scholarly journals Effectiveness and Safety of an Intravenous Immune Globulin (IVIG) Preparation in Post-exposure Prophylaxis (PEP) Against Measles in Infants

2021 ◽  
Vol 9 ◽  
Author(s):  
Benno Kohlmaier ◽  
Heidemarie Holzmann ◽  
Karin Stiasny ◽  
Manuel Leitner ◽  
Christoph Zurl ◽  
...  
Keyword(s):  
Neutralizing Antibody ◽  
Active Immunization ◽  
Ivig Treatment ◽  
Post Exposure Prophylaxis ◽  
Igg Antibodies ◽  
Post Exposure ◽  
Ivig Preparation ◽  
Specific Igg ◽  
Exposure Prophylaxis ◽  
Maternal Igg

Background: Administration of measles virus (MV)-specific IgG as post-exposure prophylaxis (PEP) is known to effectively prevent measles. Since the introduction of active immunization against measles, the levels of MV-specific IgG antibodies in the population have dropped. Therefore, the concentration of MV-specific antibodies in immunoglobulin products derived from human plasma donors has declined as the proportion of vaccinated donors has increased. Literature on the effectiveness of PEP with current available immunoglobulins is limited. Here we examine the effectiveness of 400 mg/kg intravenous immunoglobulin (IVIG) (IgVena®, Kendrion) as PEP in infants during a measles outbreak in Austria, 2019.Methods: After exposure to a highly contagious measles patient, identified infants were evaluated for eligibility for IVIG PEP. Infants were tested for measles maternal antibodies, if the result was expected to be available within 72 h after exposure. IVIG was administered to eligible infants with negative maternal IgG antibody levels (n = 11), infants with protective levels but result beyond 72 h (n = 2) and infants not tested for maternal IgG antibodies (n = 52). Telephone enquiries were made asking for measles infection. Effectiveness was calculated using exact logistic regression. Samples of four out of seven used IVIG batches were tested for MV-neutralizing antibody capacity.Results: In 63 (96.9%) of 65 infants PEP with IVIG was administered. The parents of two infants declined IVIG PEP. None of the infants with IVIG PEP got measles or symptoms suggestive for measles, but both infants who did not receive PEP were infected. Effectiveness of IVIG PEP was calculated to be 99.3% (CI 95%: 88.7–100%). No serious adverse event of IVIG treatment was observed. The investigation on MV-neutralizing antibody capacity showed a geometric mean titer ranging from 10.0 to 12.7 IU/ml, resulting in a 1.57–2.26-fold higher concentration than postulated as minimum level for immunity.Conclusions: Our findings suggest that the used IVIG preparation provided an at least non-inferior protection rate compared to IVIG preparations derived from donors before the global introduction of standard active immunization against measles.

scholarly journals Clinical evaluation of purified chick embryo cell rabies vaccine administered intradermally in animal exposures

2018 ◽  
Vol 5 (2) ◽  
pp. 585
Author(s):  
Ravish S. Hardanahalli ◽  
Veena V. ◽  
Ramesh Holla ◽  
Rachana R. Annadani ◽  
Sathish Chandra M. R.
Keyword(s):  
Cell Culture ◽  
Chick Embryo ◽  
Adverse Drug Events ◽  
Neutralizing Antibody ◽  
Embryo Cell ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Chick Embryo Cell ◽  
Exposure Prophylaxis

