scholarly journals Findings from the initial Stepwise Approach to Rabies Elimination (SARE) Assessment in China, 2019

2021 ◽  
Vol 15 (3) ◽  
pp. e0009274
Author(s):  
Qiulan Chen ◽  
Xiaoyue Ma ◽  
Jeanette J. Rainey ◽  
Yu Li ◽  
Di Mu ◽  
...  
Keyword(s):  
Disease Control ◽  
Vaccination Coverage ◽  
Assessment Tool ◽  
Animal Health ◽  
The United States ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Stepwise Approach ◽  
Control And Prevention ◽  
Exposure Prophylaxis

In 2015, China and other member states of the United Nations adopted the goal of eliminating dog-mediated rabies by 2030. China has made substantial progress in reducing dog-mediated human rabies since peaking with more than 3,300 reported cases in 2007. To further improve coordination and planning, the Chinese Center for Disease Control and Prevention, in collaboration with the United States Centers for Disease Control and Prevention, conducted a Stepwise Approach towards Rabies Elimination (SARE) assessment in March 2019. Assessment goals included outlining progress and identifying activities critical for eliminating dog-mediated rabies. Participants representing national, provincial and local human and animal health sectors in China used the SARE assessment tool to answer 115 questions about the current dog-mediated rabies control and prevention programs in China. The established surveillance system for human rabies cases and availability of post-exposure prophylaxis were identified as strengths. Low dog vaccination coverage and limited laboratory confirmation of rabid dogs were identified gaps, resulting in an overall score of 1.5 on a scale of 0 to 5. Participants outlined steps to increase cross-sectoral information sharing, improve surveillance for dog rabies, increase dog vaccination coverage, and increase laboratory capacity to diagnose rabies at the provincial level. All assessment participants committed to strengthening cross-sector collaboration using a One Health approach to achieve dog-mediated human rabies elimination by 2030.

Updates on the development of vaccines and therapeutic options against rabies

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Roshan Arjun Ananda ◽  
Hooi-Leng Ser ◽  
Vengadesh Letchumanan
Keyword(s):  
Animal Health ◽  
Viral Disease ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Therapeutic Approaches ◽  
The Public ◽  
Health Authorities ◽  
Initial Stage ◽  
Potential Development ◽  
Exposure Prophylaxis

Even though rabies has been claiming more than 50,000 deaths annually worldwide, it is considered as a vaccine-preventable viral disease. More than 95 % of the total human rabies cases are caused by dogs. During the initial stage of infection, affected individuals usually show weakess at the bitten extremities and the virus can ultimately travel to the brain causing neurological signs. In attenuated (inactivated) form, the currently in use vaccines have been recommended by WHO for the prevention (i.e. pre-exposure prophylaxis, PrEP) and treatment (i.e. post-exposure prophylaxis, PEP) regime againstthe rabies virus (RABV). However, given that they normally require refrigeration and are costly, there have been discussions revolving around potential development of newer, safer and cheaper alternative that can perform better and more convenient than the ones that are currently in use. The current review aims to explore general characteristics of RABV before looking into potential candidates of vaccines that have been studied. Further studies on the pathogenic mechanism of RABV and therapeutic approaches are still required to prevent the deathly infection following clinical manifestation. In sum, integrated interventional strategy emphasizing human health and animal health is essential and requires collaboration between health authorities and the public.

scholarly journals Benefit–Risk Assessment of the French Surveillance Protocol of Apparently Healthy Biting Dogs and Cats for Human Rabies Prevention

2021 ◽  
Vol 8 (7) ◽  
pp. 132
Author(s):  
Guillaume Crozet ◽  
Tiffany Charmet ◽  
Florence Cliquet ◽  
Emmanuelle Robardet ◽  
Barbara Dufour ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Traffic Accidents ◽  
Scenario Tree ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Policy Makers ◽  
Benefit Risk Assessment ◽  
Surveillance Protocol ◽  
Exposure Prophylaxis ◽  
Apparently Healthy

In France, apparently healthy dogs and cats that bite humans must undergo an observation period of 15 days with three veterinary visits to ascertain that they remain healthy, indicating that no zoonotic transmission of rabies virus occurred via salivary presymptomatic excretion. This surveillance protocol is mandatory for all pets that have bitten humans, despite France’s rabies-free status in non-flying mammals (i.e., a very low rabies risk). In this context, we aimed to perform a benefit–risk assessment of the existing regulatory surveillance protocol of apparently healthy biting animals, as well as alternative surveillance protocols. A scenario-tree modelling approach was used to consider the possible successions of events between a dog or cat bite and a human death attributed to either rabies or to lethal harm associated with the surveillance protocol (e.g., lethal traffic accidents when traveling to veterinary clinics or anti-rabies centers). The results demonstrated that the current French surveillance protocol was not beneficial, as more deaths were generated (traffic accidents) than avoided (by prompt post-exposure prophylaxis administration). We showed here that less stringent risk-based surveillance could prove more appropriate in a French context. The results in this study could allow policy-makers to update and optimize rabies management legislation.

