RESUMO
Introduction: Rabies is a zoonosis caused by viruses of the family Rhabdoviridae. Prophylaxis with the rabies vaccine and immunoglobulins, depending on the severity of the case, is recommended. After vaccination, mild, moderate, or severe adverse events (AE) are described. Although rare, severe skin reactions may occur, increasing the risk of anaphylaxis. Case report: An 84-year-old woman was attacked by a stray unknown cat, leaving her with bites and scratches in the neck region and multiple injuries. The case was classified as severe. About 3 h after the first dose of the rabies vaccine, disseminated purplish spots appeared on her lower limbs, worsening significantly after the second dose, requiring hospitalization for the application of the third dose under observation, dermatology evaluation, and collection of skin tissue for biopsy. She was discharged 24 h after the third vaccination, and the purple spots cleared gradually. The biopsy suggested an adverse reaction to the vaccine components. Immunohistochemistry of the rabies virus antigen in dermal nerve fillets was negative. The seroconversion post rabies vaccine showed IgG antibody values below the reference levels. Conclusion: Vaccination against rabies is extremely important; however, AEs may occur. Our patient developed an important AE and required hospitalization. After complete vaccination, the serum was not converted. A similar case was not previously described, and the case report is important for the creation of jurisprudence on rabies vaccination in elderly patients in Brazil.
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Se relata el nacimiento, auge y decadencia, de la producción de vacunas en el antiguo Instituto Bacteriológico de Chile, desde su fundación en 1929 hasta su fin en 1980, por boca de quien fuera por diecisiete años primero encargado de la fabricación de vacunas bacterianas y luego director de la institución. Las vicisitudes de la vacuna BCG, la introducción del toxoide tetánico, el fin de la vacuna antivariólica y el triunfo de vacuna antirrábica de Fuenzalida y Palacios, se narran a menudo con comentarios de quienes participaron en estos hechos.
The birth, rise and decline, of vaccine production at the Bacteriological Institute of Chile is recounted by mouth of who was for seventeen years first in charge of manufacturing and then director of the institution. The vicissitudes of the BCG vaccine, the introduction of tetanus toxoid, the end of smallpox vaccine, and the triumph of the rabies vaccine are often related with comments from those who participated in the events.
Assuntos
Humanos , História do Século XX , Bacteriologia/história , Controle de Doenças Transmissíveis/história , Desenvolvimento de Vacinas/história , Vacina Antivariólica/história , Vacinas Tíficas-Paratíficas/história , Vacina Antirrábica/história , Vacina contra Difteria, Tétano e Coqueluche/história , Chile , Vacinas contra a Tuberculose/históriaRESUMO
Louis Pasteur is the renowned chemist and microbiologist of the 19th century involved in the development of the rabies vaccine. He worked with a researchers team in the laboratory, mainly Pierre Paul Emile Roux, and also physicians in the clinical practice approach and the defense of Pasteur's anti-rabies technique in the Académie Nationale de Médecine, Alfred Vulpian being the most notable. Pasteur's first studies on rabies are noted in his 1881 publication. But in 1885, he revealed that he had already immunized 50 dogs against rabies. Meanwhile, he was looking for human subjects. The most polemic of this search involves the second and last Emperor of Brazil, Dom Pedro II, who was a patron of the arts and sciences and followed and supported the work of the great scientist. During the reign of Dom Pedro II, the first Pasteur's Institute was founded in Rio de Janeiro, nine months before the Parisian, which had the financial support of Dom Pedro. This article deals with the interaction between the two outstanding characters, especially in the development of prophylactic treatment against rabies, and with the utilitarian aspects of this vaccine researches development against individual autonomy.
