Postexposure prophylaxis for rabies with antiserum and intradermal vaccination

Area of Science:

• * Infectious Diseases
• * Vaccinology
• * Public Health

Background:

• * Rabies remains a significant public health threat, particularly in regions with high animal bite incidence.
• * Effective postexposure prophylaxis (PEP) is crucial for preventing rabies after potential exposure.
• * Intradermal vaccine administration offers a potentially more cost-effective alternative to intramuscular routes.

Purpose of the Study:

• * To prospectively evaluate the efficacy and safety of the Thai Red Cross intradermal rabies PEP regimen.
• * To assess the 1-year outcomes in patients receiving this specific intradermal vaccination schedule.

Main Methods:

• * A prospective study involving 100 Thai patients with severe bites from proven rabid animals.
• * Administration of purified Vero cell rabies vaccine intradermally on days 0, 3, 7, 30, and 90.
• * Use of rabies immunoglobulin infiltrated around wounds for severe exposures; 1-year follow-up.

Main Results:

• * The study achieved a 100% efficacy rate, with no rabies-related deaths among the 100 patients followed for 1 year.
• * Antibody titre analysis in a subgroup confirmed seroconversion in all tested patients.
• * The regimen was well-tolerated, with no reported adverse events impacting efficacy.

Conclusions:

• * The Thai Red Cross intradermal rabies PEP regimen is highly effective and safe for preventing rabies in severely exposed individuals.
• * This vaccination schedule provides complete protection, evidenced by the absence of rabies cases and confirmed seroconversion.
• * Intradermal rabies PEP represents a successful public health intervention strategy.