9845例动物咬伤者及狂犬疫苗接种情况分析

目的 了解分析平江县近两年来动物咬伤者狂犬疫苗接种情况,探讨咬伤后处置方法,采取综合性预防措施,为有效遏制狂犬病疫情提供参考. 方法收集两年来门诊病历,进行资料统计分析. 结果在本门诊就诊的9 845例暴露后伤者经规范的伤口处置、疫苗接种,无一例发生狂犬病.咬伤动物以犬为主占86.68%,头部、躯干咬伤以10岁以下儿童所占比重最高,经χ2检验,与其他各年龄组比较差异均有统计学意义. 结论动物咬伤后应按规范清洗伤口、及时、全程、足量接种狂犬疫苗,加强狂犬病预防控制的宣传教育,加强儿童监护,将预防接种费用纳入新型农村合作医疗补偿是提高暴露后疫苗接种率,降低狂犬病发病率的有力措施.值得深入推广.     

狂犬病疫苗接种者的流行病学分析

狂犬病是人畜共患的自然疫源性疾病 ,病死率极高 ,人患狂犬病后几乎全部死亡。因此 ,加强人暴露后狂犬病疫苗接种是挽救生命的唯一手段。 80年代以来 ,我国生产并使用原代地鼠肾细胞疫苗对暴露人群进行免疫 ,以防止狂犬病的发生。本文对新津县 1999～ 2 0 0 0年 196 8名狂犬病疫苗接种者进行流行病学分析 ,现将结果报告如下。1　材料和方法1 1　材料　卫生部长春生物制品研究所提供狂犬病疫苗共 5批次 ;数据来源于新津县卫生防疫站犬伤门诊登记表 1999～ 2 0 0 0年。1 2　方法　描述性流行病学分析2　结果2 1　免疫接种时间　 196 8名狂犬…     

468名狂犬病疫苗接种者流行病学分析

对468名狂犬病疫苗接种者的流行病学分析结果表明，经过几年卫生知识的宣传普及，人们对接种狂犬病疫苗预防狂犬病的意识增强了，县城犬养殖数量增加而管理措施滞后，是县城暴露人群高于乡镇农村的主要因素。     

108例动物致伤者及狂犬疫苗接种者的调查分析

为了解疫苗接种后的免疫应答情况,提高免疫效果,科学有效的预防狂犬病的发生,我们对来我站时行全程接种国产人用狂犬疫苗者于15天—20天左右进行血清抗体测定,现将108例狂犬设苗接种者的血清抗体检测情况报告如下。     

狂犬病疫苗2-2-1接种程序的研究

接种狂犬病疫苗是预防狂犬病的重要措施之一,目前已经使用过的接种程序不少于21种(包括ＷＨＯ推荐的常规免疫程序[1])。这些方法都有一定的不足之处。为此,我们对免疫的抗原量和免疫程序进行了研究,旨在突发的狂犬病暴露后注射针次少、抗体产生早且效价高。一、材料与方法...     

南郑县2011—2012年狂犬病暴露者处置情况比较分析

目的比较南郑县2011—2012年狂犬病暴露者伤口处置间隔时间、狂犬病疫苗、狂犬病人免疫球蛋白接种（使用）率和24小时内及时接种（使用）率,为改进防控措施提供信息和依据。方法汇总、统计2011—2012年南郑县犬伤人及疫苗接种登记数据,比较两年间狂犬病暴露者伤口处置时间、狂犬病疫苗、狂犬病人免疫球蛋白接种（使用）率和24小时内及时接种（使用）率有无统计学差异。结果 2012年狂犬病暴露者暴露至处置间隔时间缩短,Ⅲ级暴露者狂犬病人免疫球蛋白使用率和24小时内及时使用率较2011年有所提高,3个指标的差异有统计学意义（P〈0.05）。两年的狂犬疫苗24小时内及时接种率基本持平,无统计学差异。结论预防人间狂犬病的发生,首先要全面落实和提高犬、猫等宿主动物的管理及免疫,同时强化人群暴露后的及时、规范处置,不能单一强调人间狂犬病暴露后的狂犬病疫苗接种和狂犬病人免疫球蛋白的使用。     

