Human Rabies: Optimization of Prevention and Paths Towards the Cure
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10657 |
Resumo: | Introduction: Rabies is one of the oldest and deadliest infectious diseases known by human beings and is commonly transmitted by animal bites. Dogs have a major role in the transmission of the virus. Rabies has no approved curative therapy, and its prevention, even though it is highly effective, it is complex, expensive and challenging in terms of accessibility, particularly regarding immunoglobulin. This review aims to provide a practical approach to cost-effective prevention as well as the future perspectives regarding the development of an effective and secure cure.Material and Methods: This review article was based on a search in PubMed using the following MeSH terms: rabies, preexposure and postexposure prophylaxis, rabies immune globulin, treatment, Milwaukee Protocol.Results: Concerning rabies infection, it’s important to apply the prevention protocols effectively as early as possible due the unpredictable time window between infection and the appearance of symptoms. The literature shows that is possible to reduce the vaccination dosage and maintain the efficiency of the immunization, and booster vaccination is only required in specific risk groups/populations.Discussion: The current philosophy of cost-effective prevention which consists of canine vaccination, restriction of vaccine overdosage used in humans and the appropriate use of rabies immunoglobulin – could make the prevention of the disease accessible for those countries that need it the most. There are several therapies in development but they’re all in early stages of development.Conclusion: The development of new and more effective therapeutic and prophylactic approaches is a goal not yet achieved and relies on a better understanding of the disease pathophysiology. |
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Human Rabies: Optimization of Prevention and Paths Towards the CureRaiva Humana: Optimização da Prevenção e Caminhos Para a CuraImmunoglobulinsRabies/immunologyRabies/prevention & controlRabies/therapyRabies VaccinesImunoglobulinaRaiva/imunologiaRaiva/prevenção e controloRaiva/tratamentoVacinas AntirrábicasIntroduction: Rabies is one of the oldest and deadliest infectious diseases known by human beings and is commonly transmitted by animal bites. Dogs have a major role in the transmission of the virus. Rabies has no approved curative therapy, and its prevention, even though it is highly effective, it is complex, expensive and challenging in terms of accessibility, particularly regarding immunoglobulin. This review aims to provide a practical approach to cost-effective prevention as well as the future perspectives regarding the development of an effective and secure cure.Material and Methods: This review article was based on a search in PubMed using the following MeSH terms: rabies, preexposure and postexposure prophylaxis, rabies immune globulin, treatment, Milwaukee Protocol.Results: Concerning rabies infection, it’s important to apply the prevention protocols effectively as early as possible due the unpredictable time window between infection and the appearance of symptoms. The literature shows that is possible to reduce the vaccination dosage and maintain the efficiency of the immunization, and booster vaccination is only required in specific risk groups/populations.Discussion: The current philosophy of cost-effective prevention which consists of canine vaccination, restriction of vaccine overdosage used in humans and the appropriate use of rabies immunoglobulin – could make the prevention of the disease accessible for those countries that need it the most. There are several therapies in development but they’re all in early stages of development.Conclusion: The development of new and more effective therapeutic and prophylactic approaches is a goal not yet achieved and relies on a better understanding of the disease pathophysiology.Introdução: A raiva é uma das doenças infecciosas mais antigas e fatais conhecidas pelo ser humano e é maioritariamente transmitida por mordeduras de animais. O cão é o principal vector. A raiva não possui uma terapia curativa aprovada e a sua prevenção ainda que possua altas taxas de eficácia, é complexa, dispendiosa e nem sempre conseguida, muito devido às dificuldades de acesso da imunoglobulina. Esta revisão pretende analisar uma abordagem prática de uma prevenção custo-efectiva e as perspectivas futuras em desenvolvimento de uma cura eficaz e segura.Material e Métodos: Foi utilizada a base de dados da PubMed para pesquisa bibliográfica. Usaram-se os termos MeSH: ‘rabies’, ‘preexposure prophylaxis’, ‘postexposure prophylaxis’, ‘rabies immune globulin’, ‘treatment’ e ‘Milwaukee Protocol’.Resultados: Relativamente à raiva, é importante executar os protocolos de prevenção atempadamente, devido à imprevisível janela de tempo entre a infecção e a sintomatologia. A literatura mostra que é possível reduzir a dose de vacina mantendo uma eficiente imunização, e que doses de reforço só são necessárias em grupos/populações de risco.Discussão: A actual filosofia de uma prevenção custo-efectiva, que assenta na vacinação canina, restrição de sobredose das vacinas usadas em seres humanos e o uso inteligente da imunoglobulina rábica – irá permitir maior acessibilidade da prevenção da doença aos países que mais carecem dela. Encontram-se em progresso terapias promissoras, ainda em estadios precoces de estudo.Conclusão: O desenvolvimento de novas abordagens terapêuticas e profilácticas mais eficazes é um objectivo ainda não alcançado e depende de uma melhor compreensão da patogénese subjacente à doença.Ordem dos Médicos2021-11-02info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10657oai:ojs.www.actamedicaportuguesa.com:article/10657Acta Médica Portuguesa; Vol. 34 No. 11 (2021): November; 767-773Acta Médica Portuguesa; Vol. 34 N.