Assuntos
Vacina Antirrábica/história , Raiva , Animais , Brasil , Cães , Pessoas Famosas , História do Século XIX , Humanos , Raiva/prevenção & controleRESUMO
BACKGROUND: Vaccines may cause non-specific effects (NSEs) on morbidity and mortality through immune-mediated mechanisms that are not explained by the prevention of the targeted disease. Much of the evidence for NSEs comes from observational studies with a high risk of bias, and there is a clear need for new data from randomized controlled trials. Recently, it was proposed that rabies vaccine has protective NSEs in people and in animals. The aim of the proposed study is to determine whether rabies vaccine reduces the incidence rate of episodes of common infectious disease syndromes in a population of veterinary students on the island of St. Kitts. METHODS: The trial design is a single-site, two-arm, parallel-group, participant-blinded, randomized, placebo-controlled, two-sided comparative study, with an internal pilot study for blinded sample size re-estimation. Allocation to study arm is by block randomization stratified by sex within cohort with a 1:1 allocation ratio. The primary study outcome is the number of new weekly episodes of common infectious diseases including respiratory, diarrheal and febrile illnesses. A vaccine immunogenicity ancillary study is planned. DISCUSSION: Demonstration of a non-specific protective effect of rabies vaccine against unrelated respiratory, gastrointestinal and febrile illnesses would provide supportive evidence for the design of similar studies in children in populations with a high burden of these illnesses. TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT03656198. Registered on 24 August 2018.
Assuntos
Imunidade Heteróloga , Vacina Antirrábica/imunologia , Ensaios Clínicos Fase IV como Assunto , Diarreia/epidemiologia , Diarreia/prevenção & controle , Febre/epidemiologia , Febre/prevenção & controle , Humanos , Incidência , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Projetos Piloto , Vacina Antirrábica/administração & dosagem , Ensaios Clínicos Controlados Aleatórios como Assunto , Infecções Respiratórias/epidemiologia , Infecções Respiratórias/prevenção & controle , São Cristóvão e NévisRESUMO
The transmembrane rabies virus glycoprotein (RVGP) is the main antigen of vaccine formulations used around the world to prevent rabies, the most lethal preventable infectious disease known. The objective of this work was to evaluate the potential of a bioreactor using wave-induced agitation in the initial steps of scaling up the rRVGP production process by a Drosophila melanogaster S2 cell line to produce rRVGP in sufficient quantities for immunization and characterization studies. Taking advantage of some remarkable features recognized in Drosophila S2 cells for scaling the culture process, a robust recombinant lineage (S2MtRVGPH-His) engineered by our group for the expression of rRVGP using a copper-inducible promoter was used in the bioreactor cultures. The WAVE Bioreactor was chosen because it represents an innovative approach to the cultivation of animal cells using single-use technology. For that purpose, we firstly established a procedure for culturing the S2MtRVGPH-His lineage in 100 mL Schott flasks. Using an inoculum of 5 × 105 cells/mL in culture medium (Sf900-III) induced with solution of CuSO4 (0.7 mM) and a convenient pH range (6.2-7.0), optimal parameter values such as time of induction (72 h) and temperature (28 °C) to increase rRVGP production could be defined. This procedure was reproduced in culture experiments conducted in a WAVE Bioreactor™ 2/10 using a 2 L Cellbag. The results in Schott flasks and in WAVE Bioreactor™ were very similar, yielding a maximum titer of rRVGP above of 1 mg.L-1. The immunization study showed that the rRVGP produced in the bioreactor was of high immunogenic quality.
Assuntos
Reatores Biológicos , Glicoproteínas/biossíntese , Microbiologia Industrial/métodos , Proteínas Recombinantes/biossíntese , Proteínas Virais/biossíntese , Animais , Técnicas de Cultura de Células , Linhagem Celular , Drosophila melanogaster/citologia , Vírus da RaivaRESUMO
