scholarly journals Renewed Public Health Threat from Emerging Lyssaviruses

Viruses ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 1769
Author(s):  
Anthony R. Fooks ◽  
Rebecca Shipley ◽  
Wanda Markotter ◽  
Noël Tordo ◽  
Conrad M. Freuling ◽  
...  
Keyword(s):  
Public Health ◽  
Protective Immunity ◽  
Post Exposure Prophylaxis ◽  
Global Public Health ◽  
New Host ◽  
Species Association ◽  
Wildlife Species ◽  
Limited Efficacy ◽  
Exposure Prophylaxis ◽  
Therapeutic Biologics

Pathogen discovery contributes to our knowledge of bat-borne viruses and is linked to the heightened interest globally in bats as recognised reservoirs of zoonotic agents. The transmission of lyssaviruses from bats-to-humans, domestic animals, or other wildlife species is uncommon, but interest in these pathogens remains due to their ability to cause an acute, progressive, invariably fatal encephalitis in humans. Consequently, the detection and characterisation of bat lyssaviruses continues to expand our knowledge of their phylogroup definition, viral diversity, host species association, geographical distribution, evolution, mechanisms for perpetuation, and the potential routes of transmission. Although the opportunity for lyssavirus cross-species transmission seems rare, adaptation in a new host and the possibility of onward transmission to humans requires continued investigation. Considering the limited efficacy of available rabies biologicals it is important to further our understanding of protective immunity to minimize the threat from these pathogens to public health. Hence, in addition to increased surveillance, the development of a niche pan-lyssavirus vaccine or therapeutic biologics for post-exposure prophylaxis for use against genetically divergent lyssaviruses should be an international priority as these emerging lyssaviruses remain a concern for global public health.

Pattern and Outcome of Dog Bite Injuries among Children-a Study in 200 Cases

2021 ◽  
pp. 1-5
Author(s):  
Md Waliur Rahman ◽  
◽  
Md Habibullah Sarkar ◽  
Samir Kumar Talukder ◽  
Md Joynal Abedin ◽  
...  
Keyword(s):  
Public Health ◽  
Health Problem ◽  
Public Health Problem ◽  
Hospital Treatment ◽  
Post Exposure Prophylaxis ◽  
Dog Bite ◽  
Post Exposure ◽  
Dog Bites ◽  
Exposure Prophylaxis ◽  
Bite Injuries

Introduction: Dog bites in humans are a major public health problem. Globally, millions of people are bitten by dogs but most of the fatal cases occur in children. Dog bites in human are a serious public health problem and have been well documented worldwide. As rabies is not a notifiable disease in Bangladesh and most deaths occur in rural areas where surveillance is poor. Objectives: To determine the pattern of dog bite injuries and associated health problems among children. Methods: The study was an observational retrospective study carried out at the Dept. of General Surgery, Chuadanga Sadar Hospital, Chuadanga, Bangladesh. The study reviewed the clinical data of patients managed for dog bite related injuries and rabies over a four and half year period between January 2016 and June 2020. A proforma was designed to extract relevant clinical data from the case records. Information extracted included the age, sex of the victims, site of the bite, time of presentation in the hospital, pre-hospital treatment, hospital treatment including post-exposure prophylaxis and complication. Results: In all, 200 cases of dog bite injuries were managed constituting 0.89% of the total consultations; 5 (2.5%) had rabies. Most of the victims were aged 6-12 years (55.0%) and majority (67.0%) was boys. Eighty two percent of the victims presented within 24hrs of the injury. 92 (46.0%) had WHO grade 3 dog bite injury at presentation and the lower limb was the commonest (56.0%) bite site. Use of herbal preparation was the most common pre-hospital treatment 60%. Although 95.0% received anti-rabies vaccine, only 55.5% of them completed the vaccination schedule. The case fatality rate for dog bite was 5.0%. The 5 that died all presented late, had no post exposure prophylaxis and died within 24 hours of admission. Conclusion: There is need for public enlightenment on dangers associated with dog bites and also for the government to ensure vaccination for cost of post exposure prophylaxis treatment for children free of cost

scholarly journals Current Rabies Vaccines Do Not Confer Protective Immunity against Divergent Lyssaviruses Circulating in Europe

