RABIES - UK (03): (LONDON, ENGLAND) ex INDIA, FATAL OUTCOME
***********************************************************
A ProMED-mail post
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Date: Mon 28 May 2012
Source: BBC News England [edited]
http://www.bbc.co.uk/news/uk-england-18244429
A woman who was being treated in London for rabies has died. The woman -- whose identity has not been revealed -- was bitten by a dog in South Asia [India] and died over the weekend [26-27 May 2012]. She was being treated at London's Hospital for Tropical Diseases after twice attending A&E at Darent Valley Hospital in Dartford. Meanwhile, it has emerged a patient in Leeds has sought medical help for a dog bite which occurred abroad. The 2 cases are not being linked.
Rabies can be transferred from the bite of an infected animal, with dogs being the most common transmitter to humans. A statement from University College London Hospitals NHS Foundation Trust said: "We regret to announce that a patient being treated for rabies by the Hospital for Tropical Diseases and colleagues at University College Hospital died over the weekend." Meanwhile, an investigation has been launched into how the woman was turned away from the emergency department at Darent Valley Hospital in Dartford. A spokesman for the hospital previously said that as the UK is rabies-free, if a patient went to a hospital with vague symptoms, a doctor was unlikely to consider rabies as a diagnosis unless the patient highlighted wild animal contact in an at-risk country. "The hospital responded to the information supplied by the patient at the time," he said.
On Friday [25 May 2012] it was announced that a patient in Leeds had sought treatment for a possible case of rabies after being bitten by a dog while abroad. The Health Protection Agency said there were "no links" between the 2 cases.
More than 55 000 people are estimated to die from the disease every year, with most cases occurring in developing countries, particularly South and South-East Asia. The hospital previously reassured patients, visitors, and staff there was no risk to them as a result of the case.
--
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[The presumed absence of post-exposure treatment after exposure in India, coupled with the late diagnosis in the England, made the fatal outcome in this case inevitable.
The status of the suspected rabies case in Leeds is unclear. No information has been released concerning the date and place of possible exposure, whether prompt post-exposure treatment was available at the time of exposure, or whether the diagnosis has been confirmed by laboratory analysis. Further information is awaited. - Mod.CP
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1DX_.]
Tollwut - Impfung und mögliche Behandlung
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Tollwut-Impfung für Reisen nach Indien empfohlen!
RABIES - INDIA: WHO TRAVEL ALERT
********************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
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Date: Fri 8 Jun 2012
Source: New York Daily News [edited]
http://india.nydailynews.com/newsarticl ... el-warning
Rabies death in UK prompts WHO travel warning
---------------------------------------------
On Thu 7 Jun 2012 the World Health Organization [WHO] has issued a travel warning after a British woman died from rabies, contracted from a dog in India [see ProMED-mail archived reports below]. India has now been slapped with a "high risk" rabies warning, with recommendations for travellers to be immunised before visiting the country. The unnamed woman contracted the disease as a result of an untreated bite from a dog in India. Her death has prompted the organisation to introduce detailed country-by-country advice on pre-travel rabies vaccination, to sit alongside recommendations for yellow fever and malaria protection. In the case of India, for example, it now says: "Rabies: High risk - Pre-exposure immunisation [is] recommended for travellers and other people for whom contact with domestic animals, particularly dogs, and other rabies vectors is likely" - advice that is repeated verbatim for almost every other tropical country.
Dr Mary Warrell, a virologist and specialist in rabies, said last month's incident was a timely reminder of the need for precautions. "In unvaccinated humans, dog rabies infection is 100 per cent fatal once symptoms appear," she added. Other than for short trips to main tourist destinations, all travellers should consider rabies vaccination. Gap-year travellers, frequent travellers, those on longer trips, anyone going far from the beaten track or likely to be in close contact with local communities or animals should have the vaccine.
Vaccine shortages are common, but at the moment the vaccine is readily available at specialist travel clinics. Rabies vaccine for travel is not provided on the NHS [National Health Service]. Ask your travel clinic for advice. For short trips, last-minute vaccination may be unhelpful unless you have future trips in mind. But if you are about to leave for a longer trip, it is sometimes worth starting the course before you go and taking the remaining doses with you.
Rabies can affect any mammal, though most cases are transmitted by dog saliva. You don't need to be bitten: licks or scratches, especially on damaged or broken skin, are also a risk. If bitten scrub and rinse the wound thoroughly, and disinfect with alcohol or strong antiseptic. Get prompt local advice, and back this up with a call to your travel insurance company, your doctor, or a specialist travel clinic. Always report a bite, and seek specialist help. Without prior rabies vaccination, you may need a rapid vaccine course, plus an injection of rabies immune globulin (RIG). RIG is scarce and very expensive, and reliable treatment can be hard to find. With the pre-travel ("pre-exposure") rabies vaccination, simple booster doses are all that are needed following a bite. These provide full protection.
