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Animal Bites
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
Rabies is an RNA virus belonging to the genus Lyssavirus in the family Rhabdoviridae, order Mononegavirales. Rabies remains the most lethal infectious disease associated with animal bites. Dog bites are the predominant route of rabies transmission worldwide. Most cases of rabies (95%) occur in Africa and Asia, mainly in India. There has been a significant decrease in dog rabies cases in Latin America and the Caribbean. In Western Europe, Canada, the United States, Japan and some Latin American countries, dog rabies has been eliminated. Bats account for the predominant route of transmission in the Americas. In Europe, rabies is mostly found in bats and foxes. Australia, the United Kingdom and parts of Western Europe are considered free of rabies in terrestrial animals due to wildlife vaccination programmes, together with the availability of effective commercial vaccination for domestic animals.
Development of palliative medicine in the United Kingdom and Ireland
Published in Eduardo Bruera, Irene Higginson, Charles F von Gunten, Tatsuya Morita, Textbook of Palliative Medicine and Supportive Care, 2015
All health-care professionals and other carers involved in caring for rabies patients need education regarding the following: The facts concerning rabies transmission. In most developing countries, PEP is prohibitively expensive. However, as mentioned earlier, transmission to health-care workers has not been reported and remains theoretical and unlikely if normal care and universal infection control rules are followed. Staff attending to patients' personal care should ideally wear protective gown, gloves, and goggles. If good symptom control is achieved, the risk of being bitten or spat at by a patient is minimized.The principles of palliative care, emphasizing the pivotal role of good symptom control with appropriate, adequate, regular medication.
Time of administration of rabies immunoglobulins and adequacy of antibody response upon post-exposure prophylaxis: a descriptive retrospective study in Belgium
Published in Acta Clinica Belgica, 2021
Patrick Soentjens, Mieke Croughs, Christoph Burm, Steven Declerq, Jan Clerinx, Ula Maniewski, Steven Van Den Broucke, Caroline Theunissen, Ralph Huits, Isabel Brosius, Eric Florence, Chris Kenyon, Johan Van Griensven, Sabrina Van Ierssel, Lut Lynen, Katleen Balliauw, Steven Van Gucht, Marjan Van Esbroeck, Erika Vlieghe, Emmanuel Bottieau, Yven Van Herrewege
The Belgian rabies PEP guideline have been recently revised in 2019 [20,21](Table). Firstly, to limit the use of HRIG, they will be only administered in and around the wound and not anymore in the adjacent limb [11,13,14]. Following the new Dutch guidelines on rabies PEP, at least 2 mL of HRIG will be injected in wounds located in difficult extremities, e.g. finger or toe [14,22]. Secondly, injuries due to monkey bites, although very frequent, represent a very low risk of rabies transmission [23]. For this reason, the use of HRIG for monkey injuries is not recommended anymore in Belgium [14]. Finally, cases with a category III lesion, related to a mucosal contact, will be in general excluded from injections with HRIG and will receive a rabies vaccine schedule with four intramuscular injections (figure: schedule 2: two injections on day 0, 1 on day 7 and one on day 21) [14].
An oral bait vaccination approach for the Tasmanian devil facial tumor diseases
Published in Expert Review of Vaccines, 2020
Andrew S. Flies, Emily J. Flies, Samantha Fox, Amy Gilbert, Shylo R. Johnson, Guei-Sheung Liu, A. Bruce Lyons, Amanda L. Patchett, David Pemberton, Ruth J. Pye
Recent evidence in humans and mice suggests that virus-specific CD8+ T cells can be repurposed for antitumor immunity [83]. This could be beneficial in DFT infection, as specific Trm induced by bait vaccination could be reactivated by subsequent exposure to DFT cells or the viral vector itself [83]. Reactivation of Trm can induce IFNγ and immune recognition of DFT cells by migrating leukocytes attracted to the site of inflammation, such as memory B cells attracted via CCL9 and CCL10 [86]. This raises the exciting possibility that the bait vaccine can serve as both a prophylactic vaccine and an immunotherapy. One hypothesis to explain natural DFT1 immune responses observed [9–11] is that sufficient ‘danger signals’ occur in the tumor microenvironment to activate anti-DFT immunity; there is a high probability that these danger signals are derived from microorganisms entering wounds (Figure 3) or ulcerated tumors. OBVs could also act as ‘danger signals’ to activate and recruit innate cells (e.g. NK cells) that directly kill DFT cells and produce IFNγ to promote Trm responses [37,47,89,90]. Incorporation of immunostimulatory cytokines (e.g. IL15) or recombinant checkpoint blocking antibodies (e.g. PD1, CD200) could provide a powerful immunotherapy approach [39,40]. In summary, the rabies transmission-immunity cycle shares many key elements with DFT transmission-immunity, suggesting the bait vaccine could powerfully prime and/or boost anti-DFT immunity.
Notifications of suspected rabies exposure increased in Finland: 26 years of one health surveillance, 1995–2020
Published in Infectious Diseases, 2023
Ruska Rimhanen-Finne, Jukka Ollgren, Tuija Gadd, Tiina Nokireki
In total, 521 animals (median: 17; range: 3–47/year) were tested as suspected sources of rabies transmission to humans when a contact between an animal and a person had occurred. One pony imported from Estonia in 2003 and one dog imported from India in 2007 were infected with the rabies virus. In addition, three bats (one each year in 2009, 2016 and 2017) were infected with bat lyssaviruses.