Rabies vaccine

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Rabies vaccine
Vaccine description
Target disease Rabies
Type Killed/Inactivated
Clinical data
AHFS/Drugs.com monograph
MedlinePlus a607023
Legal status
?
Identifiers
CAS number  YesY
ATC code J07BG01
 N (what is this?)  (verify)

Rabies vaccine is a vaccine used to control rabies. Rabies can be prevented by vaccination, both in humans and other animals. It is unusual in that it is effective even when injected after infection by the virus, which usually is noticed. It is on the World Health Organization's List of Essential Medicines, a list of the most important medication needed in a basic health system.[1]

Modern vaccines[edit]

The human diploid cell rabies vaccine (H.D.C.V.) was started in 1967. Human diploid cell rabies vaccines are inactivated vaccines made using the attenuated Pitman-Moore L503 strain of the virus.[2] Human diploid cell rabies vaccines have been given to more than 1.5 million people as of 2006.

Aside from vaccinating humans, another approach was also developed by vaccinating dogs to prevent the spread of the virus. In 1979 the Van Houweling Research Laboratory of the Silliman University Medical Center in Dumaguete in the Philippines, then headed by Dr. George Beran,[3] developed and produced a dog vaccine that gave a three-year immunity from rabies. The development of the vaccine resulted in the elimination of rabies in many parts of the Visayas and Mindanao Islands. The successful program in the Philippines was later used as a model by other countries, such as Ecuador and the Yucatan State of Mexico, in their fight against rabies conducted in collaboration with the World Health Organization.[4]

In addition to these developments, newer and less expensive purified chicken embryo cell vaccine, and purified Vero cell rabies vaccine are now available. The purified Vero cell rabies vaccine uses the attenuated Wistar strain of the rabies virus, and uses the Vero cell line as its host.

In Tunisia a rabies control program was initiated to give dog owners free vaccination to promote mass vaccination which was sponsored by their government. The vaccine is known as Rabisin® (Mérial) , which is a cell based rabies vaccine only used countrywide. Vaccinations are often administered when owners take in their dogs for check-ups and visits at the vet.[5]

Recombinant rabies vaccine (V-RG)[edit]

Aerially distributed wildlife rabies vaccine in a bait from Estonia.

In 1984 researchers at the Wistar Institute developed a recombinant vaccine called V-RG by inserting the glycoprotein gene from rabies into a vaccinia virus.[6] The V-RG vaccine has since been commercialised by Merial under the trademark Raboral.[7] It is harmless to humans and has been shown to be safe for various species of animals that might accidentally encounter it in the wild, including birds (gulls, hawks, and owls).[8]

V-RG has been successfully used in the field in Belgium, France, Germany and the United States to prevent outbreaks of rabies in wildlife. The vaccine is stable under relatively high temperatures and can be delivered orally, making mass vaccination of wildlife possible by putting it in baits. The plan for immunization of normal populations involves dropping bait containing food wrapped around a small dose of the live virus[clarification needed]. The bait would be dropped by helicopter concentrating on areas that have not been infected yet. Such a strategy of oral immunization of foxes in Europe has already achieved substantial reductions in the incidence of human rabies. In November 2008, Germany had been free of new cases for two years and is therefore currently believed to be rabies-free, together with a few other countries. A strategy of vaccinating “neighborhood dogs” in Jaipur, India, combined with a sterilization program, has also resulted in a large reduction in the number of human cases.[9]

Duration of immunity[edit]

The duration of immunity afforded to humans by a two injection vaccination course was found to be between two to three years.[10][11][12] Following administration of a booster dose (recommended at one year), one study found 97% of immuno-competent individuals demonstrate protective levels of neutralizing antibodies at 10 years.[13]

Other animals[edit]

Baits with vaccine for oral vaccination

Currently, pre-exposure immunization has been used on domesticated and normal non-human populations. In many jurisdictions, domestic dogs, cats, ferrets, and rabbits are required to be vaccinated

Imrab is an example of a veterinary rabies vaccine containing the Pasteur strain of killed rabies virus. Several different types of Imrab exist, including Imrab, Imrab 3, and Imrab Large Animal. Imrab 3 has been approved for ferrets and, in some areas, pet skunks.[14][15]

Oral vaccination against rabies is a preventive measure to eradicate rabies in wild animals, vectors of disease, mainly foxes, raccoons, raccoon dogs, coyotes and jackals, but also can be used for dogs in developing countries.[16]

Baits used for oral vaccination are made of fishmeal or dog food and contains a vaccine packet with V-RG, a recombinant vaccine made from a living pox virus vector, vaccinia, that carries the rabies antigen in the form of rabies glycoprotein. When animals eat through the outer bait matrix, the inner sachet gets punctured allowing vaccine to enter the animal’s mouth and coat the lymphatic tissue in the throat. There is an immune response to the rabies antigen which creates antibodies for rabies.[17]