º 11 (2021): Novembro; 767-7731646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10657https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10657/5850Direitos de Autor (c) 2020 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessConceição, PauloAbreu, Cândida2022-12-20T11:06:03Zoai:ojs.www.actamedicaportuguesa.com:article/10657Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:55.372392Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Human Rabies: Optimization of Prevention and Paths Towards the Cure Raiva Humana: Optimização da Prevenção e Caminhos Para a Cura |
title |
Human Rabies: Optimization of Prevention and Paths Towards the Cure |
spellingShingle |
Human Rabies: Optimization of Prevention and Paths Towards the Cure Conceição, Paulo Immunoglobulins Rabies/immunology Rabies/prevention & control Rabies/therapy Rabies Vaccines Imunoglobulina Raiva/imunologia Raiva/prevenção e controlo Raiva/tratamento Vacinas Antirrábicas |
title_short |
Human Rabies: Optimization of Prevention and Paths Towards the Cure |
title_full |
Human Rabies: Optimization of Prevention and Paths Towards the Cure |
title_fullStr |
Human Rabies: Optimization of Prevention and Paths Towards the Cure |
title_full_unstemmed |
Human Rabies: Optimization of Prevention and Paths Towards the Cure |
title_sort |
Human Rabies: Optimization of Prevention and Paths Towards the Cure |
author |
Conceição, Paulo |
author_facet |
Conceição, Paulo Abreu, Cândida |
author_role |
author |
author2 |
Abreu, Cândida |
author2_role |
author |
dc.contributor.author.fl_str_mv |
Conceição, Paulo Abreu, Cândida |
dc.subject.por.fl_str_mv |
Immunoglobulins Rabies/immunology Rabies/prevention & control Rabies/therapy Rabies Vaccines Imunoglobulina Raiva/imunologia Raiva/prevenção e controlo Raiva/tratamento Vacinas Antirrábicas |
topic |
Immunoglobulins Rabies/immunology Rabies/prevention & control Rabies/therapy Rabies Vaccines Imunoglobulina Raiva/imunologia Raiva/prevenção e controlo Raiva/tratamento Vacinas Antirrábicas |
description |
Introduction: Rabies is one of the oldest and deadliest infectious diseases known by human beings and is commonly transmitted by animal bites. Dogs have a major role in the transmission of the virus. Rabies has no approved curative therapy, and its prevention, even though it is highly effective, it is complex, expensive and challenging in terms of accessibility, particularly regarding immunoglobulin. This review aims to provide a practical approach to cost-effective prevention as well as the future perspectives regarding the development of an effective and secure cure.Material and Methods: This review article was based on a search in PubMed using the following MeSH terms: rabies, preexposure and postexposure prophylaxis, rabies immune globulin, treatment, Milwaukee Protocol.Results: Concerning rabies infection, it’s important to apply the prevention protocols effectively as early as possible due the unpredictable time window between infection and the appearance of symptoms. The literature shows that is possible to reduce the vaccination dosage and maintain the efficiency of the immunization, and booster vaccination is only required in specific risk groups/populations.Discussion: The current philosophy of cost-effective prevention which consists of canine vaccination, restriction of vaccine overdosage used in humans and the appropriate use of rabies immunoglobulin – could make the prevention of the disease accessible for those countries that need it the most. There are several therapies in development but they’re all in early stages of development.Conclusion: The development of new and more effective therapeutic and prophylactic approaches is a goal not yet achieved and relies on a better understanding of the disease pathophysiology. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-11-02 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
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publishedVersion |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10657 oai:ojs.www.actamedicaportuguesa.com:article/10657 |
url |
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10657 |
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oai:ojs.www.actamedicaportuguesa.com:article/10657 |
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por |
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por |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10657 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/10657/5850 |
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Direitos de Autor (c) 2020 Acta Médica Portuguesa info:eu-repo/semantics/openAccess |
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Direitos de Autor (c) 2020 Acta Médica Portuguesa |
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openAccess |
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application/pdf |
dc.publisher.none.fl_str_mv |
Ordem dos Médicos |
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Ordem dos Médicos |
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Acta Médica Portuguesa; Vol. 34 No. 11 (2021): November; 767-773 Acta Médica Portuguesa; Vol. 34 N.º 11 (2021): Novembro; 767-773 1646-0758 0870-399X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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