Rabies Post-Exposure Prophylaxis in the Philippines Health Status of Patients Having Received Purified Equine F(ab)2 Fragment Rabies Immunoglobulin (Favirab) 英文参考文献.docVIP

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Rabies Post-Exposure Prophylaxis in the Philippines Health Status of Patients Having Received Purified Equine F(ab)2 Fragment Rabies Immunoglobulin (Favirab) 英文参考文献.doc

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Rabies Post-Exposure Prophylaxis in the Philippines Health Status of Patients Having Received Purified Equine F(ab)2 Fragment Rabies Immunoglobulin (Favirab) 英文参考文献

RabiesPost-ExposureProphylaxisinthePhilippines: HealthStatusofPatientsHavingReceivedPurified EquineF(ab’)2FragmentRabiesImmunoglobulin (Favirab) BeatrizP.Quiambao1,HazelZ.DyTioco2,RubyM.Dizon2,MarilynE.Crisostomo3,ThelmaM.Laot1, DirkE.Teuwen4* 1Research Institute for Tropical Medicine, Alabang, Manila, Philippines, 2Sanofi Pasteur, Manila, Philippines, 3College of Public Health, University of the Philippines, QuezonCity,Manila,Philippines,4SanofiPasteur,Lyon,France Abstract Background: Recommended treatment for severe rabies exposure in unvaccinated individuals includes wound cleaning, administration of rabies immunoglobulins (RIG), and rabies vaccination. We conducted a survey of rabies treatment outcomesinthePhilippines. Methods:Thiswasacaseseriesinvolving7,660patients(4monthsto98yearsofage)givenpurifiedequineRIG(pERIG)at theResearchInstituteforTropicalMedicine(Muntinlupa,Philippines)fromJuly2003toAugust2004followingCategoryIIor III exposures. Data on local and systemic adverse reactions (AR) within 28days and biting animal status were recorded; outcomedatawereobtainedbytelephoneorhomevisit6–29monthspost-exposure. Results:Follow-updatawerecollectedfor6,464patients.Of151patientswithlaboratory-confirmedrabiesexposure,143 wereingoodhealth6–48monthslater,sevencouldnotbecontacted,andone4-year-oldgirldied.Of16deathsintotal,14 were unrelated to rabies exposure or treatment. Two deaths were considered PEP failures: the 4-year old girl, who had multiple deep lacerated wounds from a rabid dog of the nape, neck, and shoulders requiring suturing on the day of exposure,andan8-year-oldboywhoonlyreceivedrabiesPEPonthedayofexposure. Conclusions:ThisextensivereviewofoutcomesinpersonswithCategoryIIIexposureshowstherecommendedtreatment scheduleatRITMusingpERIGiswelltolerated,whilesurvivalof143laboratory-confirmedrabiesexposuresconfirmsthe interventionefficacy.TwoPEPinterventionfailuresdemonstratethatsustainededucationandtrainingisessentialinrabies management. Citation: Quiambao BP