WHO Collaborating Center for Reference and Research on Rabies, National Reference Center for Rabies, Pasteur Institute of Iran, Tehran, Iran.
Zoonosis Department, Center for Communicable Disease Control, Ministry of Health and Medical Education, Iran.
Virus Res. 2020 Mar;278:197883. doi: 10.1016/j.virusres.2020.197883. Epub 2020 Jan 22.
Rabies is still threatening half of the world's population with the global burden of canine rabies being estimated as 59,000 human deaths, annually. With no cure existing for clinical rabies, post-exposure prophylaxis (PEP) is the only certain means to save lives of the exposed people. In Iran, bite incidences exceed 180,000 per year, where all victims receive 5 vaccine doses for PEP, conforming to the Essen regimen. More than two-thirds of the exposed individuals stop receiving treatments after day 7, for the reason of being exposed to a non-rabid dog or cat. According to the national standard protocols, these individuals should re-start a complete 5-dose PEP course upon the re-exposure. New WHO recommendations based on scientific data is encouraging revisions to the existing prophylaxis programs. In order to know if an incomplete Essen regimen can provide adequate immunity, in the present study, 5 groups of individuals who had only received 3 first doses of the Essen regimen within the previous 1, 3, 6, 12 and 24 months were examined for immunity against rabies. Our results indicated sufficient anti-rabies neutralizing antibody in all individuals, before and after receiving two standard booster doses (i.e. days 0 and 3). This might also suggest the adequacy of the 3 first doses of vaccination, as a one-week long post-exposure vaccination program.
狂犬病仍然威胁着全球一半的人口,据估计,全球每年有 59,000 人死于狂犬病。由于目前尚无治疗临床狂犬病的方法,暴露后预防(PEP)是拯救暴露人群生命的唯一可靠手段。在伊朗,每年咬伤事件超过 18 万例,所有受害者都按照 Essen 方案接受 5 剂疫苗用于 PEP。超过三分之二的暴露者在第 7 天后停止治疗,原因是他们接触的是非狂犬病犬或猫。根据国家标准方案,这些人在再次暴露时应重新开始完整的 5 剂 PEP 疗程。根据科学数据,世界卫生组织(WHO)的新建议鼓励对现有预防方案进行修订。为了了解不完整的 Essen 方案是否能提供足够的免疫力,在本研究中,我们检查了在过去 1、3、6、12 和 24 个月内仅接受 3 剂 Essen 方案首剂的 5 组个体的狂犬病免疫力。我们的结果表明,所有个体在接受两剂标准加强剂量(即第 0 天和第 3 天)之前和之后均具有足够的抗狂犬病中和抗体。这也可能表明 3 剂疫苗接种是足够的,可作为一周的 PEP 疗程。