--
communicated by:
ProMED-mail
<promed@promedmail.org>
[This travel alert could apply equally to other regions of the world where rabies is still prevalent. Worldwide, rabies is believed to be killing about 55 000 people per year, with canine rabies most prevalent in South East Asia and Africa, while bat rabies predominates in South America. The human death toll in India has been estimated as 35 000 per annum, but may now be declining. - Mod.CP
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1pSH.]
___________________________________________________________________________________
RABIES - INDIA: MORTALITY ESTIMATES
***********************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Sat 9 Jun 2012
From: Merritt Clifton
Comment on human rabies death toll in India
-------------------------------------------
[Merritt Clifton has forwarded the following commentary in response to ProMED-mail post Rabies - India: WHO travel alert 20120609.1162367, in which the moderator stated that: "The human death toll in India has been estimated as 35 000 per annum, but may now be declining".]
Some history and discussion of the Indian estimates of human rabies deaths appears to be in order, not least because the figure of 35 000 per year has been used by Indian mass media since 1976, at least, and though it is often cited with various different attributions, I have yet to find anyone who really knows where it came from, or how it was calculated. The following is pared down from my cover article in the current edition of ANIMAL PEOPLE.
On 29 Apr 2012, as ProMed noted on 1 May 2012 [Rabies - India: (WB) 20120501.1119730], Indian national health minister Gulam Nabi Azad presented the most recent Indian government statistics on mortality from all causes to the Lok Sabha, the Indian parliament. After discussing heart disease, diabetes, and cancer, Gulam Nabi Azad mentioned that only 223 human rabies deaths were recorded in India in 2011. This was barely 1% of the 2002 government estimate (20 000), which was a projection meant to be an average over 10 years, 1992-2002.
As rabies is not a notifiable disease in India, reports of human rabies deaths are not routinely forwarded to the federal health ministry. Therefore, the figure that Gulam Nabi Azad used on 29 Apr 2012 may have been low -- but how low? The Animal Welfare Board of India, Federation of Indian Animal Protection Organizations, and Animal Birth Control India all track canine rabies outbreaks, albeit relatively informally, and do collect and share human mortality information as part of their work. Longtime Blue Cross of India chief executive and Animal Welfare Board of India member Chinny Krishna e-mailed to me shortly after Gulam Nabi Azad spoke that 'the figure given by Gulam Nabi Azad is in the opinion of many of us working on the ground much closer to reality" than the previous figures of 20 000.
Introducing the use of street dog vaccination and sterilization to combat canine rabies in 1966, Krishna was already skeptical of the WHO and Indian government estimates of human rabies fatalities by 1976, when he first criticized the figure of 35 000. "For at least 25 years, I fought the claim of 35 000 rabies deaths in India yearly," Krishna posted recently to FIAPO. "I spoke at the Association for Prevention and Control of Rabies in India conference at Bhubaneshwar when the decennial figures for 1992-2002 were released," lowering the estimated toll to 17 000 diagnosed human deaths and 3000 deaths that went undiagnosed. Krishna suspected that the high figures were produced by the combination of inadequate case tracking, faulty diagnostic work, and official projections based on obsolescent and inaccurate presumptions about how rabies spreads.
Eventually Krishna persuaded People for Animals founder Maneka Gandhi, who for more than five years was the Indian federal minister for animal welfare, and was also for a time minister for statistics, but Mrs Gandhi lost her cabinet position before she could organise an official reappraisal of the rabies numbers. Likewise convinced was Animal Welfare Board of India chair Rammehar Kharb, a retired military veterinarian who on appointment in May 2006 pledged to "eradicate rabies from India by mass vaccination of stray dogs." WHO-South East Asia Regional Organization technical officer for veterinary public health Gyanendra Gongal also came to question the official numbers. Journalist Hiranmay Karlekar in a 2008 book entitled 'Savage Humans & Stray Dogs' attributed the inflated human rabies death estimates to the desire of makers of post-exposure vaccines to sell more of their product to dog bite victims and to their biggest customers, the government clinics that are mandated to treat dog bite victims free of charge.
ANIMAL PEOPLE pointed out repeatedly, beginning in 1997, that several mosquito-borne and tick-borne diseases, common to India but not widely recognized until relatively recently, also produce high fever and other rabies symptoms, and are likewise frequently fatal if left untreated. Undetected insect-carried febrile illnesses could easily have accounted for most of the unconfirmed "rabies" death toll. Chinny Krishna sought unsuccessfully on several occasions to enlist FIAPO members to participate in an unfunded national rabies data collection effort. At the June 2011 Asia for Animals conference in Chengdu, China, Krishna assembled representatives of the AWBI, ABC India, ANIMAL PEOPLE (including myself), and Humane Society International for an informal brainstorming session which concluded that available information on clinically confirmed rabies cases suggested that the annual human rabies death toll in India could not be more than 2000 to 3000. Data from Andhra Pradesh and Goa states, released after rabies outbreaks in 2011, later projected a range of 2000 to 3150 human rabies deaths per year, if all states were afflicted to the same extent."I would not necessarily go so far as to say that the number of human rabies cases a year in India is around 2000," Humane Society International president Andrew Rowan said at the time, "but I certainly suspect it is well below 20 000."
