General Features and Post-Exposure Prophylaxis of Rabies

Jun-Sun Park; Myung-Guk Han

doi:10.3947/ic.2010.42.1.6

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Park and Han: General Features and Post-Exposure Prophylaxis of Rabies

Review Article

Infection & Chemotherapy

Infection & Chemotherapy 2010; 42(1): 6-11.

Published online: 28 February 2010

DOI: https://doi.org/10.3947/ic.2010.42.1.6

General Features and Post-Exposure Prophylaxis of Rabies

Jun-Sun Park, Myung-Guk Han

Division of Arboviruses, National Institute of Health, Korea Centers for Disease Control and Prevention, Seoul, Korea.

Corresponding Author: Myung-Guk Han, D.V.M., Ph.D. Address: Division of Arboviruses, National Institute of Health, Korea Centers for Disease Control and Prevention, 192, Tongil-ro, Eunpyeong-gu, Seoul 122-704, Korea. Tel: +82-2-380-2171, Fax: +82-2-380-1499, mghan@korea.kr

Received 23 February 2009

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Rabies is a representative zoonotic disease caused by rabies virus. The discriminative features of rabies are broad range of hosts including humans, a wide variety of incubation periods ranging from a few weeks to more than a year, ability to bring about acute fetal consequence, and scare pathological lesions. Although rabies is fatal, it is preventable disease by vaccination and post-exposure prophylaxis (PEP). This review will focus on general features of rabies, and immunoglobulin and vaccines for PEP.

Keywords: Rabies, vaccine, post-exposure prophylaxis

Figures and Tables

Figure 1

High- and suspect-risk regions of rabies. High-risk and suspect-risk regions are indicated in blue and light blue, respectively. The areas where rabies in humans and animals was reported since 1993 were designated as high-risk region of rabies.

Figure 2

Guideline on post-exposure prophylaxis for animal bite patients (Korea CDC, 2007).

Figure 3

Management of animals to determine post-exposure treatment in 2008. (A) Bite cases by animals vaccinated to rabies. (B) Bite cases by unvaccinated animals.

Table 1

Laboratory confirmation of rabies (29)

N, Number of sample

References

1. Rupprecht CE, Hanlon CA, Hemachudha T. Rabies re-examined. Lancet Infect Dis. 2002. 2:327–343.

2. Smith JS, Fishbein DB, Rupprecht CE, Clark K. Unexplained rabies in three immigrants in the United States. A virologic investigation. N Engl J Med. 1991. 324:205–211.

3. Grattan-Smith PJ, O'Regan WJ, Ellis PS, O'Flaherty SJ, McIntyre PB, Barnes CJ. Rabies. A second Australian case, with a long incubation period. Med J Aust. 1992. 156:651–654.

4. Johnson N, Fooks A, McColl K. Human rabies case with long incubation, Australia. Emerg Infect Dis. 2008. 14:1950–1951.

5. Jackson AC, Warrell MJ, Rupprecht CE, Ertl HC, Dietzschold B, O'Reilly M, Leach RP, Fu ZF, Wunner WH, Bleck TP, Wilde H. Management of rabies in humans. Clin Infect Dis. 2003. 36:60–63.

6. Wilde H, Hemachudha T, Jackson AC. Viewpoint: Management of human rabies. Trans R Soc Trop Med. Hyg. 2008. 102:979–982.

7. Hattwick MA, Weis TT, Stechschulte CJ, Baer GM, Gregg MB. Recovery from rabies. A case report. Ann Intern Med. 1972. 76:931–942.

8. Hattwick MAW. Human rabies. Public Health Rev. 1974. 3:229–274.

9. Willoughby RE Jr, Tieves KS, Hoffman GM, Ghanayem NS, Amlie-Lefond CM, Schwabe MJ, Chusid MJ, Rupprecht CE. Survival after treatment of rabies with induction of coma. N Engl J Med. 2005. 352:2508–2514.

10. Warrell MJ, Warrell DA. Rabies and other lyssavirus diseases. Lancet. 2004. 363:959–969.

11. Noah DL, Drenzek CL, Smith JS, Krebs JW, Orciari L, Shaddock J, Sanderlin D, Whitfield S, Fekadu M, Olson JG, Rupprecht CE, Childs JE. Epidemiology of human rabies in the United States, 1980 to 1996. Ann Intern Med. 1998. 128:922–930.

12. Kim CH, Lee CG, Yoon HC, Nam HM, Park CK, Lee JC, Kang MI, Wee SH. Rabies, an emerging disease in Korea. J Vet Med B Infect Dis Vet Public Health. 2006. 53:111–115.

13. Korea Centers for Disease Control and Prevention. Human Rabies Prevention & Control. 2007.

14. Han MY, Cho JE, Seo SY, Jeong YE. Epidemiological features of animal bite cases occurred in highly risk areas of rabies in Korea, 2005 to 2008. 2009. In : 20th International Conference on Rabies in the Americas; 45–46.

15. Rabies facts. Alliance for Rabies Control. Accessed 10 February 2009. Available at: http://www.rabiescontrol.net/EN/About-Rabies/Rabies-Facts.html.

16. Knobel DL, Cleaveland S, Coleman PG, Fèvre EM, Meltzer MI, Miranda ME, Shaw A, Zinsstag J, Meslin FX. Re-evaluating the burden of rabies in Africa and Asia. Bull World Health Organ. 2005. 83:360–368.