The main prophylactic tool to control rabies in herbivores is the systematic vaccination of susceptible animals. This study aimed to evaluate the positive effect of organic zinc (Zn) supplementation on the persistence of anti-rabies neutralizing antibodies in healthy sheep. A total of 36 Texel ewes were selected and randomly divided into 2 groups of 18 animals each. The treated group (TG) received organic Zn supplementation for 90 days, and after this period, 2 doses of rabies vaccine with a 30-day interval. The control group (CG) received the vaccine doses only and was not supplemented with organic Zn. Blood samples were collected before the first vaccination and 30, 60, and 90 days after vaccination, to determine the anti-rabies neutralizing antibody titer using the Rapid Fluorescent Focus Inhibition Test (RFFIT). The average values of anti-rabies serum-neutralizing antibodies 30 days after the first dose were 1.33 ± 0.62 IU mL-1 for the CG and 1.57 ± 0.80 IU mL-1 for the TG; 60 days after the second dose the average values were 7.60 ± 7.08 IU mL-1 and 12.97 ± 9.46 IU mL-1 for the CG and TG, respectively, with a significant difference between groups. The TG presented 100% vaccine coverage of the primary vaccination, whereas the CG presented 89.47% coverage. Oral supplementation with 75 mg organic Zn significantly increased the persistence of anti-rabies antibody titers in...(AU)
A principal ferramenta profilática para o controle da raiva em herbívoro é a vacinação sistemática de animais susceptíveis. A presente pesquisa teve como objetivo avaliar o efeito positivo da suplementação de zinco orgânico na persistência de anticorpos neutralizantes anti-rábicos em ovinos saudáveis. Foram selecionadas 36 ovelhas Texel, aleatoriamente divididos em dois grupos com 18 animais cada. O grupo tratado (GT) recebeu suplementação com zinco orgânico durante 90 dias, e, após este período, foram administradas 2 doses de vacina anti-rábica com intervalo entre elas de 30 dias. O grupo controle (GC) recebeu apenas as doses da vacina, e não foi suplementado com zinco. Amostras de sangue foram colhidas antes da primeira dose da vacina, e 30, 60 e 90 dias depois da vacinação, a fim de determinar o título de anticorpos neutralizantes anti-rábicos utilizando o teste rápido de inibição do foco fluorescente (RFFIT). As medias dos anticorpos anti-rábicos do soro, 30 dias após a primeira dose foi de 1,33 ± 0,62 IU mL-1 para o grupo controle, e 1,57 ± 0,80 IU mL-1 para o grupo tratado. 60 dias após a segunda dose, as medias foram de 7,60 ± 7,08 IU mL-1 e 12,97 ± 9,46 UI ml-1 no GC e GT, respectivamente, com significância entre os grupos. O GT apresentou 100% de cobertura vacinal na primeira dose, enquanto o GC apresentou 89,47%. A suplementação oral com 75 mg de zinco orgânico...(AU)
Assuntos
Animais , Suplementos Nutricionais , Zinco/imunologia , Anticorpos Neutralizantes , Vacina Antirrábica/agonistas , Ovinos/imunologiaRESUMO
The main prophylactic tool to control rabies in herbivores is the systematic vaccination of susceptible animals. This study aimed to evaluate the positive effect of organic zinc (Zn) supplementation on the persistence of anti-rabies neutralizing antibodies in healthy sheep. A total of 36 Texel ewes were selected and randomly divided into 2 groups of 18 animals each. The treated group (TG) received organic Zn supplementation for 90 days, and after this period, 2 doses of rabies vaccine with a 30-day interval. The control group (CG) received the vaccine doses only and was not supplemented with organic Zn. Blood samples were collected before the first vaccination and 30, 60, and 90 days after vaccination, to determine the anti-rabies neutralizing antibody titer using the Rapid Fluorescent Focus Inhibition Test (RFFIT). The average values of anti-rabies serum-neutralizing antibodies 30 days after the first dose were 1.33 ± 0.62 IU mL-1 for the CG and 1.57 ± 0.80 IU mL-1 for the TG; 60 days after the second dose the average values were 7.60 ± 7.08 IU mL-1 and 12.97 ± 9.46 IU mL-1 for the CG and TG, respectively, with a significant difference between groups. The TG presented 100% vaccine coverage of the primary vaccination, whereas the CG presented 89.47% coverage. Oral supplementation with 75 mg organic Zn significantly increased the persistence of anti-rabies antibody titers in...
