Recent research highlights - April 2015

Here we list the recent research papers most relevant to GARC's Mission

Dog vaccination

Uptake of rabies control measures by dog owners in Flores Island, Indonesia A survey of dog owners revealed a high level of knowledge of rabies and its control, but this was not associated with uptake of the 2012 vaccination campaign. Geographical accessibility was one of the important factors influencing the vaccination uptake and the most important reasons not to join the vaccination campaign were lack of information about the campaign schedule and problems with catching the dog.

Surveillance

Trends in animal rabies surveillance in the endemic state of Minas Gerais, Brazil An analysis of 10,112 rabies diagnoses in animals from the Brazilian passive surveillance system suggest a deterioration in the effectiveness of the passive surveillance for rabies . The number of rabies cases, total number of tests performed and positivity rate are good indicators for evaluating passive surveillance

Rabies  in the State of Rio de Janeiro, Brazil: analysis of surveillance and control actions in the municipal field [In Portuguese] A survey revealed that rabies surveillance and control actions were being unsatisfactorily conducted, especially for items related to the monitoring of vampire bat colonies, viral circulation surveillance, notification and monitoring of suspect or aggressive animals, quantification of dog population and population control of stray dogs.

Human vaccination

30 years of rabies vaccination with Rabipur: a summary of clinical data and global experience Rabipur, the first purified chick embryo cell-culture vaccine, has been licensed in more than 60 countries worldwide. Numerous clinical trials in pre- and post-exposure regimens, using both intramuscular and intradermal routes of administration and extensive, worldwide clinical experience with Rabipur has shown the vaccine to be immunogenic, effective and generally well tolerated.

Comparative study on the immunogenicity and safety of a purified chick embryo cell rabies vaccine (PCECV) administered according to two different simulated post exposure intramuscular regimens (Zagreb versus Essen) 250 healthy adults were enrolled and randomized into a Zagreb or Essen group, each receiving PCECV according to their respective regimen. The Zagreb regimen was immunologically non-inferior to the Essen regimen by Day 14, no safety issues were noted and the occurrence of adverse events was similar in both groups.

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. The non-inferiority in immune response and safety of the Zagreb vs. the Essen regimen was demonstrated in children and older adults in China, as assessed by RVNA concentrations ≥0.5 IU/mL, at day 15 and at day 43.

Factors associated with delay in post-exposure prophylaxis in bitten people Of 425 animal bites cases in Iran, 71.8% were male and 81.2% were from rural areas. Only 37.2% of the cases received timely PEP (< 6 hours), with delayed PEP associated with sex, type of animal, injury status, place of residence and distance from RTC

Evaluation of intradermal vaccination at the anti rabies vaccination OPD. A survey of PEP compliance of pre and post introduction of the ID regimen calculated much lower vaccine costs and increased patient adherence and enrolment with the ID administration route.ID has now been routinely adopted at the clinic.

Rabies epidemiology

Complex Epidemiology of a Zoonotic Disease in a Culturally Diverse Region: Phylogeography of rabies Virus in the Middle East. An investigation of the evolution of 183 rabies virus isolates collected from over 20 countries in the Middle East between 1972 and 2014 shows evidence of four genetically distinct clades with separate origins. Regular and multidirectional trans-boundary movements of viral lineages in some parts of the region, but relative isolation in others suggest that regional collaboration is essential for rabies elimination.

Molecular epidemiology of rabies viruses circulating in two rabies endemic provinces of laos, 2011-2012: regional diversity in southeast Asia. Similar to other rabies -endemic countries, dogs are the main viral reservoir and 3 viral lineages closely related to viruses from neighboring countries are currently circulating in Laos. There is evidence of periodic historic exchanges of the viruses with neighboring countries, but no recent invasion.

Antigenic characterisation of lyssaviruses in South Africa. A total of 624 brain specimens, containing lyssavirus antigen by direct fluorescent antibody test, were subjected to antigenic differentiation. The lyssaviruses were differentiated into two species, namely rabies virus (99.5%, with canid and mongoose biotypes) and Mokola virus (0.5%, from an unknown reservoir species).

Rabies in Saudi Arabia: a need for epidemiological data. Little has been published about the endemic rabies situation in Saudi Arabia. A total of 11069 animal bites to human were reported during the 2007-2009 and 40 animals suspect of rabies were examined for rabies infection from 2005 through 2010. Animal-related injuries remains a public health problem with feral dogs accounting for the majority of bites and animals found to be rabid. Over the last 10 years no confirmed human rabies cases have been reported.

Economic impacts

Towards Canine rabies Elimination in Cebu, Philippines: Assessment of Health Economic Data. An analysis of dog vaccination and human PEP costs for dog bite patients in a highly urbanized area and a low-income rural municipality in Philippines shows that eliminating rabies in dogs through mass vaccination is more cost-effective than treating rabies exposures in humans.

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. In 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 of the exposure category.