--
communicated by:
Merritt Clifton
Editor, ANIMAL PEOPLE
PO Box 960
Clinton, WA 98236
USA
[It is apparent from the above that the figure for the extent of human rabies mortality in India is in urgent need of revision. It would help if human rabies was ranked as a notifiable disease in India.
The HealthMap interactive map of India can be accessed t: http://healthmap.org/r/1pSH. - Mod.CP]
********************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Fri 8 Jun 2012
Source: New York Daily News [edited]
http://india.nydailynews.com/newsarticl ... el-warning
Rabies death in UK prompts WHO travel warning
---------------------------------------------
On Thu 7 Jun 2012 the World Health Organization [WHO] has issued a travel warning after a British woman died from rabies, contracted from a dog in India [see ProMED-mail archived reports below]. India has now been slapped with a "high risk" rabies warning, with recommendations for travellers to be immunised before visiting the country. The unnamed woman contracted the disease as a result of an untreated bite from a dog in India. Her death has prompted the organisation to introduce detailed country-by-country advice on pre-travel rabies vaccination, to sit alongside recommendations for yellow fever and malaria protection. In the case of India, for example, it now says: "Rabies: High risk - Pre-exposure immunisation [is] recommended for travellers and other people for whom contact with domestic animals, particularly dogs, and other rabies vectors is likely" - advice that is repeated verbatim for almost every other tropical country.
Dr Mary Warrell, a virologist and specialist in rabies, said last month's incident was a timely reminder of the need for precautions. "In unvaccinated humans, dog rabies infection is 100 per cent fatal once symptoms appear," she added. Other than for short trips to main tourist destinations, all travellers should consider rabies vaccination. Gap-year travellers, frequent travellers, those on longer trips, anyone going far from the beaten track or likely to be in close contact with local communities or animals should have the vaccine.
Vaccine shortages are common, but at the moment the vaccine is readily available at specialist travel clinics. Rabies vaccine for travel is not provided on the NHS [National Health Service]. Ask your travel clinic for advice. For short trips, last-minute vaccination may be unhelpful unless you have future trips in mind. But if you are about to leave for a longer trip, it is sometimes worth starting the course before you go and taking the remaining doses with you.
Rabies can affect any mammal, though most cases are transmitted by dog saliva. You don't need to be bitten: licks or scratches, especially on damaged or broken skin, are also a risk. If bitten scrub and rinse the wound thoroughly, and disinfect with alcohol or strong antiseptic. Get prompt local advice, and back this up with a call to your travel insurance company, your doctor, or a specialist travel clinic. Always report a bite, and seek specialist help. Without prior rabies vaccination, you may need a rapid vaccine course, plus an injection of rabies immune globulin (RIG). RIG is scarce and very expensive, and reliable treatment can be hard to find. With the pre-travel ("pre-exposure") rabies vaccination, simple booster doses are all that are needed following a bite. These provide full protection.
--
communicated by:
ProMED-mail
<promed@promedmail.org>
[This travel alert could apply equally to other regions of the world where rabies is still prevalent. Worldwide, rabies is believed to be killing about 55 000 people per year, with canine rabies most prevalent in South East Asia and Africa, while bat rabies predominates in South America. The human death toll in India has been estimated as 35 000 per annum, but may now be declining. - Mod.CP
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1pSH.]
___________________________________________________________________________________
RABIES - INDIA: MORTALITY ESTIMATES
***********************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Sat 9 Jun 2012
From: Merritt Clifton
Comment on human rabies death toll in India
-------------------------------------------
[Merritt Clifton has forwarded the following commentary in response to ProMED-mail post Rabies - India: WHO travel alert 20120609.1162367, in which the moderator stated that: "The human death toll in India has been estimated as 35 000 per annum, but may now be declining".]
Some history and discussion of the Indian estimates of human rabies deaths appears to be in order, not least because the figure of 35 000 per year has been used by Indian mass media since 1976, at least, and though it is often cited with various different attributions, I have yet to find anyone who really knows where it came from, or how it was calculated. The following is pared down from my cover article in the current edition of ANIMAL PEOPLE.
On 29 Apr 2012, as ProMed noted on 1 May 2012 [Rabies - India: (WB) 20120501.1119730], Indian national health minister Gulam Nabi Azad presented the most recent Indian government statistics on mortality from all causes to the Lok Sabha, the Indian parliament. After discussing heart disease, diabetes, and cancer, Gulam Nabi Azad mentioned that only 223 human rabies deaths were recorded in India in 2011. This was barely 1% of the 2002 government estimate (20 000), which was a projection meant to be an average over 10 years, 1992-2002.