Background: In India, presently there are two purified chick embryo cell culture vaccines (PCECV) viz., Rabipur (Flury LEP strain) and Vaxirab – N (Pitman Moore strain) which are commonly used both in public as well as private sectors. The present study was conducted to assess the clinical efficacy in terms of safety, immunogenicity and survival status of both the PCECV administered animal exposures taking complete PEP at the anti-rabies clinic.Methods: A longitudinal study was conducted at the anti-rabies clinic, Kempegowda Institute of Medical Sciences (KIMS), Bangalore, India. 86 suspect rabid dog bite cases attending clinic were enrolled and followed up for 1year. All the animal bite cases were given post exposure prophylaxis of full course of PCECV i.e. Rabipur or Vaxirab - N as per schedule intradermally using updated Thai Red Cross regimen. The rabies virus neutralizing antibody (RVNA) concentrations on days 14, 28, 90, and 180 were tested by modified rapid fluores­cent focus inhibition test.Results: Out of 86 study subjects, 43 subjects received Rabipur and another 43 subjects received Vaxirab –N vaccines. The incidence of adverse drug events (ADEs) was found to be 9.3%. All subjects had protective RVNA titers of ³0.5 IU/ml from day 14 till day 180. All the study subjects were healthy and alive after 6 months of completing PEP.Conclusions: The currently available purified chick embryo cell culture rabies vaccines are safe, immunogenic and clinically effective for post exposure prophylaxis in animal bite cases, which will help in eliminating human rabies by 2020. 

scholarly journals In Vivo Efficacy of SYN023, an Anti-Rabies Monoclonal Antibody Cocktail, in Post-Exposure Prophylaxis Animal Models

2020 ◽  
Vol 5 (1) ◽  
pp. 31 ◽  
Author(s):  
Tzu-Yuan Chao ◽  
Shou-feng Zhang ◽  
Li Chen ◽  
Eric Tsao ◽  
Charles E. Rupprecht
Keyword(s):  
Animal Models ◽  
Standard Dose ◽  
Neutralizing Antibody ◽  
Cost Effective ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Vaccine Response ◽  
Post Exposure ◽  
Exposure Prophylaxis

Rabies immune globulin (RIG) is an indispensable component of rabies post-exposure prophylaxis (PEP) because it provides passive immunity to prevent this otherwise inescapably fatal disease in Category III exposed patients. Even with decades of development, RIG products are still criticized for their high cost, lot-to-lot variation, and potential safety issues. They remain largely unattainable in most developing regions of the world, where demand is highest. In recent years, monoclonal antibodies (MAbs) have become widely accepted as safer and more cost-effective alternatives to RIG products. As an example, SYN023 is a 1:1 cocktail of two humanized anti-rabies MAbs previously shown to display extensive neutralizing capabilities. Here, we further assessed the efficacy of SYN023 in animal models of rabies, and found that SYN023 afforded protection equal to a standard dose of human RIG (HRIG) at 0.03 mg/kg in Syrian hamsters and 0.1 mg/kg in beagles. Potential interference with vaccine-induced immunity was analyzed for the MAbs at these concentrations. While individual MAbs did not interfere with vaccine response, SYN023 at dosages of 0.1 mg/kg and above resulted in reduced neutralizing antibody titers similar to HRIG. Thus, the in vivo characterization of SYN023 supports its utility in human rabies PEP as an efficacious alternative to RIG products.

Low awareness and use of post-exposure prophylaxis among adolescents and young adults in South Africa: implications for the prevention of new HIV infections

2020 ◽  
Vol 19 (3) ◽  
pp. 242-248
Author(s):  
Anthony Idowu Ajayi ◽  
Mohammed Sanusi Yusuf ◽  
Elmon Mudefi ◽  
Oladele Vincent Adeniyi ◽  
Ntombana Rala ◽  
...  
Keyword(s):  
South Africa ◽  
Young Adults ◽  
Hiv Infections ◽  
Adolescents And Young Adults ◽  
Post Exposure Prophylaxis ◽  
Post Exposure ◽  
Exposure Prophylaxis

Study of sharp injuries and blood splash exposures among healthcare workers in a tertiary hospital in Bangalore

2016 ◽  
Vol 12 (3) ◽  
Author(s):  
Shalini Sivananjiah Pradeep ◽  
Suman Gadicherla Raghu ◽  
Prathab A G ◽  
Banashankari G Rudresh ◽  
Radhika Kunnavil
Keyword(s):  
Healthcare Workers ◽  
Tertiary Hospital ◽  
Post Exposure Prophylaxis ◽  
Care Hospital ◽  
Post Exposure ◽  
Increased Risk ◽  
Management Procedures ◽  
Exposure Prophylaxis ◽  
Sharps Injury ◽  
Sharps Injuries