Viruses ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 892 ◽  
Author(s):  
Juan E. Echevarría ◽  
Ashley C. Banyard ◽  
Lorraine M. McElhinney ◽  
Anthony R. Fooks
Keyword(s):  
Protective Immunity ◽  
Rabies Vaccine ◽  
Human Rabies ◽  
Post Exposure Prophylaxis ◽  
Efficient Tool ◽  
Imported Case ◽  
Health Authorities ◽  
European Health ◽  
Preventive Vaccination ◽  
Exposure Prophylaxis

The use of the rabies vaccine for post-exposure prophylaxis started as early as 1885, revealing a safe and efficient tool to prevent human rabies cases. Preventive vaccination is the basis for the control of canine-mediated rabies, which has already been eliminated from extensive parts of the world, including Europe. Plans to eliminate canine-mediated human rabies by 2030 have been agreed upon by international organisations. However, rabies vaccines are not efficacious against some divergent lyssaviruses. The presence in European indigenous bats of recently described lyssaviruses, which are not neutralised by antibody responses to existing vaccines, as well as the declaration of an imported case of an African lyssavirus, which also escapes vaccine-derived protection, leaves the European health authorities unable to provide efficacious protective vaccines to some potential situations of human exposure. All these circumstances highlight the need for a universal pan-lyssavirus rabies vaccine, able to prevent human rabies in all circumstances.

scholarly journals Monoclonal Antibody Treatment, Prophylaxis and Vaccines Combined to Reduce SARS CoV-2 Spread

2021 ◽  
Author(s):  
Mohamed A. Kamal ◽  
Andreas Kuznik ◽  
Luyuan Qi ◽  
Witold Więcek ◽  
Mohamed Hussein ◽  
...  
Keyword(s):  
Public Health ◽  
Diagnostic Testing ◽  
Post Exposure Prophylaxis ◽  
Antibody Treatment ◽  
Viral Shedding ◽  
The Us ◽  
Monoclonal Antibody Treatment ◽  
Exposure Prophylaxis ◽  
Respiratory Coronavirus ◽  
The Impact

Background Antiviral monoclonal antibodies (mAbs) developed for treatment of COVID-19 reduce the magnitude and duration of viral shedding and can thus potentially contribute to reducing transmission of the causative virus, severe acute respiratory coronavirus 2 (SARS-CoV-2). However, use of these mAbs in combination with a vaccine program has not been considered in public health strategic planning. Methods We developed an agent-based model to characterize SARS-CoV-2 transmission in the US population during an aggressive phase of the pandemic (October 2020 to April 2021), and simulated the effects on infections and mortality of combining mAbs as treatment and post-exposure prophylaxis (PEP) with a vaccine program plus non-pharmaceutical interventions. We also interrogated the impact of rapid diagnostic testing, increased mAb supply, and vaccine rollout. Findings Allocation of mAbs as PEP or targeting those ≥65 years provided the greatest incremental benefits relative to vaccine in averting infections and deaths, by up to 17% and 41%, respectively. Rapid testing, facilitating earlier diagnosis and mAb use, amplified these benefits. The model was sensitive to mAb supply; doubling supply further reduced infections and mortality, by up to two-fold, relative to vaccine. mAbs continued to provide incremental benefits even as proportion of the vaccinated population increased. Interpretation Use of anti-viral mAbs as treatment and PEP in combination with a vaccination program would substantially reduce SARS-CoV-2 transmission and pandemic burden. These results may help guide resource allocation and patient management decisions for COVID-19 and can also be used to inform public health policy for current and future pandemic preparedness.

scholarly journals Is there sufficient scientific evidence to rule out the use of hydroxychloroquine for postexposure prophylaxis of COVID-19?

2020 ◽  
Author(s):  
Llorenç Quintó ◽  
Jose Miguel Morales-Asencio ◽  
Raquel González ◽  
Clara Menéndez
Keyword(s):  
Public Health ◽  
Effect Size ◽  
Statistical Power ◽  
Scientific Evidence ◽  
Post Exposure Prophylaxis ◽  
Postexposure Prophylaxis ◽  
Post Hoc Analysis ◽  
Exposure Prophylaxis ◽  
Post Hoc ◽  
Rule Out

Since the beginning of the COVID-19 pandemic, the use of hydroxychloroquine (HCQ) has been surrounded by a lot of controversy, both scientific and non-scientific. This has continued with the publication of two trials of HCQ for post-exposure prophylaxis of the infection, which concluded that HCQ is not efficacious to prevent SARS-CoV-2 infection, and their results are influencing public health decisions.We have carried out a comprehensive post-hoc analysis of the statistical power of the two trials, which shows that their power to detect an effect of HCQ in preventing COVID-19 is low, not only for their observed effect size, but also for other clinically important levels of efficacy, and therefore both studies are inconclusive.

