Haviv J, Rishpon S, Gdalevich M, Mimouni D, Gross E, Shpilberg O
Medical Corps, Israel Defense Forces, Rishon-Lezion, 75702, USA.
Prev Med. 1999 Jul;29(1):28-31. doi: 10.1006/pmed.1999.0498.
Postexposure prophylaxis, adequately applied after exposure to a rabid animal, is highly effective in prevention of human disease. Deviations from the recommended vaccination postexposure treatment protocol have been associated with vaccination failure and human mortality. We investigated an incident in which seven Israel Defense Forces soldiers were bitten by a rabid fox and initially treated not in accordance with the recommended vaccination protocol.
The soldiers received modified anti-rabies postexposure prophylaxis, including a higher dosage of both the active and the passive vaccines. The humoral antibody response was monitored subsequently.
All soldiers showed a satisfactory increase (above 0.5 UE/ml by ELISA) in serum anti-rabies antibody titers. None developed the disease more than a year after follow-up.
Strict adherence to the treatment guidelines following an injury by a rabid animal is of utmost importance. We suggest possible compensatory management after a potentially lethal deviation from protocol.
暴露后预防措施在接触狂犬病动物后充分应用时，对预防人类疾病非常有效。偏离推荐的暴露后疫苗接种治疗方案与疫苗接种失败和人类死亡有关。我们调查了一起事件，7名以色列国防军士兵被一只狂犬病狐狸咬伤，最初未按照推荐的疫苗接种方案进行治疗。
这些士兵接受了改良的暴露后狂犬病预防措施，包括更高剂量的主动和被动疫苗。随后监测体液抗体反应。
所有士兵血清抗狂犬病抗体滴度均有令人满意的升高（ELISA法检测高于0.5 UE/ml）。随访一年多后，无人发病。
狂犬病动物致伤后严格遵循治疗指南至关重要。我们建议在可能致命的偏离方案情况后采取可能的补偿性管理措施。
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