scholarly journals Post-exposure prophylaxis vaccination rate and risk factors of human rabies in mainland China: a meta-analysis

2018 ◽  
Vol 147 ◽  
Author(s):  
D. L. Wang ◽  
X. F. Zhang ◽  
H. Jin ◽  
X. Q. Cheng ◽  
C. X. Duan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Rural Areas ◽  
Meta Analysis ◽  
Mainland China ◽  
Vaccination Rate ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Eastern Region ◽  
Post Exposure ◽  
Exposure Prophylaxis

AbstractRabies is one of the major public health problems in China, and the mortality rate of rabies remains the highest among all notifiable infectious diseases. A meta-analysis was conducted to investigate the post-exposure prophylaxis (PEP) vaccination rate and risk factors for human rabies in mainland China. The PubMed, Web of Science, Chinese National Knowledge Infrastructure, Chinese Science and Technology Periodical and Wanfang databases were searched for articles on rabies vaccination status (published between 2007 and 2017). In total, 10 174 human rabies cases from 136 studies were included in this meta-analysis. Approximately 97.2% (95% confidence interval (CI) 95.1–98.7%) of rabies cases occurred in rural areas and 72.6% (95% CI 70.0–75.1%) occurred in farmers. Overall, the vaccination rate in the reported human rabies cases was 15.4% (95% CI 13.7–17.4%). However, among vaccinated individuals, 85.5% (95% CI 79.8%–83.4%) did not complete the vaccination regimen. In a subgroup analysis, the PEP vaccination rate in the eastern region (18.8%, 95% CI 15.9–22.1%) was higher than that in the western region (13.3%, 95% CI 11.1–15.8%) and this rate decreased after 2007. Approximately 68.9% (95% CI 63.6–73.8%) of rabies cases experienced category-III exposures, but their PEP vaccination rate was 27.0% (95% CI 14.4–44.9%) and only 6.1% (95% CI 4.4–8.4%) received rabies immunoglobulin. Together, these results suggested that the PEP vaccination rate among human rabies cases was low in mainland China. Therefore, standardised treatment and vaccination programs of dog bites need to be further strengthened, particularly in rural areas.

Hitch a Sugar to a Protein

2019 ◽  
pp. 197-222
Author(s):  
Janet R. Gilsdorf
Keyword(s):  
United States ◽  
Bacterial Meningitis ◽  
American Indian ◽  
Disease Control ◽  
The United States ◽  
Indian Children ◽  
Control And Prevention ◽  
Centers For Disease Control ◽  
American Children ◽  
Native Alaskan

The success of the conjugate Hib vaccines has been spectacular. Prior to their introduction, an estimated 10,000 cases of Hib meningitis occurred annually in the United States, which was approximately 1 in 300 children. It was even higher among native Alaskan and American Indian children. Since the widespread use of the vaccine, the disease has nearly disappeared in the United States, with only 40 cases in children under age 5 years reported by the Centers for Disease Control and Prevention in 2014. Thus, bacterial meningitis, once a scourge that killed and damaged too many American children is, for the most part, now a bad memory.

Nurses’ Implementation of Guidelines for Ventilator-Associated Pneumonia From the Centers for Disease Control and Prevention

2007 ◽  
Vol 16 (1) ◽  
pp. 28-37 ◽  
Author(s):  
Carolyn L. Cason ◽  
Tracy Tyner ◽  
Sue Saunders ◽  
Lisa Broome
Keyword(s):  
Intensive Care ◽  
Disease Control ◽  
Intensive Care Units ◽  
Oral Care ◽  
The United States ◽  
Hand Washing ◽  
Ventilator Associated Pneumonia ◽  
Care Protocol ◽  
Control And Prevention ◽  
Centers For Disease Control