A principal ferramenta profilática para o controle da raiva em herbívoro é a vacinação sistemática de animais susceptíveis. A presente pesquisa teve como objetivo avaliar o efeito positivo da suplementação de zinco orgânico na persistência de anticorpos neutralizantes anti-rábicos em ovinos saudáveis. Foram selecionadas 36 ovelhas Texel, aleatoriamente divididos em dois grupos com 18 animais cada. O grupo tratado (GT) recebeu suplementação com zinco orgânico durante 90 dias, e, após este período, foram administradas 2 doses de vacina anti-rábica com intervalo entre elas de 30 dias. O grupo controle (GC) recebeu apenas as doses da vacina, e não foi suplementado com zinco. Amostras de sangue foram colhidas antes da primeira dose da vacina, e 30, 60 e 90 dias depois da vacinação, a fim de determinar o título de anticorpos neutralizantes anti-rábicos utilizando o teste rápido de inibição do foco fluorescente (RFFIT). As medias dos anticorpos anti-rábicos do soro, 30 dias após a primeira dose foi de 1,33 ± 0,62 IU mL-1 para o grupo controle, e 1,57 ± 0,80 IU mL-1 para o grupo tratado. 60 dias após a segunda dose, as medias foram de 7,60 ± 7,08 IU mL-1 e 12,97 ± 9,46 UI ml-1 no GC e GT, respectivamente, com significância entre os grupos. O GT apresentou 100% de cobertura vacinal na primeira dose, enquanto o GC apresentou 89,47%. A suplementação oral com 75 mg de zinco orgânico...
Assuntos
Animais , Anticorpos Neutralizantes , Ovinos/imunologia , Suplementos Nutricionais , Vacina Antirrábica/agonistas , Zinco/imunologiaRESUMO
The transmembrane rabies virus glycoprotein (RVGP) is the main antigen of vaccine formulations used around the world to prevent rabies, the most lethal preventable infectious disease known. The objective of this work was to evaluate the potential of a bioreactor using wave-induced agitation in the initial steps of scaling up the rRVGP production process by a Drosophila melanogaster S2 cell line to produce rRVGP in sufficient quantities for immunization and characterization studies. Taking advantage of some remarkable features recognized in Drosophila S2 cells for scaling the culture process, a robust recombinant lineage (S2MtRVGPH-His) engineered by our group for the expression of rRVGP using a copper-inducible promoter was used in the bioreactor cultures. The WAVE Bioreactor was chosen because it represents an innovative approach to the cultivation of animal cells using single-use technology. For that purpose, we firstly established a procedure for culturing the S2MtRVGPH-His lineage in 100 mL Schott flasks. Using an inoculum of 5 x 10(5) cells/mL in culture medium (Sf900-III) induced with solution of CuSO4 (0.7 mM) and a convenient pH range (6.2-7.0), optimal parameter values such as time of induction (72 h) and temperature (28 degrees C) to increase rRVGP production could be defined. This procedure was reproduced in culture experiments conducted in a WAVE Bioreactor (TM) 2/10 using a 2 L Cellbag. The results in Schott flasks and inWAVE Bioreactor (TM) were very similar, yielding a maximum titer of rRVGP above of 1 mg.L-1. The immunization study showed that the rRVGP produced in the bioreactor was of high immunogenic quality.
RESUMO
El objetivo de estudio fue conocer las percepciones sobre la vacunación contra la rabia silvestre en comunidades nativas de la etnia Awajún, en Amazonas, Perú, 2012. Realizamos un estudio cualitativo a través de entrevistas de baja estructuración, para recoger las percepciones de la población, autoridades locales y personal de salud. Las percepciones sobre las causas de la RS fueron atribuidas a murciélagos portadores de alguna infección, veneno y daño sobrenatural, o al efecto de brujería. Manifestaron el efecto mortal de la RS e información variada sobre la posibilidad o ausencia de tratamiento. Como medidas de prevención refirieron el uso de mosquiteros, mallas, tramperas, infusiones e ungüentos, luego mencionaron a la vacuna. Sobre la vacunación contra la RS, refirieron haber recibido información del personal de salud, manifestando argumentos para oponerse o cuestionarla como: el objetivo encubierto de perjudicar el desarrollo del pueblo Awajún, no ser una vacuna necesaria y la generación de efectos negativos en niños y adultos. Las percepciones recogidas hacia este tipo de vacunación manifiestan diversos cuestionamientos sobre su potencial beneficio o necesidad en la comunidad y están relacionadas tanto a aspectos religiosa-culturales y socioeconómicos como a las relaciones de comunicación con el estado y el sistema de salud peruano.
