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人类狂犬病负担:通过人用狂犬病纯化疫苗(Rabipur)进行潜在预防

Burden of human rabies disease: its potential prevention by means of Rabipur vaccine.

作者信息

Amicizia Daniela, Lai Piero Luigi, Massaro Elvira, Panatto Donatella

机构信息

Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.

Interuniversity Research Center on Influenza and Other Transmissible Infections (CIRI-IT), Genoa, Italy.

出版信息

J Prev Med Hyg. 2024 Oct 31;65(3):E356-E370. doi: 10.15167/2421-4248/jpmh2024.65.3.3404. eCollection 2024 Sep.

Abstract

Rabies is a zoonotic viral disease transmitted mainly by bites of infected animals, especially dogs, which are responsible for 99% of human cases. Despite being preventable, it remains a neglected disease in low-income countries, with approximately 60,000 deaths per year, mostly concentrated in Africa and Asia. The real worldwide burden of rabies is probably underestimated, as death-reporting systems are inadequate and active surveillance is limited. Rabies prevention implies two main, non-exclusive strategies: (i) dog vaccination, in order to interrupt virus transmission to humans, and (ii) human vaccination i.e. pre-exposure prophylaxis (PrEP) and Post-Esposure Prophylaxis (PEP) through the use of purified cell-culture and embryonated egg-based vaccines (CCEEVs). Rabipur is one of the available anti-rabies vaccines and is indicated for active immunization in individuals of all ages. Its efficacy and safety have been amply demonstrated. In rabies-free countries, PrEP is indicated for individuals who face occupational and/or travel-related exposure to the rabies virus in specific settings or over an extended period. Wider use of human rabies vaccination for PrEP and PEP in conjunction with programs to eradicate rabies from animal populations is the challenging goal in order to reduce the burden of disease and achieve zero rabies.

摘要

狂犬病是一种人畜共患的病毒性疾病,主要通过受感染动物(尤其是狗,99%的人类病例由其导致)的咬伤传播。尽管狂犬病是可预防的,但在低收入国家它仍是一种被忽视的疾病,每年约有6万例死亡,主要集中在非洲和亚洲。由于死亡报告系统不完善且主动监测有限,狂犬病在全球的实际负担可能被低估了。狂犬病预防主要有两种并非相互排斥的策略:(i)给狗接种疫苗,以阻断病毒向人类的传播;(ii)给人接种疫苗,即通过使用纯化细胞培养疫苗和鸡胚疫苗(CCEEV)进行暴露前预防(PrEP)和暴露后预防(PEP)。瑞必补尔是现有的抗狂犬病疫苗之一,适用于各年龄段人群的主动免疫。其有效性和安全性已得到充分证明。在无狂犬病国家,PrEP适用于在特定环境中或长期面临职业和/或与旅行相关的狂犬病病毒暴露风险的个人。将人用狂犬病疫苗更广泛地用于PrEP和PEP,并结合从动物群体中根除狂犬病的计划,是一项具有挑战性的目标,目的是减轻疾病负担并实现狂犬病零死亡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ac03/11698110/43b67c040380/jpmh-2024-03-e356-g001.jpg

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