Machine for distribution of baits from airplane

Baits are distributed by airplanes in rural areas and by hand in urban and suburban areas. The idea of wildlife vaccination was conceived during the 1960s, and modified-live rabies viruses were used for the experimental oral vaccination of carnivores by the 1970s. The development of safe and effective rabies virus vaccines applied in attractive baits resulted in the first field trials in Switzerland in 1978.[18]

History[edit]

Virtually every infection with rabies resulted in death until two French scientists, Louis Pasteur and Émile Roux, developed the first rabies vaccination in 1885. This vaccine was first used on a human on July 6, 1885, on nine-year-old Joseph Meister (1876–1940), who had been mauled by a rabid dog.[19]

Their vaccine consisted of a sample of the virus harvested from infected (and necessarily dead) rabbits, which was weakened by allowing it to dry for 5 to 10 days. Similar nerve tissue-derived vaccines are still used now in some countries, and while they are much cheaper than modern cell culture vaccines, they are not as effective.[citation needed] Neural tissue vaccines also carry a certain risk of neurological complications.[20]

References[edit]

  1. ^ "WHO Model List of EssentialMedicines". World Health Organization. October 2013. Retrieved 22 April 2014. 
  2. ^ "Rabies - Human Vaccines". World Health Organization. Retrieved 1 October 2012. 
  3. ^ "Dr. George W. Beran's Biography". World Rabies Day. Retrieved 2010-04-23.
  4. ^ "One World, One Health Rabies".OneHealthInitiative.com. Retrieved 2010-04-23.
  5. ^ Touihri; Zaouia, I.; Elhili, K.; Dellagi, K.; Bahloul, C. (23 Dec 2009). "Evaluation of Mass Vaccination Campaign Coverage Against Rabies in Dogs in Tunisia". Zoonoses and Public Health (Institut Pasteur de Tunis and Blackwell Verlag GmbH) 58 (2): 110. doi:10.1111/j.1863-2378.2009.01306.x. PMID 20042063. 
  6. ^ Wiktor TJ, Macfarlan RI, Reagan KJ, Dietzschold B, Curtis PJ, Wunner WH, Kieny MP, Lathe R, Lecocq JP, Mackett M; MacFarlan; Reagan; Dietzschold; Curtis; Wunner; Kieny; Lathe; Lecocq; MacKett (1984). "Protection from rabies by a vaccinia virus recombinant containing the rabies virus glycoprotein gene". Proc. Natl. Acad. Sci. U.S.A. 81 (22): 7194–8. doi:10.1073/pnas.81.22.7194. PMC 392104. PMID 6095272. 
  7. ^ Raboral
  8. ^ Artois M, Charlton KM, Tolson ND, Casey GA, Knowles MK, Campbell JB; Charlton; Tolson; Casey; Knowles; Campbell (1990). "Vaccinia recombinant virus expressing the rabies virus glycoprotein: safety and efficacy trials in Canadian wildlife". Can. J. Vet. Res. 54 (4): 504–7. PMC 1255701. PMID 2249183. 
  9. ^ Reece JF, Chawla SK.; Chawla (2006). "Control of rabies in Jaipur, India, by the sterilisation and vaccination of neighbourhood dogs". Vet Rec 159 (12): 379–83. doi:10.1136/vr.159.12.379. PMID 16980523. 
  10. ^ Patient Group Direction Information for Rabies Vaccine BP (Sanofi Pasteur MSD), page 3
  11. ^ Travelturtle.co.uk health guide
  12. ^ An Advisory Committee Statement (ACS) Committee to Advise on Tropical Medicine and Travel (CATMAT) STATEMENT ON TRAVELLERS AND RABIES VACCINE
  13. ^ STATEMENT ON TRAVELLERS AND RABIES VACCINE
  14. ^ Merial
  15. ^ Aspen Skunk Rabies Research, Inc.
  16. ^ http://www.rabies-vaccination.com/oral-vaccination.asp
  17. ^ http://www.aphis.usda.gov/ws/rabies/vaccine.html
  18. ^ http://www.ncbi.nlm.nih.gov/pubmed/15742629
  19. ^ Geison GL (1978). "Pasteur's work on rabies: Reexamining the ethical issues diagnosis for developing countries". Hastings Center Report (The Hastings Center) 8 (April): 26–. doi:10.2307/3560403. JSTOR 3560403. PMID 348641. 
  20. ^ Srivastava AK, Sardana V, Prasad K, Behari M; Sardana; Prasad; Behari (March 2004). "Diagnostic dilemma in flaccid paralysis following anti-rabies vaccine". Neurol India 52 (1): 132–3. PMID 15069272.