O objetivo do estudo foi determinar as perspectivas sobre a vacinação contra raiva silvestre na população awajún da província de Condorcanqui, Amazonas, em 2012. Foi realizada pesquisa qualitativa em seis comunidades por meio de entrevistas de baixa estrutura para a recolecção das perspectivas dos moradores, autoridades locais tradicionais e pessoal de saúde. As principais percepções recolhidas sobre as causas do RS foram atribuídas a: morcegos portadores de uma infecção, veneno ou portadores de algum poder sobrenatural; ou por efeito de feitiçaria. Foram expressos o efeito letal da enfermidade e diversas informações sobre a possibilidade ou não de tratamento. Na prevenção da RS, mencionou-se principalmente uso de mosquiteiros, malhas, caçadores, chás e pomadas, depois as opções da vacina foram expressas. Em relação à vacinação, além de expressar a recepção de informações de saúde, foram dados argumentos para justificar sua rejeição ou questionamentos, como: o objetivo secreto de prejudicar ao desenvolvimento do povo Awajun; não ser necessária; e a geração de efeitos negativos em crianças e adultos. Estas perspectivas expressam diversos questionamentos enquanto seu potencial benéfico ou necessidade na comunidade e estão relacionadas tanto aos fatores socioeconômicos como as relações de comunicação com o estado e o sistema de saúde peruano.
The aim of this study was to determine the perspective for wild rabies (RS) vaccine in Awajún Peruvian population, Amazonas, 2012. A qualitative study was conducted in six communities across low structured interviews, designed to collect the perspective of the participants. We included community members, local authorities and health care personnel. Perception about RS causes was attributed to bats carrying infection, poison and supernatural harm, or the effect of witchcraft or damage. It was expressed the deadly effect and several information on the possibility or no treatment. To prevent the use of insecticide RS, tights, trappers, teas and ointments were mentioned, then came the vaccine. In relation to vaccination, besides expressing receipt of health information, were given arguments to oppose or question it as: the hidden objective to harm the Awajún people; not required by the population; and generation of adverse effects in children and adults. These perspectives addressing several questions about their potential benefit or right need it in the population and are associated to religious-cultural and socioeconomic factors as to the relationship with the health care systems and Peruvian government.
Assuntos
Humanos , Peru , Vírus da Raiva , Percepção Social , Vacina Antirrábica , Vacinação , Pessoal de Saúde , Pesquisa Qualitativa , Prevenção de Doenças , Povos Indígenas , Serviços de SaúdeRESUMO
En la Argentina, la rabia está circunscripta a algunas provincias del norte. La disponibilidad de nuevas vacunas que eliminen la manipulación del virus rábico y que permitan el control de la enfermedad es de importancia estratégica nacional y regional. Las vacunas basadas en poxvirus recombinantes se han utilizado con éxito como vacunas antirrábicas a nivel mundial. SI bien estos sistemas no están disponibles comercialmente, la plataforma de obtención de virus canarypox (CNPV) recombinantes ya ha sido implementada en nuestro laboratorio. El objetivo de este trabajo fue obtener y evaluar un candidato a vacuna antirrábica basado en CNPV recombinantes que expresan la glicoproteína G (RG) del virus rábico (RV). Se construyó un virus recombinante que expresa la secuencia codificante de RG (CNPV-RG). La inoculación de ratones con este virus indujo altos títulos de anticuerpos seroneutralizantes de RV (3,58 y 9,76 Ul/ml después de una o dos inmunizaciones, respectivamente) y protegió al 78 % de los animales desafiados intracerebralmente con RV. Además, se determinó que el CNPV-RG posee una potencia relativa de 3,5 Ul/ml. Los resultados obtenidos constituyen la primera etapa en la evaluación del CNPV-RG como candidato a vacuna antirrábica. Se requerirán nuevos ensayos para confirmar su utilidad en especies de interés veterinario.
In Argentina, rabies is limited to some northern provinces. Availability of new vaccines abolishing the handling of the rabies virus and allowing disease control has regional and national strategic importance. Vaccines based on recombinant poxviruses have been successfully used as antirabic vaccines worldwide. Although these systems are not commercially available, the platform to obtain recombinant canarypox viruses (CNPV) has been previously set up in our laboratory. The aim of this work was the development and evaluation of an antirabic vaccine candidate based on recombinant CNPV expressing the rabies virus (RV) glycoprotein G (RG). A recombinant virus (CNPV-RG) expressing the RG coding sequence was designed. Inoculation of mice with this virus induced high RV seroneutralizing antibodies (3.58 and 9.76 lU/ml after 1 or 2 immunizations, respectively) and protected 78% of intracerebrally RV-challenged animals. In addition, it was determined that CNPV-RG has a relative potency of 3.5 lU/ml. The obtained results constituted the first stage of CNPV-RG evaluation as antirabic vaccine candidate. Further assays will be necessary to confirm its utility in species of veterinary Interest.
