Vaccins antirabiques: Note de synthèse de l’OMS – avril 2018
Weekly epidemiological record / Relevé épidémiologique hebdomadaire
20 APRIL 2018, 93th YEAR / 20 AVRIL 2018, 93e ANNÉE
An estimated 59 000 people die from rabies each year. That’s one person every nine minutes of every day, 40% of whom are children living in Asia and Africa. As dog bites cause almost all human cases, we can prevent rabies deaths by increasing awareness, vaccinating dogs to prevent the disease at i...ts source and administering life-saving treatment after people have been bitten. We have the vaccines, medicines, tools and technologies to prevent people from dying from dog-mediated rabies. For a relatively low cost it is possible to break the disease cycle and save lives
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Overview
The aim of this guide is to support national immunization programme managers and others responsible for implementing human rabies vaccine programmes to:
inform policy discussions and operational planning for introducing or expanding rabies post-exposure prophylaxis (PEP) into a nationa...l immunization programme (e.g. through the national immunization programme, or other programmes); and
highlight considerations specific to rabies PEP for integration into existing systems, including for implementation, and monitoring and evaluation.
While the guide is mainly intended for programme managers and focuses on human vaccination, complementary animal health measures are highlighted where relevant given the zoonotic nature of rabies.
The guide was developed collaboratively with input from technical experts in rabies and immunization, vaccines and biologicals.
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Rabies is fatal, vaccine-preventable disease responsible for an estimated 59,000 human deaths each year. Most cases are transmitted by dogs, and most deaths occur in underserved populations in Africa and Asia. Approximately 40% of deaths occur in children.
Rabies is entirely preventable, and vaccines, medicines, tools and technologies have long been available to prevent people from dying of dog-mediated rabies. Nevertheless, rabies still kills about 60 000 people a year, of whom over 40% are children under 15, mainly in rural areas of economically dis...advantaged countries in Africa and Asia. Of all human cases, up to 99% are acquired from the bite of an infected dog.
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The new WHO recommendations for rabies immunization supersede the 2010 WHO position
on pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) for rabies. These updated
recommendations are based on new evidence and directed by public health needs that are cost-,
dose- and time-sparing..., while assuring safety and clinical effectiveness. In addition, new guidance on
prudent use of rabies immunoglobulins (RIG) is provided.
The following sections summarize the main points of the updated WHO position as endorsed by the
Strategic Advisory Group of Experts on immunization (SAGE) at its meeting in October 20171. The full
version of the WHO position on rabies vaccines and immunoglobulins will be published in the Weekly
Epidemiological Record2 in April 2018.
Rabies prevention involves two main strategies: (i) dog vaccination to interrupt virus transmission to
humans; and (ii) human vaccination as a series of vaccine administrations before or after an exposure.
Currently, rabies vaccines made from inactivated cell cultures are extremely well tolerated and have no
contraindications.
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Rabies is a public health problem in Asia and vaccine affordability is an issue.
There is no reduction in the number of persons seeking post-exposure prophylaxis.
The high cost of cell culture vaccines for intramuscular use is a limiting factor.
Intradermal rabies vaccination offers cost-effectiv...e alternative to intramuscular.
WHO recommended one week intradermal schedule will ensure good patient compliance.
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Rabies is a vaccine-preventable viral disease which occurs in more than 150 countries and territories. Dogs are the source of the vast majority of human rabies deaths, contributing up to 99% of all rabies transmissions to humans.
For more than 100 years, the clearest route to elimination of dog-mediated rabies has been via mass vaccination of the animal hosts. It’s worked in plenty of countries. Still, in others, like India, which grapples with a third of the world’s rabies burden, large populations of free-roaming, hard...-to-track, often hard-to-reach dogs have made elimination an elusive goal.
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Rabies is a zoonotic, vaccine-preventable viral disease that causes damage to the brain and spinal
cord in infected animals and humans. A zoonotic disease is a disease that can be transmitted
between animals and humans. Rabies is nearly 100% fatal once symptoms appear.
A regimen of four 1-mL doses of HDCV or PCEC vaccines should be administered intramuscularly to previously unvaccinated persons.
The first dose of the four-dose course should be administered as soon as possible after exposure. Additional doses should be administered on days 3, 7, and 14 after the... first vaccination. For adults, the vaccination should always be administered intramuscularly in the deltoid area (arm). For children, the anterolateral aspect of the thigh is also acceptable. The gluteal area should never be used for rabies vaccine injections because observations suggest administration in this area results in lower neutralizing antibody titers.
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Rabies is an infectious viral disease that is almost always fatal once clinical symptoms appear.
In most cases, the disease is transmitted to humans by the bite of a rabid dog, but infection can also spread through scratches or via saliva.
Rabies kills one person every 9 minutes and children aged ...5–14 years are frequent victims.
Yet rabies is 100% vaccine preventable. Vaccinating dogs is the most cost-effective way to prevent rabies in people.
Education about dog behaviour, immediate care measures after a bite, responsible dog ownership and bite prevention are essential components of rabies elimination.
WHO and partners aim to achieve zero human rabies deaths by 2030.
The time to act is now.
More information: http://www.who.int/rabies/en/
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Video
Further OIE Support for African Countries on Rabies vaccines
Rabies is entirely preventable, and vaccines, medicines, tools and technologies have long
been available to prevent people from dying of dog-mediated rabies. Nevertheless, rabies still
kills about 60 000 people a year, of whom over 40% are children under 15, mainly in rural areas
of economically ...disadvantaged countries in Africa and Asia. Of all human cases, up to 99% are
acquired from the bite of an infected dog.
more
Rabies is a vaccine-preventable, zoonotic, viral disease affecting the central nervous system. Once clinical symptoms appear, rabies is virtually 100% fatal. In up to 99% of cases, domestic dogs are responsible for rabies virus transmission to humans. Yet, rabies can affect both domestic and wild an...imals. It spreads to people and animals via saliva, usually through bites, scratches or direct contact with mucosa (e.g. eyes, mouth or open wounds). Children between the age of 5 and 14 years are frequent victims.
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WHO strongly recommends discontinuation of the nerve tissue vaccine, and replacement with modern concentrated and purified cell culture derived vaccines (CCDV) and embryonated eggbased rabies vaccines.
These vaccines must comply with WHO criteria for potency and innocuity following satisfactory ass...essment in humans during well-designed field trials
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‘World Rabies Day’ is observed worldwide to mark the death anniversary of Louis Pasteur, a
French biologist, microbiologist and chemist who developed the first rabies vaccine. It’s a day where
Anti Rabies actions are collated, intensified and showcased.