• Background Ventilator-associated pneumonia accounts for 47% of infections in patients in intensive care units. Adherence to the best nursing practices recommended in the 2003 guidelines for the prevention of ventilator-associated pneumonia from the Centers for Disease Control and Prevention should reduce the risk of ventilator-associated pneumonia. • Objective To evaluate the extent to which nurses working in intensive care units implement best practices when managing adult patients receiving mechanical ventilation. • Methods Nurses attending education seminars in the United States completed a 29-item questionnaire about the type and frequency of care provided. • Results Twelve hundred nurses completed the questionnaire. Most (82%) reported compliance with hand-washing guidelines, 75% reported wearing gloves, half reported elevating the head of the bed, a third reported performing subglottic suctioning, and half reported having an oral care protocol in their hospital. Nurses in hospitals with an oral care protocol reported better compliance with hand washing and maintaining head-of-bed elevation, were more likely to regularly provide oral care, and were more familiar with rates of ventilator-associated pneumonia and the organisms involved than were nurses working in hospitals without such protocols. • Conclusions The guidelines for the prevention of ventilator-associated pneumonia from the Centers for Disease Control and Prevention are not consistently or uniformly implemented. Practices of nurses employed in hospitals with oral care protocols are more often congruent with the guidelines than are practices of nurses employed in hospitals without such protocols. Significant reductions in rates of ventilator-associated pneumonia may be achieved by broader implementation of oral care protocols.

scholarly journals Mapping the study topics and characteristics of HIV pre-exposure prophylaxis research literature: a protocol for a scoping review

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e024212 ◽  
Author(s):  
Emiko Kamitani ◽  
Adebukola H Johnson ◽  
Megan Wichser ◽  
Yuko Mizuno ◽  
Julia B DeLuca ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Scoping Review ◽  
The United States ◽  
Research Literature ◽  
Population Characteristics ◽  
Sexually Transmitted ◽  
Research Areas ◽  
Control And Prevention ◽  
Study Characteristics ◽  
Exposure Prophylaxis

IntroductionThe research literature addressing pre-exposure prophylaxis (PrEP) has increased considerably over the last decade. To better understand the research areas and explore research gaps, we will conduct a scoping review to map study topics and describe study characteristics and populations in publications focused on PrEP. The purpose of this protocol is to describe planned methods for the scoping review.Methods and analysisWe will implement a comprehensive systematic literature search to identify PrEP citations in the United States Centres for Disease Control and Prevention HIV/AIDS Prevention Research Synthesis Project database that is unique and extensively focuses on HIV/sexually transmitted infections/hepatitis. We will screen and include studies that are (1) focused on HIV PrEP, (2) primary research with human participants and (3) published in English. Two reviewers will independently abstract data on authors’ names, study years, countries, population characteristics and design. To describe and summarise study topics, we will use 19 codes and five categories that were developed from a preliminary study. The five categories arecategory 1: potential PrEP user/prescriber(behaviours/issues for potential PrEP takers/healthcare professionals),category 2: considerations while on PrEP(experiences of and problems related to staying on or prescribing PrEP),category 3: PrEP efficacy and safety(biomedical aspects and medication efficacy),category 4: methods of and experiences with PrEP clinical trials(possesses/experiences of clinical trials) andcategory 5: cost-effectiveness or economic evaluation(cost studies). Data will be analysed with descriptive statistics.Ethics and disseminationThe findings will be presented at HIV-related conferences and published in peer-review journals.

scholarly journals Human rabies post-exposure prophylaxis relative to the disease epidemiological status

2019 ◽  
Vol 24 (1) ◽  
pp. 315-322 ◽  
Author(s):  
Bruno Fonseca Martins da Costa Andrade ◽  
Taísa Santos de Melo Andrade ◽  
Luzia Helena Queiroz
Keyword(s):  
Rabies Vaccine ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Paulo State ◽  
Technical Manual ◽  
Prophylactic Measures ◽  
Exposure Prophylaxis ◽  
Main City ◽  
Technical Recommendations

Abstract This study evaluated the prophylactic measures adopted after attacks by dogs and cats in the main city of Northwester São Paulo State, based on the technical manual for post-exposure treatment, considering the not controlled (1990-1996) and controlled (1997-2010) rabies status. A retrospective analysis was done using the data from the SINAN records (W64-CID10) between 1990 and 2010. In most cases, the accidents were mild (76.9%), and biting animals were healthy (75.4%); therefore, no treatment was needed in 53.3% of the cases. In 64.6% of cases, the prescribed PEP treatment was inappropriate. The most indicated PEP treatments consisted of vaccine and RIG (43.4%), and either three doses of mouse brain vaccine or two doses of cell culture vaccine (76.5%), during the not controlled and controlled rabies periods, respectively. The treatment was more appropriate and followed the technical recommendations during controlled rabies periods compared to not controlled (p < 0.0001) periods. However, excessive application of RIG and rabies vaccine was observed in both periods.

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