Assuntos
Animais , Embrião de Galinha , Cricetinae , Camundongos , Antígenos Virais/imunologia , Vírus da Varíola dos Canários/imunologia , Glicoproteínas/imunologia , Vacina Antirrábica , Proteínas do Envelope Viral/imunologia , Anticorpos Antivirais/biossíntese , Anticorpos Antivirais/imunologia , Antígenos Virais/genética , Chlorocebus aethiops , Vírus da Varíola dos Canários/genética , Vírus da Varíola dos Canários/crescimento & desenvolvimento , Vírus da Varíola dos Canários/isolamento & purificação , Linhagem Celular/virologia , Fibroblastos/virologia , Glicoproteínas/genética , Rim , Mesocricetus , Fragmentos de Peptídeos/genética , Fragmentos de Peptídeos/imunologia , Vacina Antirrábica/imunologia , Raiva/prevenção & controle , Organismos Livres de Patógenos Específicos , Cultura de Vírus , Vacinas Sintéticas/imunologia , Células Vero/virologia , Proteínas do Envelope Viral/genéticaRESUMO
En la Argentina, la rabia está circunscripta a algunas provincias del norte. La disponibilidad de nuevas vacunas que eliminen la manipulación del virus rábico y que permitan el control de la enfermedad es de importancia estratégica nacional y regional. Las vacunas basadas en poxvirus recombinantes se han utilizado con éxito como vacunas antirrábicas a nivel mundial. SI bien estos sistemas no están disponibles comercialmente, la plataforma de obtención de virus canarypox (CNPV) recombinantes ya ha sido implementada en nuestro laboratorio. El objetivo de este trabajo fue obtener y evaluar un candidato a vacuna antirrábica basado en CNPV recombinantes que expresan la glicoproteína G (RG) del virus rábico (RV). Se construyó un virus recombinante que expresa la secuencia codificante de RG (CNPV-RG). La inoculación de ratones con este virus indujo altos títulos de anticuerpos seroneutralizantes de RV (3,58 y 9,76 Ul/ml después de una o dos inmunizaciones, respectivamente) y protegió al 78 % de los animales desafiados intracerebralmente con RV. Además, se determinó que el CNPV-RG posee una potencia relativa de 3,5 Ul/ml. Los resultados obtenidos constituyen la primera etapa en la evaluación del CNPV-RG como candidato a vacuna antirrábica. Se requerirán nuevos ensayos para confirmar su utilidad en especies de interés veterinario.(AU)
In Argentina, rabies is limited to some northern provinces. Availability of new vaccines abolishing the handling of the rabies virus and allowing disease control has regional and national strategic importance. Vaccines based on recombinant poxviruses have been successfully used as antirabic vaccines worldwide. Although these systems are not commercially available, the platform to obtain recombinant canarypox viruses (CNPV) has been previously set up in our laboratory. The aim of this work was the development and evaluation of an antirabic vaccine candidate based on recombinant CNPV expressing the rabies virus (RV) glycoprotein G (RG). A recombinant virus (CNPV-RG) expressing the RG coding sequence was designed. Inoculation of mice with this virus induced high RV seroneutralizing antibodies (3.58 and 9.76 lU/ml after 1 or 2 immunizations, respectively) and protected 78% of intracerebrally RV-challenged animals. In addition, it was determined that CNPV-RG has a relative potency of 3.5 lU/ml. The obtained results constituted the first stage of CNPV-RG evaluation as antirabic vaccine candidate. Further assays will be necessary to confirm its utility in species of veterinary Interest.(AU)
Assuntos