17. WHO. WHO Expert Consultation on rabies. World Health Organ Tech Rep Ser. 2005. 931:1–88.

18. Bronnert J, Wilde H, Tepsumethanon V, Lumlertdacha B, Hemachudha T. Organ transplantations and rabies transmission. J Travel Med. 2007. 14:177–180.

19. Conomy JP, Leibovitz A, McCombs W, Stinson J. Airborne rabies encephalitis: demonstration of rabies virus in the human central nervous system. Neurology. 1977. 27:67–69.

20. Gibbons RV. Cryptogenic rabies, bats, and the question of aerosol transmission. Ann Emerg Med. 2002. 39:528–536.

21. Johnson N, Brookes SM, Fooks AR, Ross RS. Review of human rabies cases in the UK and in Germany. Vet Rec. 2005. 157:715.

22. Srinivasan A, Burton EC, Kuehnert MJ, Rupprecht C, Sutker WL, Ksiazek TG, Paddock CD, Guarner J, Shieh WJ, Goldsmith C, Hanlon CA, Zoretic J, Fischbach B, Niezgoda M, El-Feky WH, Orciari L, Sanchez EQ, Likos A, Klintmalm GB, Cardo D, LeDuc J, Chamberland ME, Jernigan DB, Zaki SR. Rabies in Transplant Recipients Investigation Team. Transmission of rabies virus from an organ donor to four transplant recipients. N Engl J Med. 2005. 352:1103–1111.

23. Pará M. An outbreak of post-vaccinal rabies (rage de laboratoire) in Fortaleza, Brazil, in 1960. Residual fixed virus as the etiological agent. Bull World Health Organ. 1965. 33:177–182.

24. Jackson AC. Rabies. Neurol Clin. 2008. 26:717–726.

25. Iwasaki Y, Tobita M. Jackson AC, Wunner WH, editors. Pathology. Rabies. 2002. San Diego: Academic Press;283–306.

26. Fu ZF, Jackson AC. Neuronal dysfunction and death in rabies virus infection. J Neurovirol. 2005. 11:101–106.

27. Dacheux L, Reynes JM, Buchy P, Sivuth O, Diop BM, Rousset D, Rathat C, Jolly N, Dufourcq JB, Nareth C, Diop S, Iehlé C, Rajerison R, Sadorge C, Bourhy H. A reliable diagnosis of human rabies based on analysis of skin biopsy specimens. Clin Infect Dis. 2008. 47:1410–1417.

28. Woldehiwet Z. Clinical laboratory advances in the detection of rabies virus. Clin Chim Acta. 2005. 351:49–63.

29. Crepin P, Audry L, Rotivel Y, Gacoin A, Caroff C, Bourhy H. Intravitam diagnosis of human rabies by PCR using saliva and cerebrospinal fluid. J Clin Microbiol. 1998. 36:1117–1121.

30. Hemachudha T, Griffin DE, Giffels JJ, Johnson RT, Moser AB, Phanuphak P. Myelin basic protein as an encephalitogen in encephalomyelitis and polyneuritis following rabies vaccination. N Engl J Med. 1987. 316:369–374.

31. Piyasirisilp S, Hemachudha T. Neurological adverse events associated with vaccination. Curr Opin Neurol. 2002. 15:333–338.

32. Swamy HS, Anisya V, Nandi SS, Kaliaperumal VG. Neurological complications due to Semple-type antirabies vaccine. Clinical and therapeutic aspects. J Assoc Physicians India. 1991. 39:667–669.

33. WHO recommendations on rabies post-exposure treatment and the correct technique of intradermal immunization against rabies. WHO. Accessed 19 February 2010. Available at: http://www.who.int/rabies/en/WHO_recommendation_post_exp_treatment.pdf.

34. Rupprecht CE, Briggs D, Brown CM, Franka R, Katz SL, Kerr HD, Lett S, Levis R, Meltzer MI, Schaffner W, Cieslak PR. Evidence for a 4-dose vaccine schedule for human rabies post-exposure prophylaxis in previously non-vaccinated individuals. Vaccine. 2009. 27:7141–7148.

35. Aoki FY, Rubin ME, Friesen AD, Bowman JM, Saunders JR. Intravenous human rabies immunoglobulin for post-exposure prophylaxis: serum rabies neutralizing antibody concentrations and side-effects. J Biol Stand. 1989. 17:91–104.

36. Champion JM, Kean RB, Rupprecht CE, Notkins AL, Koprowski H, Dietzschold B, Hooper DC. The development of monoclonal human rabies virus-neutralizing antibodies as a substitute for pooled human immune globulin in the prophylactic treatment of rabies virus exposure. J Immunol Methods. 2000. 235:81–90.

37. Bakker AB, Python C, Kissling CJ, Pandya P, Marissen WE, Brink MF, Lagerwerf F, Worst S, van Corven E, Kostense S, Hartmann K, Weverling GJ, Uytdehaag F, Herzog C, Briggs DJ, Rupprecht CE, Grimaldi R, Goudsmit J. First administration to humans of a monoclonal antibody cocktail against rabies virus: safety, tolerability, and neutralizing activity. Vaccine. 2008. 26:5922–5927.

38. Goudsmit J, Marissen WE, Weldon WC, Niezgoda M, Hanlon CA, Rice AB, Kruif J, Dietzschold B, Bakker AB, Rupprecht CE. Comparison of an anti-rabies human monoclonal antibody combination with human polyclonal anti-rabies immune globulin. J Infect Dis. 2006. 193:796–801.

39. Rabies vaccines. WHO position paper. Wkly Epidemiol Rec. 2007. 82:425–435.

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