As rabies is not a notifiable disease in India, reports of human rabies deaths are not routinely forwarded to the federal health ministry. Therefore, the figure that Gulam Nabi Azad used on 29 Apr 2012 may have been low -- but how low? The Animal Welfare Board of India, Federation of Indian Animal Protection Organizations, and Animal Birth Control India all track canine rabies outbreaks, albeit relatively informally, and do collect and share human mortality information as part of their work. Longtime Blue Cross of India chief executive and Animal Welfare Board of India member Chinny Krishna e-mailed to me shortly after Gulam Nabi Azad spoke that 'the figure given by Gulam Nabi Azad is in the opinion of many of us working on the ground much closer to reality" than the previous figures of 20 000.
Introducing the use of street dog vaccination and sterilization to combat canine rabies in 1966, Krishna was already skeptical of the WHO and Indian government estimates of human rabies fatalities by 1976, when he first criticized the figure of 35 000. "For at least 25 years, I fought the claim of 35 000 rabies deaths in India yearly," Krishna posted recently to FIAPO. "I spoke at the Association for Prevention and Control of Rabies in India conference at Bhubaneshwar when the decennial figures for 1992-2002 were released," lowering the estimated toll to 17 000 diagnosed human deaths and 3000 deaths that went undiagnosed. Krishna suspected that the high figures were produced by the combination of inadequate case tracking, faulty diagnostic work, and official projections based on obsolescent and inaccurate presumptions about how rabies spreads.
Eventually Krishna persuaded People for Animals founder Maneka Gandhi, who for more than five years was the Indian federal minister for animal welfare, and was also for a time minister for statistics, but Mrs Gandhi lost her cabinet position before she could organise an official reappraisal of the rabies numbers. Likewise convinced was Animal Welfare Board of India chair Rammehar Kharb, a retired military veterinarian who on appointment in May 2006 pledged to "eradicate rabies from India by mass vaccination of stray dogs." WHO-South East Asia Regional Organization technical officer for veterinary public health Gyanendra Gongal also came to question the official numbers. Journalist Hiranmay Karlekar in a 2008 book entitled 'Savage Humans & Stray Dogs' attributed the inflated human rabies death estimates to the desire of makers of post-exposure vaccines to sell more of their product to dog bite victims and to their biggest customers, the government clinics that are mandated to treat dog bite victims free of charge.
ANIMAL PEOPLE pointed out repeatedly, beginning in 1997, that several mosquito-borne and tick-borne diseases, common to India but not widely recognized until relatively recently, also produce high fever and other rabies symptoms, and are likewise frequently fatal if left untreated. Undetected insect-carried febrile illnesses could easily have accounted for most of the unconfirmed "rabies" death toll. Chinny Krishna sought unsuccessfully on several occasions to enlist FIAPO members to participate in an unfunded national rabies data collection effort. At the June 2011 Asia for Animals conference in Chengdu, China, Krishna assembled representatives of the AWBI, ABC India, ANIMAL PEOPLE (including myself), and Humane Society International for an informal brainstorming session which concluded that available information on clinically confirmed rabies cases suggested that the annual human rabies death toll in India could not be more than 2000 to 3000. Data from Andhra Pradesh and Goa states, released after rabies outbreaks in 2011, later projected a range of 2000 to 3150 human rabies deaths per year, if all states were afflicted to the same extent."I would not necessarily go so far as to say that the number of human rabies cases a year in India is around 2000," Humane Society International president Andrew Rowan said at the time, "but I certainly suspect it is well below 20 000."
--
communicated by:
Merritt Clifton
Editor, ANIMAL PEOPLE
PO Box 960
Clinton, WA 98236
USA
[It is apparent from the above that the figure for the extent of human rabies mortality in India is in urgent need of revision. It would help if human rabies was ranked as a notifiable disease in India.
The HealthMap interactive map of India can be accessed t: http://healthmap.org/r/1pSH. - Mod.CP]
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Tollwut in Indien - Sterblichkeitsschätzungen
RABIES - INDIA (06): MORTALITY ESTIMATES
*****************************************
A ProMED-mail post
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ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Thu 14 Jun 2012
From: Merritt Clifton [edited]
Rabies mortality estimates - the last word
------------------------------------------
The National Health Profile of India, published by the Central Bureau of Health Intelligence within the Directorate General of Health Services, under the Ministry of Health and Family Welfare, actually began reporting markedly lower rabies death numbers in 2005 -- but apparently nobody noticed until Indian health minister Gulam Nabi Azad on 29 Apr 2012 brought the latest data to the Lok Sabha [House of the People, the lower house of the Parliament of India].
The National Health Profile of India human rabies death numbers:
2005: 274
2006: 361
2007: 221
2008: 244
2009: 260
2010: 162
2011: 223
The National Health Profile is a source of data about many other diseases commonly discussed by ProMED-mail (see http://cbhidghs.nic.in/index2.asp?slid= ... linkid=706). Why has no one brought this resource to our attention before?
--
Merritt Clifton
Editor, Animal People
PO Box 960
Clinton, WA 98236
USA
< a="">
<>http://www.animalpeoplenews.org
[ProMED-mail thanks Merritt Clifton for his continuing analysis of estimates of human rabies mortality in India. With these data from the Indian Central Bureau of Health Intelligence, this thread is now cut.