The working environment of healthcare workers (HCW) exposes them to sharp injuries. This communication attempts to examine the injury registers, incidence of sharps injuries and blood splash exposures, and the post-exposure prophylaxis status of employees in a tertiary care hospital. Analysis included records form 54 locations of two units of a tertiary hospital attached to a Medical College. Maintenance of the injury register overall was highly satisfactory in both units. Two hundred and nine injuries were recorded from both units of the hospital. The majority of injuries (60.5%) occurred in the age group of 20-30 years with 70% among females. Waste handlers were at increased risk during waste management procedures. Thirty two percent of sharps injury injuries occurred in wards. Of the ward nursing staff, 25.3% received sharps injuries. Post-exposure prophylaxis for Hepatitis B (primary dose) was given to 25 HCWs; 11 received booster doses. The basic regimen for HIV post-exposure prophylaxis was given to 4 HCWs. Awareness about records maintenance, regular documentation, awareness and training, and implementation of appropriate preventive measures can reduce the incidence of injuries. Key words: Sharps, injury register, Health care workers (HCW),Post exposure prophylaxis (PEP)

scholarly journals 986. Improvement in Administration of HIV Post-Exposure Prophylaxis in the Emergency Department Following Sexual Assault

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S521-S522
Author(s):  
Jennifer R Silva-Nash ◽  
Stacie Bordelon ◽  
Ryan K Dare ◽  
Sherrie Searcy
Keyword(s):  
Emergency Department ◽  
Sexual Assault ◽  
Hiv Transmission ◽  
Post Exposure Prophylaxis ◽  
Intervention Period ◽  
Post Intervention ◽  
Post Exposure ◽  
Assault Victims ◽  
Exposure Prophylaxis

Abstract Background Nonoccupational post exposure prophylaxis (nPEP) following sexual assault can prevent HIV transmission. A standardized Emergency Department (ED) protocol for evaluation, treatment, and follow up for post assault victims was implemented to improve compliance with CDC nPEP guidelines. Methods A single-center observational study of post sexual assault patients before/after implementation of an ED nPEP protocol was conducted by comparing the appropriateness of prescriptions, labs, and necessary follow up. A standardized order-set based on CDC nPEP guidelines, with involvement of an HIV pharmacist and ID clinic, was implemented during the 2018-2019 academic year. Clinical data from pre-intervention period (07/2016-06/2017) was compared to post-intervention period (07/2018-08/2019) following a 1-year washout period. Results During the study, 147 post-sexual assault patients (59 Pre, 88 Post) were included. One hundred thirty-three (90.4%) were female, 68 (46.6%) were African American and 133 (90.4%) were candidates for nPEP. Median time to presentation following assault was 12.6 hours. nPEP was offered to 40 (67.8%) and 84 (95.5%) patients (P< 0.001) and ultimately prescribed to 29 (49.2%) and 71 (80.7%) patients (P< 0.001) in pre and post periods respectively. Renal function (37.3% vs 88.6%; P< 0.001), pregnancy (39.0% vs 79.6%; P< 0.001), syphilis (3.4% vs 89.8%; P< 0.001), hepatitis B (15.3% vs 95.5%; P< 0.001) and hepatitis C (27.1% vs 94.3%) screening occurred more frequently during the post period. Labratory, nPEP Prescription and Follow up Details for Patients Prescribed nPEP Conclusion The standardization of an nPEP ED protocol for sexual assault victims resulted in increased nPEP administration, appropriateness of prescription, screening for other sexually transmitted infectious and scheduling follow up care. While guideline compliance dramatically improved, further interventions are likely warranted in this vulnerable population. Disclosures Ryan K. Dare, MD, MS, Accelerate Diagnostics, Inc (Research Grant or Support)

Sign in / Sign up

Export Citation Format

Share Document