Animais , Embrião de Galinha , Cricetinae , Camundongos , Antígenos Virais/imunologia , Vírus da Varíola dos Canários/imunologia , Glicoproteínas/imunologia , Vacina Antirrábica , Proteínas do Envelope Viral/imunologia , Anticorpos Antivirais/biossíntese , Anticorpos Antivirais/imunologia , Antígenos Virais/genética , Vírus da Varíola dos Canários/genética , Vírus da Varíola dos Canários/crescimento & desenvolvimento , Vírus da Varíola dos Canários/isolamento & purificação , Linhagem Celular/virologia , Chlorocebus aethiops , Fibroblastos/virologia , Glicoproteínas/genética , Rim , Mesocricetus , Fragmentos de Peptídeos/genética , Fragmentos de Peptídeos/imunologia , Raiva/prevenção & controle , Vacina Antirrábica/imunologia , Organismos Livres de Patógenos Específicos , Vacinas Sintéticas/imunologia , Células Vero/virologia , Proteínas do Envelope Viral/genética , Cultura de VírusRESUMO
Objetivando analisar as indicações de profilaxia antirrábica humana no Município de Jaboticabal-SP, foi realizado um estudo retrospectivo descritivo no período de 2000 a 2006, com levantamento de dados registrados nas fichas de investigação de atendimento e cálculo do custo com as vacinas destinadas à profilaxia pós-exposição. Constatou-se que 2.493 pessoas agredidas por animais foram submetidas à profilaxia com uso de vacina, num total de 7.108 doses e um custo de R$ 179.105,14. Da totalidade de casos notificados, 2.184 (71,5 por cento) foram causados por cães e gatos clinicamente sadios no momento da agressão e que assim se mantiveram durante o período de observação, a qual foi feita pela própria vítima ou pelo dono do animal. Considerando este fato e também a situação epidemiológica da raiva no Município, pode-se inferir que essas vítimas poderiam ter sido dispensadas da profilaxia; entretanto, apenas 464 o foram, ou seja, 1.720 pessoas podem ter recebido vacina sem necessidade, ou seja 4.590 doses a um custo de R$ 114.420,81. Em comparação com os números de outros municípios do Estado de São Paulo e com a média nacional, constata-se que o número de profilaxias pós-exposição contra raiva é muito alto em Jaboticabal, evidenciando que na conduta não se considerou o estado do agressor e a condição do Município de área controlada para raiva. Recomenda-se conscientização e capacitação permanentes das equipes de saúde pública quanto à epidemiologia da doença e à necessidade de observação adequada do animal agressor. É essencial a integração dos serviços médicos e veterinários no atendimento às vitimas, visando uma melhor avaliação do caso para que a decisão de se instituir ou não a profilaxia pós-exposição seja feita com critério e segurança.
The present study aimed to evaluate rabies post-exposure prophylaxis (PEP) in humans in the municipality of Jaboticabal, São Paulo from 2000 through 2006. A descriptive and retrospective study was conducted by collecting data available in patient records. Vaccination costs were also calculated; 2,493 patients injured by animals received PEP, totaling R$ 179,105.14 and 7,108 doses; 2,184 (71.5 percent) out of the total reports were caused by dogs and cats clinically healthy at the moment of the attack. These animals remained sound throughout the 10-day observation period. The observation was conducted by the victim or by the owner. Considering animal observation and the epidemiological status of rabies in the municipality, all of these patients could have been dismissed from PEP treatment. Instead, only 464 were dismissed, meaning that 1,720 patients were unnecessarily vaccinated. An estimated 4,590 doses and R$114,420.81 could have been saved. In comparison with rates of other municipalities of the State of São Paulo and with the national mean, the number of PEP in Jaboticabal is very high and it became evident that management evaluated neither the health status of the animal nor the epidemiological status of the area for rabies. Permanent awareness and education of public health professionals with respect to rabies epidemiology and the need to perform correct observation of the aggressors are recommended. It is essential that medical and veterinary services be integrated to provide better assessment of cases and safer decisions on the institution of PEP.