Hopefully the relevant international agencies and travel advice organisations will take note and revise their statements downward accordingly.
A map of the states of India can be accessed at http://www.mapsofindia.com/maps/india/i ... al-map.htm and the HealthMap/ProMED-mail interactive map at http://healthmap.org/r/1pSH. - Mod.CP]
*****************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Thu 14 Jun 2012
From: Merritt Clifton [edited]
Rabies mortality estimates - the last word
------------------------------------------
The National Health Profile of India, published by the Central Bureau of Health Intelligence within the Directorate General of Health Services, under the Ministry of Health and Family Welfare, actually began reporting markedly lower rabies death numbers in 2005 -- but apparently nobody noticed until Indian health minister Gulam Nabi Azad on 29 Apr 2012 brought the latest data to the Lok Sabha [House of the People, the lower house of the Parliament of India].
The National Health Profile of India human rabies death numbers:
2005: 274
2006: 361
2007: 221
2008: 244
2009: 260
2010: 162
2011: 223
The National Health Profile is a source of data about many other diseases commonly discussed by ProMED-mail (see http://cbhidghs.nic.in/index2.asp?slid= ... linkid=706). Why has no one brought this resource to our attention before?
--
Merritt Clifton
Editor, Animal People
PO Box 960
Clinton, WA 98236
USA
< a="">
<>http://www.animalpeoplenews.org
[ProMED-mail thanks Merritt Clifton for his continuing analysis of estimates of human rabies mortality in India. With these data from the Indian Central Bureau of Health Intelligence, this thread is now cut.
Hopefully the relevant international agencies and travel advice organisations will take note and revise their statements downward accordingly.
A map of the states of India can be accessed at http://www.mapsofindia.com/maps/india/i ... al-map.htm and the HealthMap/ProMED-mail interactive map at http://healthmap.org/r/1pSH. - Mod.CP]
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Tollwut in Südafrika - Kwazulu Natal
In Südafrika, Provinz Kwazulu-Natal (SO), sind in den letzten 3 Monaten drei Menschen an der Infektion gestorben, nachdem sie zuvor von tollwütigen Hunden gebissen wurden. Momentan wird ein 4-jähriger Junge intensivmedizinisch behandelt, auch er ist an Tollwut erkrankt. Ende Juni wurde nun im Rahmen einer staatlichen Kampagne damit begonnen, Hunde der Region gegen Tollwut zu impfen. Die Kampagne startet in Durban, das Programm wird dann in ländlichen Regionen fortgesetzt. Reisende sollten sich von Tieren grundsätzlich fernhalten und im Falle eines Bisses unverzüglich eine Klinik aufsuchen, damit die Behandlung (Postexpositionsprophylaxe) durchgeführt werden kann. Für Risikoreisende ist eine vorherige Impfung zu empfehlen. / Quelle: crm, 29.06.2012
Gruß
Birgitt
Gruß
Birgitt
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Birgitt
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Tollwut in Peru - Ohne Behandlung überlebt
Bislang gilt eine Infektion mit dem Tollwutvirus als Todesurteil, wenn nicht sofort nach dem Biss eines erkrankten Tiers Gegenmaßnahmen eingeleitet werden – davon gingen nicht nur Laien, sondern ebenso die meisten Mediziner aus. Nun haben jedoch Amy Gilbert vom US Center for Disease Control and Prevention (CDC) in Atlanta und ihre Kollegen mehrere Menschen im peruanischen Amazonasgebiet aufgespürt, die offensichtlich einen Tollwutbefall ohne Folgeschäden überlebt haben [...] Die schützenden Antikörper fanden sich durchweg in älteren Personen. "Wir vermuten daher, dass diese Menschen mehrfach mit geringen Mengen des Virus in Kontakt gerieten und deshalb eine natürliche Immunantwort aufbauten", sagt die Forscherin weiter. Da sie nicht erkrankten, suchten sie auch keinen Arzt auf. Nun sollen weitere Untersuchungen folgen, um eventuellen genetischen Grundlagen der Tollwutimmunität auf die Spur zu kommen. Womöglich ließen sich daraus auch neue Behandlungsmethoden und Medikamente gewinnen, die die Behandlung von Tollwut erleichtern und verbessern ...
Tollwut ohne Behandlung überlebt
02.08.2012 - spektrum
Gruß
Birgitt
Tollwut ohne Behandlung überlebt
02.08.2012 - spektrum
Gruß
Birgitt
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Tollwut in Indien - Impfung und mögliche Behandlung
RABIES - INDIA (07): (HARYANA) VACCINE WITHDRAWN
************************************************
A ProMED-mail post
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ProMED-mail is a program of the
International Society for Infectious Diseases
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Date: Wed 29 Aug 2012
Source: Hindustani Times [edited]
http://www.hindustantimes.com/Punjab/Ch ... 21450.aspx
Following the death of a 6-year-old boy after being administered an anti-rabies vaccine (ARV) here on Wednesday [29 Aug 2012], the Haryana health department has alerted all civil hospitals to temporarily discontinue using the vaccine. The incident took place at Karnal Civil Hospital, and doctors termed it a case of vaccine reaction. Karnal civil surgeon Dr Shiv Kumar said that the vaccine, AbhyaRab, manufactured by Human Biological Institute, Tamil Nadu, has been withdrawn.
