scholarly journals Atypical paralytic rabies — A case-study from Kerala, India

2021 ◽  
Vol 7 (2) ◽  
pp. 131-136
Author(s):  
Minu Mohan ◽  
Geethu John
Keyword(s):  
Wound Care ◽  
Fluorescent Antibody ◽  
Antibody Test ◽  
Poor Quality ◽  
Rabies Vaccine ◽  
Post Exposure Prophylaxis ◽  
Notifiable Disease ◽  
Mri Findings ◽  
Treatment Protocols

Rabies, though endemic in India, has been a disease of low public health priority throughout the years. Being a non-notifiable disease together with limited diagnostic facilities, it often ends up in under-reporting of cases, especially atypical rabies. Failure of complete rabies Post Exposure Prophylaxis (PEP) with Immunoglobulin has been rarely reported. We report a case of atypical rabies in a 60-year-old man from a rural village in Kerala, who presented with fever, paralysis of limbs, fluctuating consciousness, phonophobia and without classical signs of hydrophobia and aerophobia 22 days after dog bite. The case is supplemented with supportive Magnetic Resonance Imaging (MRI) findings and corneal imprint smear Fluorescent Antibody Test (FAT). The death of the patient on the 28th day of exposure despite early PEP with rabies vaccine and immunoglobulin is suggestive of PEP failure. The case study stresses on the need in making rabies a notifiable disease in the study setting, encouraging disease specific investigation, ensuring availability of vaccine and immunoglobulins with adherence to standardized treatment protocols.Deviations from the recommended protocol for Animal bite management, such as delay in seeking PEP, lack of or improper administration of rabies immunoglobulin (e.g. missing out bite sites), lack of or improper primary wound care, and/or poor-quality rabies vaccine, may lead to death.

scholarly journals Antibody (Serology) Tests for COVID-19: a Case Study

mSphere ◽  
2021 ◽  
Vol 6 (3) ◽  
Author(s):  
Rachel M. West ◽  
Amanda Kobokovich ◽  
Nancy Connell ◽  
Gigi Kwik Gronvall
Keyword(s):  
Antibody Test ◽  
Poor Quality ◽  
Lessons Learned ◽  
Antibody Testing ◽  
Future Health ◽  
Validation Data ◽  
Health Security ◽  
Fda Guidance ◽  
Antibody Tests

ABSTRACT Serology (antibody) tests to detect previous SARS-CoV-2 infection have been in high demand from the beginning of the COVID-19 pandemic. The initial shortage of diagnostic tests coupled with asymptomatic infections led to a significant demand for serology tests to identify past infections. Despite serious limitations on the interpretation of a positive antibody test in terms of immunity to SARS-CoV-2, antibody testing was initially considered for release from social distancing, return to employment, and “immunity passports.” The regulatory approach to antibody tests was limited; manufacturers were encouraged to develop and market antibody tests without submitting validation data to the FDA. FDA guidance grew more stringent, but many poor-quality tests were already on the market—potentially inappropriately used for individual decision-making. This is a case study describing COVID-19 serology tests and the U.S. market and describes lessons learned for a future health security crisis.

scholarly journals Assessment of a Rabies Virus Rapid Diagnostic Test for the Detection of Australian Bat Lyssavirus

2018 ◽  
Vol 3 (4) ◽  
pp. 109 ◽  
Author(s):  
Andrea Certoma ◽  
Ross A. Lunt ◽  
Wilna Vosloo ◽  
Ina Smith ◽  
Axel Colling ◽  
...  
Keyword(s):  
Rabies Virus ◽  
Laboratory Testing ◽  
Fluorescent Antibody ◽  
Rapid Test ◽  
Antibody Test ◽  
Weighted Kappa ◽  
Medical Intervention ◽  
Clinical Samples ◽  
Post Exposure Prophylaxis ◽  
Australian Bat Lyssavirus