狂犬疫苗接种者不良反应及相关知识知晓情况调查分析

目的：分析狂犬疫苗接种者不良反应及相关知识知晓情况。方法：选取2020年1～2021年1月期间在焦作市疾病预防控制中心进行免疫接种的犬伤者4385例，对狂犬病暴露处进行规范的处理，并注射疫苗，对疫苗注射后是否出现不良反应进行严密监测，并及时处理；于4385例犬伤者中采用随机数字表法选取其中的500例进行相关知识知晓情况调查分析。结果：4385例接种者共发生不良反应12例，其中以注射部位红肿、瘙痒和硬结等一般反应较为常见，占比66.67%,患者经过积极对症的处理后，症状均缓解，并全部治愈，未发生因不良反应造成的严重事件。12例不良反应者中男性8例，女性4例，其中以15～40岁人群占比最高，为41.67%。对500例接种者进行调查分析可见，对调查内容的知晓情况认知整体水平较低，对狂犬病是传染病的认知水平较高，为98.2%;另外500例接种者对狂犬病相关知识的获取途径仍以报纸书籍最高，为79.2%。结论：狂犬疫苗能引起一定的不良反应，临床应进行积极处理，同时不良反应的监测工作不容忽视，应进一步增强群众预防狂犬病知识，扩大狂犬病预防相关知识的覆盖面。     

2153例狂犬病疫苗接种者流行病学分析

目的 了解2153例狂犬病疫苗接种者的流行病学特征及预防处理情况,为制定及时有效的狂犬病防治措施提供依据.方法 对2008～2009年2153名暴露后全程免疫者进行流行病学分析.结果 本次调查的2153例免疫者中,男女相差不大,40～49岁年龄组所占比例较大,82.0%的暴露者能在24小时内就诊,使用狂犬病免疫球蛋白的人数占应使用者的12.07%,第二、三季度动物致伤者较多.结论 加强犬、猫等动物的管理,普及群众狂犬病防治知识,暴露后正确处理伤口,及时注射狂犬疫苗和狂犬病免疫球蛋白是预防狂犬病发生的有效措施.     

1971例狂犬病疫苗接种者流行病学调查

近年来,全国狂犬病疫情持续上升,疫情波及范围不断扩大,2004--2006年全国报告狂犬病死亡人数8403例,占同期各种传染病病死数的30．1％,高居37种法定传染病报告病死数之首。2007年全国报告狂犬病病例3010例,2007年广东省狂犬病病例报告334例,病情波及19个地级以上市,疫情仍处于近年来高流行水平,防控形势十分严峻。接种狂犬病疫苗是预防狂犬病最有效的手段之一。为有效控制狂犬病的蔓延,我们对本市狂犬病接种者作一次流行病学调查。     

25例狂犬病病例流行病学及临床分析

目的　了解狂犬病流行病学及临床特点。方法　对某院1991年1月～2 0 0 3年10月收治的2 5例狂犬病患者的流行病学及临床资料进行回顾性分析。结果　本组病例以农村居民为主,占80 % (2 0例)。犬伤害发病者占92 % (2 3例) ;头面部与多部位受伤者潜伏期明显短于四肢受伤者(P <0 .0 1)。18例(72 % )患者受伤后未采取预防措施。临床症状以恐水、怕风、发热较常见,多伴有多器官损害。2 5例患者全部病死。结论　狂犬病患者以农村居民及犬伤害为主;头面部与多部位受伤者潜伏期较短;病死率高达10 0 % ;人们对狂犬病的预防不够重视。     

Public health impact of reemergence of rabies,New York

This report summarizes the spread of a raccoon rabies epizootic into New York in the 1990s, the species of animals affected, and human postexposure treatments (PET). A total of 57,008 specimens were submitted to the state laboratory from 1993 to 1998; 8,858 (16%) animals were confirmed rabid, with raccoons the most common species (75%). After exposure to 11,769 animals, 18,238 (45%) persons received PET, mostly because of contact with saliva or nervous tissue. We analyzed expenditure reports to estimate the cost of rabies prevention activities. An estimated $13.9 million was spent in New York State to prevent rabies from 1993 to 1998. Traditional prevention methods such as vaccinating pets, avoiding wildlife, and verifying an animal's rabies status must be continued to reduce costly PET. To reduce rabid animals, exposures, and costs, oral vaccination of wildlife should also be considered.     

Serological methods used for rabies post vaccination surveys: An analysis

The assessment of fox immunity following oral rabies vaccination (ORV) is commonly applied to assess the efficacy of an ORV campaign in the field. Several ELISA kits have been developed and validated for their use for rabies serology in wildlife as an alternative to neutralizing techniques (NT), such as the fluorescent antibody virus neutralization test (FAVN) and the rapid fluorescent foci inhibition test (RFFIT). At a European level, NT and ELISA tests are used interchangeably and on different types of samples collected for vaccination follow-up. This has resulted in a difficulty in comparing the results generated with different diagnostic tools. We have evaluated (a) the effect of two different matrices commonly used for serology in red foxes on the results of the FAVN and (b) the performance of two commercially available ELISAs in comparison with the FAVN, as a gold standard, using a panel of over 700 field fox samples. Moderate agreement was observed when comparing results from different matrices. We found a very low level of agreement and low values of relative sensitivity and specificity of the ELISAs tested in comparison with the FAVN. Our findings confirm, using a vast collection of field samples obtained during post-vaccination surveillance campaigns in Italy, the need for improved reliability of certain serological tests.     