The vaccine is available at all government hospitals, and following suspicion about its quality, its use has been suspended with immediate effect. "The vaccine stock in Karnal has been sealed, and the civil surgeons across the state have been informed telephonically to stop using the vaccine till it gets a quality clearance," Dr Kumar said. He said that the patient from Panipat was undergoing treatment at the local civil hospital after being bitten by a stray dog. He had been referred here to undergo a treatment of 5 ARVs in a row. "The patient was administered the vaccine on 3 earlier occasions, and he responded well. But after being administered the ARV at the hospital today [29 Aug 2012], his condition deteriorated suddenly. Despite the best efforts of the team of doctors attending on him, the patient died within 20 minutes of being injected the vaccine," the civil surgeon added.
District drug controller Parvinder Malik confirmed that the stock of Human Biological Institute ARV had been sealed and samples would be sent to the Central Research Laboratory at Kasauli in Himachal Pradesh. Meanwhile, the parents of the boy have not lodged any complaint and have declined a post-mortem.
[Byline: Vishal Joshi]
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[The AbhyaRab vaccine is produced by Human Biological Institute. It is a purified Vero cell rabies vaccine. It is a freeze dried preparation that should be reconstituted with 0.5 mL of a diluent supplied with the vaccine. The reconstituted vaccine should be administered immediately and should not be stored for administration later. Abhayrab vaccine should be administered intra-muscularly in the deltoid region in both adults and children. Under no circumstances should it be administered intravenously.
The tolerance of the child to the 1st 3 inoculations followed by abrupt deterioration of his condition following the 4th administration of the vaccine suggests that there may been some error in preparation or administration of the vaccine rather than a defect in the vaccine itself. The outcome of the investigation of this incident is awaited.
Karnal is a district in the Indian state of Haryana. The interactive HealthMap of Haryana can be accessed at: http://healthmap.org/r/3cXh. - Mod.CP]
************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Wed 29 Aug 2012
Source: Hindustani Times [edited]
http://www.hindustantimes.com/Punjab/Ch ... 21450.aspx
Following the death of a 6-year-old boy after being administered an anti-rabies vaccine (ARV) here on Wednesday [29 Aug 2012], the Haryana health department has alerted all civil hospitals to temporarily discontinue using the vaccine. The incident took place at Karnal Civil Hospital, and doctors termed it a case of vaccine reaction. Karnal civil surgeon Dr Shiv Kumar said that the vaccine, AbhyaRab, manufactured by Human Biological Institute, Tamil Nadu, has been withdrawn.
The vaccine is available at all government hospitals, and following suspicion about its quality, its use has been suspended with immediate effect. "The vaccine stock in Karnal has been sealed, and the civil surgeons across the state have been informed telephonically to stop using the vaccine till it gets a quality clearance," Dr Kumar said. He said that the patient from Panipat was undergoing treatment at the local civil hospital after being bitten by a stray dog. He had been referred here to undergo a treatment of 5 ARVs in a row. "The patient was administered the vaccine on 3 earlier occasions, and he responded well. But after being administered the ARV at the hospital today [29 Aug 2012], his condition deteriorated suddenly. Despite the best efforts of the team of doctors attending on him, the patient died within 20 minutes of being injected the vaccine," the civil surgeon added.
District drug controller Parvinder Malik confirmed that the stock of Human Biological Institute ARV had been sealed and samples would be sent to the Central Research Laboratory at Kasauli in Himachal Pradesh. Meanwhile, the parents of the boy have not lodged any complaint and have declined a post-mortem.
[Byline: Vishal Joshi]
--
Communicated by:
ProMED-mail <promed@promedmail.org>
[The AbhyaRab vaccine is produced by Human Biological Institute. It is a purified Vero cell rabies vaccine. It is a freeze dried preparation that should be reconstituted with 0.5 mL of a diluent supplied with the vaccine. The reconstituted vaccine should be administered immediately and should not be stored for administration later. Abhayrab vaccine should be administered intra-muscularly in the deltoid region in both adults and children. Under no circumstances should it be administered intravenously.
The tolerance of the child to the 1st 3 inoculations followed by abrupt deterioration of his condition following the 4th administration of the vaccine suggests that there may been some error in preparation or administration of the vaccine rather than a defect in the vaccine itself. The outcome of the investigation of this incident is awaited.
Karnal is a district in the Indian state of Haryana. The interactive HealthMap of Haryana can be accessed at: http://healthmap.org/r/3cXh. - Mod.CP]
Re: Tollwut - Impfung und mögliche Behandlung
Hallo Gemeinde
Ich bin im Moment an der Tollwutimpfung und ich kann sie jedem nur empfehlen.