Assuntos
Animais , Humanos , Mordeduras e Picadas/epidemiologia , Gatos , Cães , Profilaxia Pós-Exposição/estatística & dados numéricos , Vacina Antirrábica/uso terapêutico , Raiva/prevenção & controle , Brasil , Profilaxia Pós-Exposição/economia , Estudos Retrospectivos , Vacina Antirrábica/economia , Fatores de TempoRESUMO
O presente trabalho visou estudar 10 isolados de vírus da raiva de morcegos hematófagos e não-hematófagos do Estado do Rio de Janeiro em suas características genéticas quanto aos genes N e G, além da resposta de camundongos vacinados com a vacina anti-rábica produzida pela replicação da amostra Pitman-Moore em cultivo celular, frente ao desafio com estes isolados virais, utilizando-se um ensaio imunológico baseado no teste de potência NIH. A vacina anti-rábica utilizada na imunização dos camundongos ofereceu proteção em mais de 80% dos camundongos vacinados com a diluição 1:5 da vacina, frente à maioria dos isolados. A análise filogenética do gene da proteína N apresentou um padrão de agregação dividido em variante de morcego hematófago e variante de morcego insetívoro, com todos os isolados de morcegos frugívoros Artibeus sp. tendo sido segregados com a variante característica de morcegos Desmodus rotundus. Foram observadas diferenças filogenéticas entre as variantes do vírus da raiva de morcego hematófago isoladas na Região Noroeste do Estado do Rio de Janeiro e aquelas isoladas nas Regiões Metropolitana e Sul do Estado. A substituição do resíduo ácido aspártico por ácido glutâmico na posição 118, encontradas na caracterização genética da proteína G dos isolados 704/97BR-DR e 151/98BR-DR, permite inferir que esta posição esteja relacionada à antigenicidade viral. Não foram observadas diferenças genéticas temporais entre os isolados estudados. A vacina anti-rabica utilizada ofereceu proteção satisfatória contra a maioria dos isolados estudados. (AU)
In the present study we analyzed 10 bats rabies viruses isolated from Rio de Janeiro State, focusing on its genetic characteristics from genes N and G, and also in the response of mice vaccinated with cell-culture rabies vaccine, produced with the Pitman-Moore strain, after viral challenge with bat rabies isolates, using an immunologic essay based on NIH vaccine potency test. The vaccine used conferred protection in more than 80% of the mice vaccinated with 1:15 vaccine dilution, after viral challenge. N gene genetic analysis divided the rabies virus isolates into haematophagous and insectivorous bat variants, with all isolates from Artibeus sp. frugivorous bats being clustered with the variant characteristic of the Desmodus rotundus vampire bat. Phylogenetic differences between isolates from Northeast Region and those from the Metropolitan and South Regions of Rio de Janeiro State were observed. The substitution of an aspartic acid to a glutamic acid found in the position 118 of G gene genetic characterization from samples 704/97BR-DR and 151/98BR-DR seems to be related to viral antigenicity. There were no time-related genetic differences between the studied samples. The vaccine employed was found with satisfactory protection against the majority of the isolates used.(AU)
Assuntos
Animais , Vírus da Raiva/imunologia , Vacina Antirrábica/efeitos adversos , Vacina Antirrábica/farmacologia , Biotecnologia/métodos , Biotecnologia/tendências , Quirópteros , Camundongos , Alergia e Imunologia/tendênciasRESUMO
Para atestar a imunogenicidade de vacinas contra a raiva, os testes de titulação e de soroneutralização de vírus rábico em células BHK-21 foram validados, com os seguintes resultados: [a]linearidade: r= 0,99 e 1,0; [ b] precisão intra- ensaio: CV= 3,4 e 6,3 % ; [ c] precisão inter-ensaios CV = 4,7 e 5, 5 % ; [ d] estabilidade ao congelar e descongelar amostras: CV = 3,5 e 11, 7% [e] estabilidade -tempo entre o descongelamento e a realização do teste: CV = 1% ; [f] exatidão > 96% e > 87% para ambos os testes. Cinco esquemas de imunização com diferentes concentrações, vias de inoculação e intervalos entre doses foram avaliados em camundongos BALB/c com a vacina contra a raiva produzida em células Vero no Instituto Butantan...
To assure the reliability of the results of immunogenicty of raccines, tests of virus titration and neutralization in BHK -21 cells were validated, with the following results: [a] linearity r = 0,99 and 1,0 ; [b] repeatability, CV = 3,4 and 6,3 %; [ c] precision, CV = 4,7 and 5,5 %; [d] freeze- thaw stability, CV =3,5 and 11,7% ; [e], C V = 1% and [f] accuracy = > 96% and > 87% for both tests. Five schemes of immunization with different concentrations, routes of inoculation and interval between doses were evaluated in BALB/c mice with rabies vaccine in Vero cells produced at Instituto Butantan...