Wilde H, Chutivongse S, Tepsumethanon W, Choomkasien P, Polsuwan C, Lumbertdacha B
Queen Saovabha Memorial Institute, Thai Red Cross Society, Bangkok, Thailand.
Rev Infect Dis. 1991 Jul-Aug;13(4):644-52. doi: 10.1093/clinids/13.4.644.
Of the more than 100,000 courses of postexposure rabies treatment given in Thailand annually, 95% consist of brain tissue-derived vaccine without immune globulin. Rabies tissue culture vaccines and immune globulins are expensive by the standards of developing countries. When they are given according to either of two proven intradermal postexposure schedules, significant savings can be achieved without loss of efficacy. Purified equine rabies immune globulins account for approximately 10% of the cost of human products administered to exposed individuals and have been shown to be safe and effective. A canine preexposure immunogenicity study with a potent, inactivated tissue culture vaccine revealed that 12.5% of Thai dogs failed to develop protective antibody titers 2 months after one subcutaneous injection. Previous studies have shown significant antigenic differences between Thai street rabies virus and European and North African strains.
在泰国,每年超过100,000例的狂犬病暴露后治疗疗程中,95%采用的是不含免疫球蛋白的脑组织衍生疫苗。按照发展中国家的标准,狂犬病组织培养疫苗和免疫球蛋白价格昂贵。当按照两种已证实的皮内暴露后接种程序中的任何一种进行接种时,在不降低疗效的情况下可以实现显著的费用节省。纯化马狂犬病免疫球蛋白约占给予暴露个体的人用产品成本的10%,并且已证明是安全有效的。一项使用高效灭活组织培养疫苗对犬进行的暴露前免疫原性研究表明,12.5%的泰国犬在一次皮下注射后2个月未能产生保护性抗体滴度。先前的研究表明,泰国街狂犬病病毒与欧洲和北非毒株之间存在显著的抗原差异。