Efficacy of antibody levels in different post-exposure rabies vaccination programs

Year 2016, Volume: 2 Issue: 1, 36 - 41, 04.03.2016

Esra Kaya Kilic , Cemal Bulut Meliha Cagla Sonmezer , Cigdem Ataman Hatipoglu Sami Kinikli Ali Pekcan Demiroz

https://doi.org/10.18621/eurj.2016.2.1.36

Abstract

Objectives. Rabies is a fatal acute viral zoonotic disease causing encephalomyelitis in humans and many other mammalian animals. Prophylaxis is vital since there is no treatment for rabies. This study was a comparison of antibody levels in patients who were vaccinated following different vaccinationprotocols. Methods. Eighty-five patients who were included in the rabies vaccination program who presented to the vaccination center of our clinic with the complaint of suspicious contact with rabies were included the study. In 61 (71.8%) patients a 2-1-1 vaccine program (Zagreb regimen) was implemented, and in 24 (28.2%) patients, a 5-dose rabies vaccine and rabies immune globulin (RIG) in a dose of 40 IU/kg (Essen regimen) was applied. Results. In patients on the 2-1-1 vaccine program, antibody levels on the 21st day were greater than 0.5 IU/ml in 49 (80.3%) patients. Antibody levels on the 28th day in the group that received the 5-dose rabies vaccine and rabies immune globulin administration was greater than 0.5 IU/ml in 17 (70.8%) patients. The difference between the two groups of vaccination programs was not statistically significant (p=0.344). Seroconversion rates for approximately one month after the last dose of vaccination in the serum samples were 90% and 75% in the groups with 2-1-1 vaccination, and RIG and 5-dose vaccinations, respectively. The differences were not statistically significant (p=0.071). Conclusions. Identification of similar seroconversion rates suggests that the 2-1-1 vaccination program may be a good alternative option to the standard vaccination program when RIG is unavailable.

