Rabies vaccine

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A rabies vaccine is a vaccine against the rabies virus .

history

Rabies-free countries and islands (green) in 2012, excluding bats

The French veterinarian Pierre Victor Galtier made the first attempts to vaccinate with undiminished rabies viruses in 1881 . Louis Pasteur experimented with an attenuated live vaccine in dogs from 1884 , and from the following year it was also used in humans. This vaccine was obtained from the nerve tissue of infected test animals. From 1907 rabies viruses were used for partially phenol - inactivated rabies vaccines. From 1913, fully phenol-inactivated rabies vaccines were used. From 1954, the rabies vaccines were obtained from the brains of infected mouse embryos. However, as these vaccines obtained from nerve tissue had occasional side effects such as demyelination of peripheral and central nerves and deaths, production was switched to non- neuronal cell cultures from 1957 onwards . From 1965 human diploid cell lines were used to cultivate the viruses ( English human diploid cell vaccine , HDCV). In 1986, further production methods such as cultivation on embryonic chicken cells ( English purified chick embryo cell , PCEC) or on Vero cells were added. Since the turn of the millennium, research has also been carried out on mRNA- based vaccines , which have already yielded initial positive results.

The oral vaccination of foxes with the attenuated vaccine has led to an eradication of the rabies virus in large parts of Europe, as the chain of infection was broken with the vaccination of the main reservoir hosts of the rabies virus .

Rabies vaccines for humans

properties

The rabies vaccines used today are inactivated dead vaccines . In humans, they are usually after exposure to rabies virus administered ( post-exposure prophylaxis ). Preventive vaccination with rabies vaccines is still recommended for people at increased risk of exposure, e.g. B. Veterinarians, hunters, forest staff and others who deal with animals in areas with newly developed wild animal rabies, people with professional or other close contact with bats, laboratory staff with a risk of exposure to rabies viruses and travelers in regions with a high risk of rabies.

Rabies vaccines are on the World Health Organization's list of Essential Medicines .

immunology

The vaccine is usually administered four times within a fortnight as part of post-exposure prophylaxis. In addition, a passive immunization by infusion of anti-rabies virus antibodies is usually carried out. After a four-fold vaccination, neutralizing antibodies against the G protein of the rabies virus are produced. A titer for neutralizing antibodies against the G protein of over 0.5 IU / ml confers immunity. In individual cases, neutralizing antibodies above 0.5 IU / ml can still be measured after years. The WHO post-exposure prophylaxis vaccination schedule for intramuscular injection calls for vaccinations on days 0, 3, 7, 14 and 30. For the shortened intramuscular vaccination, on the other hand, two vaccinations are carried out on different parts of the body on day 0, followed by one dose each on days 7 and 21. The intradermal injection is administered using the vaccination schedule 2-2-2-0-1-1, with 2 for two doses in different parts of the body.

Rabies vaccines for animals

Pets

Rabies vaccines are available for almost all domestic mammals. They are only used as a vaccine and administered subcutaneously . Use for post-exposure prophylaxis is not permitted.

Regulation (EU) No. 576/2013 permits the use of an inactivated vaccine with an efficiency of at least one antigen unit per dose (WHO recommendation) or a recombinant vaccine that expresses the immunizing glycoprotein of the rabies virus in a live virus vector. Vaccinations are required by law for dogs, cats and ferrets according to this regulation both in cross-border traffic within the EU and outside the EU and must be documented in the EU pet passport. When staying in or passing through countries that belong to neither the EU nor the EU countries, so-called third countries, an antibody determination in the serum in an approved laboratory is necessary, with a titer of at least 0.5 IU / ml got to.

Wildlife

Lured bait with rabies vaccine

Vaccines packaged in bait are used to vaccinate foxes. There are three attenuated virus strains and a recombinant vaccine (Vakzinia-Rabies-Glycoprotein). The attenuated live vaccines are derived from the SAD virus strain ( Street Alabama Dufferin ), which was isolated from a rabies-infected dog in Alabama in 1935. The vaccine is in a blister included, which is embedded in a bait composition. By biting into the blister, it comes into contact with the tonsils , which triggers an immune reaction. Bait swallowed whole is ineffective. Tetracycline was added to the bait until 1998 , as this antibiotic can easily be detected in hard substances (bones, teeth). Rabies baits were laid out in Germany from 1983. The use of these vaccines in domestic animals is prohibited, nor would they provide adequate vaccination protection in dogs.