Postexposure rabies vaccination during pregnancy: experience with 21 patients

Twenty-one pregnant rabies exposed patients received postexposure vaccination using purified Vero cell rabies vaccine. Twelve of these with severe exposures were also given equine rabies immune globulin. Adverse reactions were mild, transient and required no treatment. Fifteen per cent of the patients reported side-effects such as myalgia, malaise, erythema and swelling at injection sites, urticarial rashes, and mild regional lymphadenopathy. The vaccine series was completed in all cases and none of the mothers or infants developed rabies after one year of follow-up. No congenital malformations were detected. All infants were well after one year. One patient experienced a spontaneous abortion.     

Influence of oral rabies vaccine bait density on rabies seroprevalence in wild raccoons

The effect of different oral rabies vaccine (ORV) bait densities (75, 150, and 300 baits/km²) on the seroprevalence of rabies virus neutralizing antibodies (RVNAs) in raccoons (Procyon lotor) was assessed at a 15% seroprevalence difference threshold in rural areas of northeast Ohio. Results (n = 588 raccoons) indicated that seropositivity for RVNAs was associated with both bait density and bait campaign frequency. Associations were not detected for raccoon gender, age, or macro-habitat. The odds of being seropositive were greater for raccoons originating from 300 bait/km² treatment areas relative to those coming from the 75 bait/km² areas (odds ratio [OR] = 4.4, probability [P] < 0.001, 95% confidence interval [CI] = 2.4–7.9), while accounting for cumulative ORV campaigns. No statistical advantage in seroprevalence was detected when comparing 150–75 baits/km². These results indicate that a relatively extreme bait density when evenly distributed may be necessary to obtain a significant increase in seroprevalence. Higher bait densities may be more appropriate and less costly to address focused outbreaks than labor intensive trap-vaccinate-release and local population reduction campaigns. Finally, dramatic increases in seroprevalence of RVNA were not observed in raccoons between sequential, semi-annual campaigns, yet cumulative ORV campaigns were associated with gradual increases in seroprevalence.     

Live attenuated rabies virus co-infected with street rabies virus protects animals against rabies

While current rabies post-exposure prophylaxis (PEP) is highly effective, it is costly and the vaccination regimen is complicated, requiring both inactivated vaccines and immunoglobulins. A one-dose rabies vaccine for human PEP remains a long-term goal. Here, we describe development of a highly attenuated rabies virus ERAg3m, with a mutation in the glycoprotein (G) gene and a switch of the G gene with the matrix protein gene in the viral genome. After a one-dose intramuscular vaccination, the ERAg3m virus protected 100% of mice and hamsters from lethal challenge. In co-infections, using a lethal dose of street rabies virus mixed with ERAg3m, 100% of hamsters and 90% of mice survived and were protected against subsequent infection. A mock co-infection, using inactivated commercial human rabies vaccine and a lethal dose of street rabies virus, protected 100% and 40% of hamsters and mice, respectively. In co-infections, when vaccine was administrated in the left leg and challenge virus in the right leg, the ERAg3m virus protected 40% of mice, while the inactivated vaccine showed no protection. Therefore, live attenuated rabies virus when given pre-exposure or co-infected with street rabies virus, is capable of preventing rabies in two different animal models. Overall, this highly attenuated live rabies virus offered better protection than the inactivated vaccine.     

Immunogenicity, safety and lot consistency in adults of a chromatographically purified Vero-cell rabies vaccine: a randomized, double-blind trial with human diploid cell rabies vaccine

The immunogenicity and safety of a chromatographically purified rabies vaccine (CPRV) was evaluated using US veterinary medical students. In the first study, 242 healthy adults were enrolled in a randomized, modified double-blind, multicenter trial and received five doses of either CPRV or human diploid cell vaccine (HDCV) by intramuscular injection on days 0, 3, 7, 14, and 28 concurrently with human rabies immunoglobulin in a simulated post-exposure prophylaxis regimen. Post-immunization titers in the CPRV and HDCV groups reached 0.5 IU/ml (the WHO-recommended minimally acceptable titer) or greater in all subjects in both vaccine groups by day 14 and remained above that level through day 90. In the second study, 438 healthy adults were enrolled in a randomized, double-blind, multicenter trial and assigned to receive five doses from one of three lots of CPRV by intramuscular injection on days 0, 3, 7, 14, and 28 in a simulated post-exposure prophylaxis regimen to evaluate lot consistency. Post-immunization titers rapidly increased to over 0.5 IU/ml by day 14 for all subjects and remained above that level through day 42 when the study was terminated. The three lots were considered equivalent. The percentage of subjects with at least one local reaction during the five-dose regimen was slightly lower in the CPRV group than in the HDCV group (P=0.06). The most frequently reported local reaction for all doses of vaccine was pain at the injection site. Headache, myalgia, and malaise were the most frequently reported systemic events. The percentage of subjects with at least one systemic event was significantly lower for CPRV (P=0.0084). No vaccine-related serious adverse reaction was reported in these studies. The results of these studies indicate that CPRV administered intramuscularly to healthy adults is immunogenic and is associated with fewer local and systemic reactions than HDCV.     

