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Rabies in Thailand: 1990.

H Wilde1, S Chutivongse, W Tepsumethanon

  • 1Queen Saovabha Memorial Institute, Thai Red Cross Society, Bangkok, Thailand.

Reviews of Infectious Diseases
|July 1, 1991
PubMed
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Implementing cost-effective rabies vaccines and immune globulins in Thailand can save money without compromising efficacy. This is crucial for rabies prevention in developing countries.

Area of Science:

  • Veterinary Medicine
  • Infectious Diseases
  • Public Health

Background:

  • Thailand annually administers over 100,000 postexposure rabies treatments, predominantly using less expensive brain tissue-derived vaccines.
  • Current rabies treatments in developing nations face cost barriers, particularly with advanced tissue culture vaccines and immune globulins.
  • Existing studies indicate antigenic variations between Thai street rabies virus and international strains, impacting vaccine effectiveness.

Purpose of the Study:

  • To evaluate the efficacy and cost-effectiveness of alternative rabies postexposure prophylaxis (PEP) strategies in Thailand.
  • To assess the immunogenicity of a tissue culture rabies vaccine in a canine model.
  • To determine the feasibility of using purified equine rabies immune globulins as a safe and effective alternative.

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Main Methods:

  • Analysis of existing data on annual rabies treatment courses in Thailand.
  • Cost-benefit analysis of different PEP schedules using tissue culture vaccines and immune globulins.
  • Canine immunogenicity study involving a potent, inactivated tissue culture vaccine administered via subcutaneous injection.
  • Review of safety and efficacy data for purified equine rabies immune globulins.

Main Results:

  • Significant cost savings are achievable with proven intradermal postexposure schedules using tissue culture vaccines and immune globulins, without compromising efficacy.
  • Purified equine rabies immune globulins are approximately 10% the cost of human products, demonstrating safety and effectiveness.
  • A canine study revealed that 12.5% of Thai dogs did not achieve protective antibody titers after one subcutaneous dose of tissue culture vaccine.

Conclusions:

  • Intradermal administration of rabies tissue culture vaccines and immune globulins offers a cost-effective and efficacious PEP strategy for Thailand.
  • Purified equine rabies immune globulins present a viable, less expensive alternative for rabies PEP.
  • Further research may be needed to optimize pre-exposure vaccination protocols for dogs in Thailand due to observed immunogenicity variations.