Dempster G, Stead S, Zbitnew A, Rhodes A J, Zalan E
Can Med Assoc J. 1979 May 5;120(9):1069-74.
Thirty-six persons -- veterinarians, technicians and students at a veterinary clinic -- were unwittingly exposed to a rabid dog over a period of 21/2 days. One veterinarian received a penetrating bite, two other individuals were grabbed by the dog but the skin was not penetrated, and many were exposed to saliva or urine or both. In addition, the owner of the dog and his wife and three children, while not bitten, were exposed to saliva. The diagnosis was made post mortem when specimens of the dog's brain were examined by indirect fluorescent antibody testing. All but one of the students had been vaccinated against rabies with hamster kidney vaccine, but eight members of the veterinary college's staff had not been so vaccinated. Treatment started with duck embryo vaccine; if necessary, rabies (human) immune globulin was also given. When one student reacted severely to the first dose of duck embryo vaccine permission was sought to bring a human diploid vaccine into Canada. In five patients the human diploid vaccine was substituted for the duck embryo vaccine because of severe reactions to the latter. Twenty-five staff members and the family of five received both vaccines. Reactions to the human diploid vaccine were minor and transient. Recommendations include the early licensing of the human diploid vaccine in Canada.
36人——一家兽医诊所的兽医、技术人员和学生——在2个半月的时间里不知不觉地接触了一只患有狂犬病的狗。一名兽医被狗深深咬伤，另外两人被狗抓住但皮肤未被咬穿，还有许多人接触到了狗的唾液或尿液，或两者都接触到了。此外，狗的主人及其妻子和三个孩子虽未被咬，但接触到了狗的唾液。在对狗的大脑标本进行间接荧光抗体检测后，死后做出了诊断。除一名学生外，其他学生都接种过仓鼠肾疫苗，但兽医学院的8名工作人员未接种过该疫苗。治疗从鸭胚疫苗开始；如有必要，还会注射狂犬病（人用）免疫球蛋白。一名学生对第一剂鸭胚疫苗反应严重，于是申请将人二倍体细胞狂犬病疫苗引入加拿大。由于对鸭胚疫苗反应严重，5名患者用人二倍体细胞狂犬病疫苗替代了鸭胚疫苗。25名工作人员和那五口之家都接种了这两种疫苗。人二倍体细胞狂犬病疫苗的反应轻微且短暂。建议包括在加拿大早日批准人二倍体细胞狂犬病疫苗。