Australian bat lyssavirus (ABLV) is closely related to the classical rabies virus and has been associated with three human fatalities and two equine fatalities in Australia. ABLV infection in humans causes encephalomyelitis, resulting in fatal disease, but has no effective therapy. The virus is maintained in enzootic circulation within fruit bats (Pteropid spp.) and at least one insectivorous bat variety (Saccolaimus flaviventris). Most frequently, laboratory testing is conducted on pteropodid bat brains, either following a potential human exposure through bites, scratches and other direct contacts with bats, or as opportunistic assessment of sick or dead bats. The level of medical intervention and post-exposure prophylaxis is largely determined on laboratory testing for antigen/virus as the demonstrable infection status of the in-contact bat. This study evaluates the comparative diagnostic performance of a lateral flow test, Anigen Rabies Ag detection rapid test (RDT), in pteropodid variant of ABLV-infected bat brain tissues. The RDT demonstrated 100% agreement with the reference standard fluorescent antibody test on 43 clinical samples suggesting a potential application in rapid diagnosis of pteropodid variant of ABLV infection. A weighted Kappa value of 0.95 confirmed a high level of agreement between both tests.

Efficacy of one-dose intramuscular rabies vaccine as pre-exposure prophylaxis in travellers

2021 ◽  
Author(s):  
Deborah J Mills ◽  
Colleen L Lau ◽  
Christine Mills ◽  
Luis Furuya-Kanamori
Keyword(s):  
Immune System ◽  
Rapid Development ◽  
Age Groups ◽  
Rabies Vaccine ◽  
Post Exposure Prophylaxis ◽  
Post Intervention ◽  
Quasi Experimental ◽  
Alternative Schedule ◽  
Insufficient Time ◽  
Exposure Prophylaxis

Abstract Background Current guidelines for rabies pre-exposure prophylaxis (PrEP) recommend multiple vaccine doses. Travellers sometimes present for pre-travel consultation with insufficient time to complete standard PrEP schedules. We investigated the efficacy of one-dose intramuscular (IM) vaccine in priming the immune system (as PrEP) by measuring antibody response to simulated post-exposure prophylaxis (PEP). Methods A quasi-experimental pre–post intervention clinical trial was conducted at a specialist travel clinic in Australia. Adults (≥18 years) without a history of rabies vaccination were included. At Visit 1, seronegative status was confirmed and one dose of 0.5 ml IM rabies vaccine (Verorab®) administered. At Visit 2 (≥60 days after Visit 1), serology was repeated and a simulated PEP dose (0.5 ml IM) given on this day and again 3 days later (Visit 3). Serology was repeated at Visit 4 (7 days after Visit 2). Results A total of 94 antibody-negative participants were included (<50 years [n = 50]; ≥50 years [n = 44]). At Visit 2, 38.0 and 31.8% of participants aged <50 and ≥50 years were antibody-positive (≥0.5 EU/ml). At Visit 4, all participants were antibody-positive; 82.0 and 47.7% of participants aged <50 and ≥50 years had antibody levels >4 EU/ml, respectively. Conclusions One-dose IM vaccine was effective as PrEP for priming the immune system in both age groups, resulting in rapid development of antibodies 7 days after commencing simulated PEP. If there is insufficient time to complete a standard PrEP schedule, one-dose IM could be considered as an alternative schedule for short trips, rather than not offering travellers any doses at all. Clinical trials registration: ACTRN12619000946112.

Considerations for Translating Medical Devices Under Development From the Clinic to the Home: A Case Study in Providing Chronic Wound Care

2021 ◽  
Vol 10 (1) ◽  
pp. 238-242
Author(s):  
Ellen J. Bass ◽  
Justine S. Sefcik ◽  
Elease McLaurin ◽  
Rose Ann DiMaria-Ghalili
Keyword(s):  
Medical Devices ◽  
Chronic Wound ◽  
Wound Care ◽  
Clinical Protocol ◽  
Structured Interviews ◽  
Home Setting ◽  
Ultrasound Application ◽  
Research Assistants ◽  
Current Device

A prototype medical device and protocol that work well in a clinic would not necessarily work reliably in the home setting. The goal of this work is to identify factors to consider when translating a device evaluated in a clinic for use by home caregivers providing chronic wound care for persons living with dementia. One must consider the current device, the associated bundle, the protocol and how they may need to be modified. Semi-structured interviews with the research assistants who have applied a prototype device were conducted to generate a list of known issues with the current clinical protocol in terms of ultrasound application The researchers performed a set of specified tasks by following the current device protocol and explaining any difficulties with use\execution. They embellished the descriptions with details about what had happened with actual patients in the clinic. Using thematic analysis, analysts identified themes and subthemes. Issues potentially relevant to translating medical devices to the home are discussed.