scholarly journals Passive surveillance of United Kingdom bats for lyssaviruses (2005–2015)

2017 ◽  
Vol 145 (12) ◽  
pp. 2445-2457 ◽  
Author(s):  
E. L. WISE ◽  
D. A. MARSTON ◽  
A. C. BANYARD ◽  
H. GOHARRIZ ◽  
D. SELDEN ◽  
...  
Keyword(s):  
Public Health ◽  
Phylogenetic Analysis ◽  
United Kingdom ◽  
Natural Population ◽  
Single Species ◽  
Post Exposure Prophylaxis ◽  
Passive Surveillance ◽  
Myotis Daubentonii ◽  
Geographical Clustering ◽  
Exposure Prophylaxis

SUMMARYPassive surveillance for lyssaviruses in UK bats has been ongoing since 1987 and has identified 13 cases of EBLV-2 from a single species;Myotis daubentonii. No other lyssavirus species has been detected. Between 2005 and 2015, 10 656 bats were submitted, representing 18 species, creating a spatially and temporally uneven sample of British bat fauna. Uniquely, three UK cases originate from a roost at Stokesay Castle in Shropshire, England, where daily checks for grounded and dead bats are undertaken and bat carcasses have been submitted for testing since 2007. Twenty per cent of Daubenton's bats submitted from Stokesay Castle since surveillance began, have tested positive for EBLV-2. Phylogenetic analysis reveals geographical clustering of UK viruses. Isolates from Stokesay Castle are more closely related to one another than to viruses from other regions. Daubenton's bats from Stokesay Castle represent a unique opportunity to study a natural population that appears to maintain EBLV-2 infection and may represent endemic infection at this site. Although the risk to public health from EBLV-2 is low, consequences of infection are severe and effective communication on the need for prompt post-exposure prophylaxis for anyone that has been bitten by a bat is essential.

scholarly journals The Role of Chloroquine and Hydroxychloroquine in Prophylaxis of Covid-19: A Literature Review

2020 ◽  
Author(s):  
Dewi Indra Sari ◽  
◽  
Mardiati Nadjib ◽  
Keyword(s):  
Public Health ◽  
Observational Studies ◽  
Cochrane Library ◽  
Post Exposure Prophylaxis ◽  
High Dose ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Exposure Prophylaxis

ABSTRACT Background: A pandemic potential Covid-19 spread rapidly worldwide. Ministry of Health, Republic Indonesia recommended one of the Covid-19 treatments with combination of hydroxychloroquine/ chloroquine and azithromycin. However, the effectiveness and safety of antimalaria regime remain debating topic. This study aimed to investigate the role of chloroquine and hydroxychloroquine in prophylaxis of Covid-19. Subjects and Method: A systematic review was conducted by searching from PubMed, SpringerLink, and Cochrane Library databases. The keywords were “prophylaxis”, “chloroquine” OR “hydroxychloroquine” “SARS-CoV-2” OR “Covid-19”. The inclusion criteria were phase IIb clinical trials, double masking, comparative observational studies, open access articles published until August 2020. The exclusion criteria were inaccessible and duplicate articles. The quality of selected articles was critically appraised. The data were reported by PRISMA flow chart. Results: Three articles out of 117 articles met the criteria inclusion. The findings showed that hydroxychloroquine could not prevent Covid-19 compatible disease or confirmed infections when used as post-exposure prophylaxis. High dose chloroquine was not recommended for critically ill COVID-19 patients because of its potential side effects, especially when administered with azithromycin and oseltamivir. Covid-19 patients with the need for oxygenation were not suggested to use hydroxychloroquine. Conclusion: There is scarce evidence to support prophylaxis and treatment effects of chloroquine or hydroxychloroquine in COVID-19 patients. Further research on the safety and use of chloroquine or hydroxychloroquine is required in the management of Covid-19. Keywords: prophylaxis, Chloroquine, Hydroxychloroquine, SARS-CoV-2, Covid-19 Correspondence: Dewi Indra Sari. Masters Program in Public Health, Faculty of Public Health, Universitas Indonesia, Depok, West Java. Email: [email protected]. Mobile: +628121983-6600. DOI: https://doi.org/10.26911/the7thicph.05.33

scholarly journals Epitope-specific immunity against Staphylococcus aureus coproporphyrinogen III oxidase

npj Vaccines ◽  
2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Alexander Klimka ◽  
Sonja Mertins ◽  
Anne Kristin Nicolai ◽  
Liza Marie Rummler ◽  
Paul G. Higgins ◽  
...  
Keyword(s):  
Public Health ◽  
Amino Acids ◽  
Staphylococcus Aureus ◽  
Immune Response ◽  
Protective Immunity ◽  
Linear Epitope ◽  
Global Public Health ◽  
Vaccine Candidates ◽  
Medical Need ◽  
Coproporphyrinogen Iii Oxidase

