Burden of human rabies disease: its potential prevention by means of Rabipur® vaccine.

Daniela Amicizia, Piero Luigi Lai, Elvira Massaro, Donatella Panatto
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Abstract

Rabies is a zoonotic viral disease transmitted mainly by bites of infected animals, especially dogs, which are responsible for 99% of human cases. Despite being preventable, it remains a neglected disease in low-income countries, with approximately 60,000 deaths per year, mostly concentrated in Africa and Asia. The real worldwide burden of rabies is probably underestimated, as death-reporting systems are inadequate and active surveillance is limited. Rabies prevention implies two main, non-exclusive strategies: (i) dog vaccination, in order to interrupt virus transmission to humans, and (ii) human vaccination i.e. pre-exposure prophylaxis (PrEP) and Post-Esposure Prophylaxis (PEP) through the use of purified cell-culture and embryonated egg-based vaccines (CCEEVs). Rabipur® is one of the available anti-rabies vaccines and is indicated for active immunization in individuals of all ages. Its efficacy and safety have been amply demonstrated. In rabies-free countries, PrEP is indicated for individuals who face occupational and/or travel-related exposure to the rabies virus in specific settings or over an extended period. Wider use of human rabies vaccination for PrEP and PEP in conjunction with programs to eradicate rabies from animal populations is the challenging goal in order to reduce the burden of disease and achieve zero rabies.

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人类狂犬病疾病负担:利用Rabipur®疫苗进行预防的可能性。
狂犬病是一种人畜共患病毒性疾病,主要通过受感染动物,特别是狗的咬伤传播,99%的人类病例由狗引起。尽管可以预防,但在低收入国家,它仍然是一种被忽视的疾病,每年造成大约6万人死亡,主要集中在非洲和亚洲。由于死亡报告系统不完善和主动监测有限,狂犬病的真正全球负担可能被低估了。狂犬病预防包括两种主要的非排他策略:(i)犬只疫苗接种,以阻断病毒向人类的传播;(ii)人类疫苗接种,即通过使用纯化细胞培养和胚胎蛋疫苗(CCEEVs)进行暴露前预防(PrEP)和暴露后预防(PEP)。Rabipur®是一种可用的抗狂犬病疫苗,适用于所有年龄段的个体主动免疫。其有效性和安全性已得到充分证明。在无狂犬病国家,针对在特定环境中或在较长时间内因职业和/或旅行而暴露于狂犬病毒的个人,建议采取预防措施。为了减轻疾病负担和实现零狂犬病,在预防前准备和预防后行动中更广泛地使用人狂犬病疫苗,并结合从动物种群中根除狂犬病的规划,是一项具有挑战性的目标。
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