scholarly journals Mind the Gap: Why the Landscape Planning System in Sardinia Does Not Work

2021 ◽  
Vol 13 (13) ◽  
pp. 7300
Author(s):  
Anna Maria Colavitti ◽  
Alessio Floris ◽  
Sergio Serra
Keyword(s):  
Landscape Planning ◽  
Comparative Method ◽  
Poor Quality ◽  
Planning System ◽  
Local Planning ◽  
The Common ◽  
Regional Landscape ◽  
Landscape Protection

In Italy, after the introduction of the Code of Cultural Heritage and Landscape in 2004, the Regional Landscape Plan (RLP) has acquired a coordination role in the urban planning system, for the implementation of policies for landscape protection and valorisation. The case study of the RLP of Sardinia is a paradigmatic application to the coastal area of the island, which is considered most vulnerable and subject to settlement pressure. The objectives of preservation and valorisation of the territorial resources should be transferred into local planning instruments by adopting strategies aimed at the preservation of the consolidated urban fabric, at the requalification and completion of the existing built-up areas according to the principles of land take limitation and increase in urban quality. The paper investigates the state of implementation and the level of integration of landscape contents in the local plans that have been adapted to the RLP, using a qualitative comparative method. In addition, the results of the plan coherence checks, elaborated by the regional monitoring bodies after the adaptation process, have been analysed to identify the common criticalities and weaknesses. The results highlight the lack of effectiveness of the RLP, after more than a decade since its approval, considering the limited number of adequate local plans and the poor quality of their analytical and regulative contents in terms of landscape protection and valorisation. Conclusions suggest some possible ways to revise the RLP, focusing on the participation of local communities and the development of a new landscape culture.

scholarly journals Occurrence of antibodies against Neospora caninum and/or Toxoplasma gondii in dogs with neurological signs

2011 ◽  
Vol 20 (3) ◽  
pp. 202-206 ◽  
Author(s):  
Nicolle Fridlund Plugge ◽  
Fabiano Montiani Ferreira ◽  
Rosária Regina Tesoni de Barros Richartz ◽  
Adriana de Siqueira ◽  
Rosangela Locatelli Dittrich
Keyword(s):  
Toxoplasma Gondii ◽  
Neospora Caninum ◽  
Neurological Diseases ◽  
Fluorescent Antibody ◽  
Antibody Test ◽  
Metropolitan Region ◽  
Serological Tests ◽  
Stray Dogs ◽  
Neurological Signs ◽  
Significant Difference

This study aimed to evaluate occurrences of antibodies against Neospora caninum and Toxoplasma gondii in dogs with neurological signs. Blood samples from 147 dogs were collected: 127 from owned dogs (attended at the Veterinary Teaching Hospital of the Federal University of Paraná (HV-UFPR) and at private veterinary clinics in the city of Curitiba), and 20 from stray dogs found in Curitiba's metropolitan region. The dogs presented one or more of the following neurological signs: seizures, paresis or paralysis, ataxia, behavioral abnormalities, sensory and somatic disorders and chorioretinitis. The samples were analyzed by means of the indirect fluorescent antibody test (IFAT), at a cutoff dilution of 1:50. Out of the 147 samples obtained, 17 (11.56%) were seropositive for N. caninum, 31 (21.08%) for T. gondii and four (2.72%) for both protozoa. Serum titration on the positive animals showed that 54.83% (17/31) and 41.18% (7/17) had titers > 1:200 against T. gondii and N. caninum, respectively. A significant difference in seropositivity for T. gondii (P = 0.021; OR = 2.87; CI = 1.1 > 2.8 > 7.4) was observed between owned dogs (18.11%) and stray dogs (40%). Inclusion of serological tests for neosporosis and toxoplasmosis is recommended in diagnosing neurological diseases in dogs.

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