Mein Tropenarzt hat mir die letzten seiner tödlich verlaufenen Fälle geschildert, wahrhaft nicht schön.
Er meint auch, dass alle Fälle, die er gekannt hat, immer tödlich verlaufen sind.
Die Impfung ist jedem Afrikafahrer und nicht nur denen wärmstens zu empfehlen.
Gruss
Turi
Ich bin im Moment an der Tollwutimpfung und ich kann sie jedem nur empfehlen.
Mein Tropenarzt hat mir die letzten seiner tödlich verlaufenen Fälle geschildert, wahrhaft nicht schön.
Er meint auch, dass alle Fälle, die er gekannt hat, immer tödlich verlaufen sind.
Die Impfung ist jedem Afrikafahrer und nicht nur denen wärmstens zu empfehlen.
Gruss
Turi
Wenn man die Ruhe nicht in sich selbst findet, ist es umsonst, sie anderswo zu suchen!
-
Birgitt
- Moderator
- Beiträge: 35199
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- Kontaktdaten:
Tollwut in Indien - Sterblichkeitsschätzungen
RABIES - INDIA (10): VERBAL AUTOPSY MORTALITY ESTIMATE
******************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Thu 4 Oct 2012
Source: PLoS Negl Trop Dis [summarised & edited]
http://www.plosntds.org/article/info%3A ... td.0001847
[Citation: Wilson Suraweera, Shaun K. Morris, Rajesh Kumar, David A. Warrell, Mary J. Warrell, Prabhat Jha, for the Million Death Study Collaborators. Editor: Jakob Zinsstag, Swiss Tropical and Public Health Institute, Switzerland]
Abstract
-----------
Background: It is estimated that India has more deaths from rabies than any other country. However, existing estimates are indirect and rely on non-representative studies.
Methods and Principal Findings: We examined rabies deaths in the ongoing Million Death Study (MDS), a representative survey of over 122 000 deaths in India that uses enhanced types of verbal autopsy. We estimated the age-specific mortality rates of symptomatically identifiable furious rabies and its geographic and demographic distributions. A total of 140 deaths in our sample were caused by rabies, suggesting that in 2005 there were 12 700 (99 percent, CI 10 000 to 15 500) symptomatically identifiable furious rabies deaths in India. Most rabies deaths were in males (62 percent), in rural areas (91 percent), and in children below the age of 15 years (50 percent). The overall rabies mortality rate was 1.1 deaths per 100 000 population (99 percent, CI 0.9 to 1.4). 1/3rd of the national rabies deaths were found in Uttar Pradesh (4300) and nearly 3/4th (8900) were in 7 central and south-eastern states: Chhattisgarh, Uttar Pradesh, Odisha, Andhra Pradesh, Bihar, Assam, and Madhya Pradesh.
Conclusions and Significance: Rabies remains an avoidable cause of death in India. As verbal autopsy is not likely to identify atypical or paralytic forms of rabies, our figure of 12 700 deaths due to classic and clinically identifiable furious rabies underestimates the total number of deaths due to this virus. The concentrated geographic distribution of rabies in India suggests that a significant reduction in the number of deaths or potentially even elimination of rabies deaths is possible.
Author Summary
--------------
Rabies, a disease of antiquity, has been partially controlled in many countries and eliminated in a few. However, according to the World Health Organization, rabies continues to kill thousands of people in India each year, more than in any other country. We used an enhanced type of verbal autopsy (a structured interview of the relatives or close associates of the dead by non-medical staff with central medical coding by at least 2 doctors) to identify the causes of over 122 000 deaths in a large scale, representative sample in India in 2001-03. Using these data, we estimate that in 2005, approximately 12 700 people died from symptomatically identifiable furious rabies. Because verbal autopsy is not able to identify atypical presentations of rabies, our figure underestimates the actual number of rabies deaths in India. The majority of rabies deaths occurred in males, in rural areas, in children below the age of 15 years, and in a few states. The concentrated geographic distribution of rabies in India suggests that targeting with preventive campaigns including vaccination of animals and post exposure vaccination of humans might achieve a significant reduction in the number of deaths or potentially even elimination of deaths from this disease.
Authors' conclusion: We estimate that there were 12 700 deaths due to symptomatically identifiable furious rabies in India in 2005. It is very important to note that this figure underestimates the total number of deaths due to rabies since paralytic and atypical cases would not have been detected by verbal autopsy.
This study is the 1st to estimate rabies mortality based upon a nationally representative sample of deaths rather than modeling or from extrapolation from selected focal surveillance. Thus, we provide previously unavailable regional and demographic information about human rabies deaths that can help to focus both human and canine rabies control programmes in the country and act as a baseline that can be used as comparison for future estimates of rabies mortality. Elimination of the canine reservoir of rabies is not likely in India at anytime in the near future. However, the concentrated geographic distribution of rabies in India suggests that a significant reduction in the number of human deaths or potentially even elimination of rabies deaths is possible, and this study serves as a baseline against which future gains may be measured.