Evaluation of immune responses in dogs to oral rabies vaccine under field conditions

During the 20th century parenteral vaccination of dogs at central-point locations was the foundation of successful canine rabies elimination programs in numerous countries. However, countries that remain enzootic for canine rabies have lower infrastructural development compared to countries that have achieved elimination, which may make traditional vaccination methods less successful. Alternative vaccination methods for dogs must be considered, such as oral rabies vaccine (ORV). In 2016, a traditional mass dog vaccination campaign in Haiti was supplemented with ORV to improve vaccination coverage and to evaluate the use of ORV in dogs. Blisters containing live-attenuated, vaccine strain SPBNGAS-GAS were placed in intestine bait and distributed to dogs by hand. Serum was collected from 107 dogs, aged 3–12 months with no reported prior rabies vaccination, pre-vaccination and from 78/107 dogs (72.9%) 17 days post-vaccination. The rapid florescent focus inhibition test (RFFIT) was used to detect neutralizing antibodies and an ELISA to detect rabies binding antibodies. Post-vaccination, 38/41 (92.7%) dogs that received parenteral vaccine had detectable antibody (RFFIT >0.05 IU/mL), compared to 16/27 (59.3%, p < 0.01) dogs that received ORV or 21/27 (77.8%) as measured by ELISA (>40% blocking, p < 0.05). The fate of 291 oral vaccines was recorded; 283 dogs (97.2%) consumed the bait; 272 dogs (93.4%) were observed to puncture the blister, and only 14 blisters (4.8%) could not be retrieved by vaccinators and were potentially left in the environment. Pre-vaccination antibodies (RFFIT >0.05 IU/mL) were detected in 10/107 reportedly vaccine-naïve dogs (9.3%). Parenteral vaccination remains the most reliable method for ensuring adequate immune response in dogs, however ORV represents a viable strategy to supplement existing parental vaccination campaigns in hard-to-reach dog populations. The hand-out model reduces the risk of unintended contact with ORV through minimizing vaccine blisters left in the community.     

Pivotal role of dogs in rabies transmission, China

The number of dog-mediated rabies cases in China has increased exponentially; the number of human deaths has been high, primarily in poor, rural communities. We review the incidence of rabies in China based on data from 1950 and 2004, obtained mainly from epidemiologic bulletins published by the Chinese Ministry of Health.     

Safety and immunogenicity of a serum-free purified Vero rabies vaccine in healthy adults: A randomised phase II pre-exposure prophylaxis study

A serum-free, highly purified Vero cell rabies vaccine (PVRV-NG) is under development. We previously demonstrated that pre-exposure prophylaxis (PrEP) with PVRV-NG had a satisfactory safety profile and was immunogenically non-inferior to the licensed purified Vero cell rabies vaccine in adults. Here, we evaluated the safety and immunogenic non-inferiority of PrEP with PVRV-NG compared to the licensed human diploid cell vaccine (HDCV) in healthy adults (NCT01784874). Participants received three vaccinations (days 0, 7, and 28) as PrEP with or without a booster injection after 12 months. Rabies virus neutralising antibodies (RVNA) were evaluated on days 0, 28 (subgroup only), and 42, and Months 6, 12, and 12 + 14 days (booster group only). Non-inferiority (first primary objective) was based on the proportion of participants with RVNA titres ≥ 0.5 IU/mL (World Health Organization criteria for seroconversion) on day 42, expected to be ≥ 99% (second primary objective). Safety was evaluated after each dose and monitored throughout the study. At day 42, PVRV-NG was non-inferior to HDCV and the first primary objective was met; seroconversion was observed for 98.3% of PVRV-NG recipients and 99.1% of HDCV recipients. As < 99% of participants in the PVRV-NG group had RVNA titres ≥ 0.5 IU/mL, the second primary objective was not met. Booster vaccination produced a strong increase in RVNA titres for all groups, primed with PVRV-NG or HDCV. RVNA geometric mean titres tended to be higher for HDCV than PVRV-NG primary vaccine recipients. In a complementary evaluation using alternative criteria for seroconversion (complete virus neutralization at 1:5 serum dilution), 99.6% and 100% of participants in the PVRV-NG and HDCV groups, respectively, achieved seroconversion across the vaccine groups. No major safety concerns were observed during the study. PVRV-NG was well tolerated, with a similar safety profile to HDCV in terms of incidence, duration, and severity of adverse events after primary and booster vaccinations.ClinicalTrials.gov number: NCT01784874.