AbstractStaphylococcus aureus represents a serious infectious threat to global public health and a vaccine against S. aureus represents an unmet medical need. We here characterise two S. aureus vaccine candidates, coproporphyrinogen III oxidase (CgoX) and triose phosphate isomerase (TPI), which fulfil essential housekeeping functions in heme synthesis and glycolysis, respectively. Immunisation with rCgoX and rTPI elicited protective immunity against S. aureus bacteremia. Two monoclonal antibodies (mAb), CgoX-D3 and TPI-H8, raised against CgoX and TPI, efficiently provided protection against S. aureus infection. MAb-CgoX-D3 recognised a linear epitope spanning 12 amino acids (aa), whereas TPI-H8 recognised a larger discontinuous epitope. The CgoX-D3 epitope conjugated to BSA elicited a strong, protective immune response against S. aureus infection. The CgoX-D3 epitope is highly conserved in clinical S. aureus isolates, indicating its potential wide usability against S. aureus infection. These data suggest that immunofocusing through epitope-based immunisation constitutes a strategy for the development of a S. aureus vaccine with greater efficacy and better safety profile.

scholarly journals Public health implications of an outbreak of rabies in arctic foxes and reindeer in the Svalbard archipelago, Norway, September 2011

2011 ◽  
Vol 16 (40) ◽  
Author(s):  
E MacDonald ◽  
K Handeland ◽  
H Blystad ◽  
M Bergsaker ◽  
M Fladberg ◽  
...  
Keyword(s):  
Public Health ◽  
Post Exposure Prophylaxis ◽  
Hunting Season ◽  
Svalbard Archipelago ◽  
Health Implications ◽  
Post Exposure ◽  
Arctic Foxes ◽  
Increased Risk ◽  
Reindeer Hunting ◽  
Exposure Prophylaxis

Between 16 September and 5 October 2011 rabies was diagnosed in two arctic foxes and eight reindeer in the Svalbard archipelago, in Norway. This outbreak occurs at the end of the reindeer hunting season and poses an increased risk to many people that were involved in the hunt. As of 28 September 2011, 280 people had received post-exposure prophylaxis. No human cases of rabies have occurred.

scholarly journals Knowledge and vaccination status of hepatitis B amongst medical interns of Rural Medical College, Loni, Maharashtra, India

2014 ◽  
Vol 3 (2) ◽  
pp. 19-22 ◽  
Author(s):  
Purushottam A Giri ◽  
Deepak B Phalke
Keyword(s):  
Public Health ◽  
Hepatitis B ◽  
Current Knowledge ◽  
Public Health Problem ◽  
Vaccination Status ◽  
Post Exposure Prophylaxis ◽  
Hepatitis B Infection ◽  
Global Public Health ◽  
Medical College ◽  
Medical Interns

Hepatitis B Virus (HBV) infection is a serious global public health problem. It is the most common blood borne viral infection which places healthcare professional at higher occupational risk. The present study was conducted to assess the current knowledge and vaccination status about hepatitis B amongst medical interns. A cross-sectional study was conducted between February and March 2009 on 100 medical interns of the Rural Medical College, Loni, India. A pre-designed questionnaire which assessed their knowledge of hepatitis B was the tool of data collection. The data was analyzed in the form of percentage and proportions, and the chi-square test was applied. In the present study, 83.3% of interns showed a good level of knowledge regarding hepatitis B infection. The percentage of interns with the correct knowledge regarding post exposure prophylaxis and mode of transmission of hepatitis B were 89% and 90% respectively. It was found that 87% of the respondents espoused vaccination as a measure for the prevention of hepatitis B and 72% of the interns were fully immunized against hepatitis B. However, there is a misconception about prophylaxis, vaccination and the treatment of HBV. Hence there is an imperative need for health education to improve the knowledge of the interns towards hepatitis B infection. DOI: http://dx.doi.org/10.3329/seajph.v3i2.20034 South East Asian Journal of Public Health Vol.3(2) 2013: 19-22

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