Keywords

Antibody, immunization schedule; rabies

References

• Madhusudana SN, Sanjay TV, Mahendra BJ. Sudarshan MK, Narayana DHA, Giri A, et al. Comparison of safety and immunogenicity of purified chick embryo cell rabies vaccine (PCEV) and purified vero cell rabies vaccine (PVRV) using the Thai Red Cross intradermal regimen at a dose of 0.1 ML. Hum Vaccine. 2006;2(5):200-4.
• Bassin SL, Rupprecht CE, Bleck TP. Rhabdoviruses. In: Mandell, Doglas and Bennett’s Principles and Practice of Infectious Diseases, 7th. edition. New York: Churchill Livingstone Press; 2010. 2: 249-58.
• Centers for Disease Control Human Rabies prevention–United States Recommendations of the Immunization Practices Advisory Committee (ACIP). MMWR Suppl. 2010; 59: RR-2.
• Hanlon CA, Carey L. Rabies virus and other rhabdoviruses. In: Kasper DL, Fauci AS, Longo DL et al. editors. Harrison’s Principles of Internal Medicine 17th edition, McGraw-Hill Press. 2008;1:811-35.
• Rabies Prevention and Control Guidelines of the Republic of Turkey, Ministry of Health, Ankara: General Directorate of Basic Health Services; 2005:p.13-22.
• World Health Organization. WHO guide for rabies pre andpost-exposure prophylaxis in humans. Available at:http://www.who.int/rabies/PEP_prophylaxis_guidelines_June10.pdf. Accessed 21 June 2013.
• Wasniewski M, Labbe A, Tribout L, Rieder J, Labadie A, Schereffer JL, et al. Evaluation of a rabies ELISA as an alternative method to seroneutralisation tests in the context of international trade of domestic carnivores. J Virol Methods. 2014 Jan;195:211-20.
• Ma X, Niezgoda M, Blanton JD, Recuenco S, Rupprecht CE. Evaluation of a new serological technique for detecting rabies virus antibodies following vaccination. Vaccine. 2012 Aug 3;30(36):5358-62.
• Rupprecht CE, Briggs D, Brown CM, Franka R, Katz ZL, Kerr HD, et al. Evidence for a 4-dose vaccine schedule for human rabies post-exposure prophylaxis in previously non-vaccinated individuals. Vaccine. 2009 Nov 27; 27(51):7141-8.
• Hu Q, Liu MQ, Zhu ZG, Zhu ZR, Lu S. Comparison of safety and immunogenicity of purified chick embryo cell vaccine using Zagreb and Essen regimens in patients with category II exposure in China. Hum Vaccin Immunother. 2014;10(6):1645-9.
• Chutivongse S, Wilde H, Fishbein DB, Baer GM, Hemachudha T. One-year study of the 2-1-1 intramuscular postexposure rabies vaccine regimen in 100 severely exposed Thai patients using rabies immune globulin and Vero cell rabies vaccine. Vaccine. 1991 Aug;9(8):573-6.
• Shantavasinkul P, Tantawichien T, Wilde H, Sawangvaree A, Kumchat A, Ruksaket N, et al. Postexposure rabies prophylaxis completed in 1 week: preliminary study. Clin Infect Dis. 2010 Jan 1;50(1):56-60.
• Wijaya L, Ford L, Lalloo D. Rabies post exposure prophylaxis in a UK travel clinic: ten years' experience. J Travel Med. 2011 Jul-Aug;18(4):257-61.
• Park JH, Lee CH, Won YK, Chin BS, Shin HS, Kim JY. Rabies post-exposure prophylaxis of overseas travelers in the international travel clinic of the national medical center from 2006 to 2012, Korea. Infect Chemother. 2014 Mar;46(1):13-20.
• Zanini F, Padinger P, Elissondo MC, Perez H. [Epidemiology of dog bite lesions in Tierra del Fuego, Argentina]. Medicina (B Aires). 2008;68(1):1-5. [Article in Spanish]
• Liu H, Huang G, Tang Q, Li J, Cao S, Fu C, et al. The immunogenicity and safety of vaccination with purified Vero cell rabies vaccine (PVRV) in China under a 2-1-1 regimen. Hum Vaccin. 2011 Feb;7(2):220-4.
• Tulek N, Senocak H, Yetkin A, Un H, Aylan O. Antibody response achieved by different rabies prophylaxis methods. Int J Infect Dis. 2006 Jan;10 (1):87-8.
• Vodopija I, Sureau P, Smerdel S, Lafon M, Baklaic Z, Luibicic M, et al. Interaction of rabies vaccine with human rabies immunoglobulin and reliability of a 2-1-1 schedule application for postexposure treatment. Vaccine. 1988 Jun;6(3):283-6.
• Vodopija I, Baklaic Z, Vodopija R. Rabipur: a reliable vaccine for rabies protection. Vaccine. 1999 Mar 26;26;17(13-14):1739-41.
• Wasi C, Chaiprasithikul P, Auewarakul P, Puthavathana P, Thongcharoen P, Trishnananda M. The abbreviated 2-1-1 schedule of purified chick embryo cell rabies vaccination for rabies postexposure treatment. Southeast Asian J Trop Med Public Health. 1993 Sep;24(3):461-6.
• Landry P, Lazzaro M, Darioli R. [Comparative immunogenicity of 2 antirabies vaccines in a 2-1-1 post-exposure vaccination schedule]. Praxis (Bern 1994). 1998 Sep;87(37):1177-9. [Article in French]
• Baysal B, Tosun S, Ozdemir M, Dogan M. [Investigation of antibody levels following rabies vaccination in the subjects who were biten by animals]. Microbiyol Bul. 2009;43(1):127-31. [Article in Turkish]
• Huang G, Liu H, Tang Q, Yu P, Shen X, Zhang Y, et al. Making rabies prophylaxis more economical: immunogenicity and safety results from a preliminary study using a 2-1 intramuscular regimen in healthy volunteers. Hum Vaccin Immunother. 2014;10(1):114-9.
• Hacibektasoglu A, Inal A, Eyigun C, Barut A, Turkay FA. [Comparison of PVRV and HDCV rabies vaccines as to immunity, reliability and protective value]. Microbiyol Bul. 1992 Jan;26(1):26-36. [Article in Turkish]
• Torun M. [Evaluation of rabies-suspected bites in Giresun, Eastern Black-Sea region]. Microbiyol Bul. 2010 Oct;44(4):685-7. [Article in Turkish]