The rabies vaccines for foxes are considered very safe, but not completely harmless (non-pathogenic). A certain disease-causing potency is present in rodents, although no rodent infected by bait has been found so far. A very low residual risk for humans cannot be ruled out, although their use in great apes never led to rabies infection. If the vaccine comes into contact with wounds or mucous membranes, post-exposure prophylaxis is therefore carried out.

Side effects

Adverse drug effects with rabies vaccines include pain, redness and swelling at the injection site, occasionally fever , gastrointestinal discomfort, headache and allergic reactions to components of the vaccine.

Trade names

Human medicine

HDC , Imovax , Rabies vero , Rabipur , Rabivac , TRC Verorab, RabAvert, Abhayrab, Speeda and Verorab .

Veterinary medicine

Enduracell T , Nobivac T , Purevax Rabies , Rabisin , Rhabdomun , Vanguard R , Virbagen rabies vaccine

In addition, there are numerous combination vaccines with components against other infectious diseases for dogs and cats.
Vaccines for foxes
  • Live vaccines: Fuchsoral , Rabifox , Sanafox , SAG-2
  • Recombinant Vaccinia Rabies Glycoprotein: Raboral V-RG

literature

  • DM Knipe, Peter M. Howley , DE Griffin, (Eds.): Fields Virology. 5th edition, Lippincott Williams & Wilkins, Philadelphia 2007, ISBN 978-0-7817-6060-7 .
  • DW Dreesen: A global review of rabies vaccines for human use. In: Vaccine. Volume 15 Suppl, 1997, pp. S2-S6, PMID 9218283 .

Individual evidence

  1. ^ V. Galtier: Les injections de virus rabique dans le torrent circulatoire ne provoquent pas l'éclosion de la rage et semblent conférer l'immunité. La rage peut être transmise par l'ingestion de la matière rabique . In: Comptes rendus de l'Académie des sciences . Volume 93, 1881, pp. 284 f.
  2. Report présenté au ministre de l'instruction publique et de beaux-arts par la commission chargée de contrôler les expériences de M. Pasteur sur la prophylaxie de la rage . In: Pasteur Vallery-Radot (ed.): Œuvres de Pasteur . Volume 6: Maladies virulentes, virus-vaccins et prophylaxie de la rage . Masson, Paris 1933, pp. 753-758. Originally published in Journal officiel de la République française . No. 216, 1884, pp. 4228-4230.
  3. ^ Hervé Bazin: L'Histoire des vaccinations . John Libbey Eurotext, Paris 2008. ISBN 9782742007059 . Pp. 264-266.
  4. a b c d e f g J. P. McGettigan: Experimental rabies vaccines for humans . In: Expert Rev Vaccines (2010), Volume 9, Issue 10, pp. 1177-1186. doi: 10.1586 / erv.10.105 . PMID 20923268 . PMC 3072237 (free full text).
  5. https://www.aerzteblatt.de/nachrichten/77246/Tollwut-Neuer-RNA-Impfstoff-besteht-ersten-klinischen-Test
  6. ^ Robert Koch Institute: Rabies (Rabies, Lyssa), RKI advice for doctors . Retrieved June 6, 2015.
  7. Centers for Disease Control and Prevention : Rabies Vaccination ( Memento of the original from May 2, 2015 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. . Retrieved June 6, 2015. @1@ 2Template: Webachiv / IABot / www.cdc.gov
  8. a b Robert Koch Institute : Vaccination against rabies: Frequently asked questions and answers ( Memento of the original from June 10, 2015 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. . Retrieved June 6, 2015. @1@ 2Template: Webachiv / IABot / www.rki.de
  9. WHO Model List of Essential Medicines . In: World Health Organization . October 2013. Retrieved April 22, 2014.
  10. Centers for Disease Control and Prevention: Rabies - When should I seek medical attention? . Retrieved June 6, 2015.
  11. World Health Organization : Weekly epidemiological record: Rabies Vaccines: WHO Position Paper (2010). Retrieved June 6, 2015.
  12. IJ Amanna, MK Slifka: Contributions of humoral and cellular immunity to vaccine-induced protection in humans. In: Virology (2011), Volume 411, Issue 2, pp. 206-215. doi : 10.1016 / j.virol.2010.12.016 . PMID 21216425 . PMC 3238379 (free full text).
  13. a b c World Health Organization: Rabies - Guide for post-exposure prophylaxis . Retrieved June 7, 2015.
  14. Regulation (EU) No. 576/2013 (PDF)
  15. Hartmut Krauss: Zoonoses: infectious diseases that can be transmitted from animal to human . Deutscher Ärzteverlag, 2004, ISBN 978-3-7691-0406-6 , p. 145 .
  16. a b c Contacts with rabies vaccine bait for foxes: risk assessment and treatment