the non-inferiority of immune responses and to assess the safety of a purified chick-embryo cell rabies vaccine (PCECV) in healthy Chinese children (6 to 17 years) and older adults (51 years) following 2 alternative intramuscular (IM) simulated post-exposure prophylaxis (PEP) regimens: 4-dose Zagreb or 5-dose Essen regimen. Serum samples were collected prior to vaccination on Days 1 and 15 and on day 43 to assess immune response by rabies virus neutralizing antibody (RVNA) concentrations. Solicited adverse events (AEs) were recorded for up to 7 days following each vaccine dose, and unsolicited AEs throughout the entire study period. PCECV vaccination induced a strong immune response at Day 15, and the non-inferiority in immune response of the Zagreb vs. the Essen regimen was demonstrated in children and older adults. At Day 15,100% of children (N D 224), and 99% of subjects 51 years of age (N D 376) developed adequate RVNA concentrations (0.5 IU/mL); at Day 43 all subjects achieved RVNA concentrations 0.5 IU/mL, for both PEP regimens. The well-known tolerability and safety profile of the PCECV was again observed in this study following either Zagreb or Essen regimens. Rabies PEP vaccination with PCECV following a Zagreb regimen induced immune responses non-inferior to those of the Essen regimen, and had a similar safety and tolerability profile to the Essen regimen in Chinese children, adolescents, and adults over 51 years. ClinicalTrials.gov identifier: NCT01680016.

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Rabies trend in China (1990–2007) and post-exposure prophylaxis in the Guangdong province

Cited by 67 publications

References 33 publications

Delay in Post-Exposure Prophylaxis and Associated Factors Among People Bitten by Animals in the Northeast of Iran, 2015

Delay in Post-Exposure Prophylaxis and Associated Factors Among People Bitten by Animals in the Northeast of Iran, 2015

Persistence of Rabies Antibody 5 Years after Postexposure Prophylaxis with Vero Cell Antirabies Vaccine and Antibody Response to a Single Booster Dose

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

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