--
Communicated by:
Ronan Kelly
[There has been an ongoing controversy in ProMED-mail (on-line and off-line) in the recent past concerning the veracity of the often repeated estimate that 5 000 of the 50 000 annual deaths from rabies virus infection occurs in India (see: Rabies - India (04): mortality estimates, archive no. 20120610.1163188, et seq.). Now, The Million Deaths Study Collaborators, using a verbal autopsy procedure, have arrived at an estimate of 12 700 symptomatically identifiable furious rabies cases in 2005. The overall rabies mortality rate was estimated by this methodology to be 1.1 deaths per 100 000 population. 1/3rd of the national rabies deaths were found in Uttar Pradesh (4 300), and nearly 3/4ths (8 900) were in 7 central and south-eastern states: Chhattisgarh, Uttar Pradesh, Odisha, Andhra Pradesh, Bihar, Assam, and Madhya Pradesh. This localisation of rabies virus infection suggests that reduction or even elimination of rabies deaths in India is an achievable goal in the long term.
A map of the states of India can be accessed at: http://www.mapsofindia.com/maps/india/i ... al-map.htm. - Mod.CP
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1pSH.]
******************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Thu 4 Oct 2012
Source: PLoS Negl Trop Dis [summarised & edited]
http://www.plosntds.org/article/info%3A ... td.0001847
[Citation: Wilson Suraweera, Shaun K. Morris, Rajesh Kumar, David A. Warrell, Mary J. Warrell, Prabhat Jha, for the Million Death Study Collaborators. Editor: Jakob Zinsstag, Swiss Tropical and Public Health Institute, Switzerland]
Abstract
-----------
Background: It is estimated that India has more deaths from rabies than any other country. However, existing estimates are indirect and rely on non-representative studies.
Methods and Principal Findings: We examined rabies deaths in the ongoing Million Death Study (MDS), a representative survey of over 122 000 deaths in India that uses enhanced types of verbal autopsy. We estimated the age-specific mortality rates of symptomatically identifiable furious rabies and its geographic and demographic distributions. A total of 140 deaths in our sample were caused by rabies, suggesting that in 2005 there were 12 700 (99 percent, CI 10 000 to 15 500) symptomatically identifiable furious rabies deaths in India. Most rabies deaths were in males (62 percent), in rural areas (91 percent), and in children below the age of 15 years (50 percent). The overall rabies mortality rate was 1.1 deaths per 100 000 population (99 percent, CI 0.9 to 1.4). 1/3rd of the national rabies deaths were found in Uttar Pradesh (4300) and nearly 3/4th (8900) were in 7 central and south-eastern states: Chhattisgarh, Uttar Pradesh, Odisha, Andhra Pradesh, Bihar, Assam, and Madhya Pradesh.
Conclusions and Significance: Rabies remains an avoidable cause of death in India. As verbal autopsy is not likely to identify atypical or paralytic forms of rabies, our figure of 12 700 deaths due to classic and clinically identifiable furious rabies underestimates the total number of deaths due to this virus. The concentrated geographic distribution of rabies in India suggests that a significant reduction in the number of deaths or potentially even elimination of rabies deaths is possible.
Author Summary
--------------
Rabies, a disease of antiquity, has been partially controlled in many countries and eliminated in a few. However, according to the World Health Organization, rabies continues to kill thousands of people in India each year, more than in any other country. We used an enhanced type of verbal autopsy (a structured interview of the relatives or close associates of the dead by non-medical staff with central medical coding by at least 2 doctors) to identify the causes of over 122 000 deaths in a large scale, representative sample in India in 2001-03. Using these data, we estimate that in 2005, approximately 12 700 people died from symptomatically identifiable furious rabies. Because verbal autopsy is not able to identify atypical presentations of rabies, our figure underestimates the actual number of rabies deaths in India. The majority of rabies deaths occurred in males, in rural areas, in children below the age of 15 years, and in a few states. The concentrated geographic distribution of rabies in India suggests that targeting with preventive campaigns including vaccination of animals and post exposure vaccination of humans might achieve a significant reduction in the number of deaths or potentially even elimination of deaths from this disease.
Authors' conclusion: We estimate that there were 12 700 deaths due to symptomatically identifiable furious rabies in India in 2005. It is very important to note that this figure underestimates the total number of deaths due to rabies since paralytic and atypical cases would not have been detected by verbal autopsy.
This study is the 1st to estimate rabies mortality based upon a nationally representative sample of deaths rather than modeling or from extrapolation from selected focal surveillance. Thus, we provide previously unavailable regional and demographic information about human rabies deaths that can help to focus both human and canine rabies control programmes in the country and act as a baseline that can be used as comparison for future estimates of rabies mortality. Elimination of the canine reservoir of rabies is not likely in India at anytime in the near future. However, the concentrated geographic distribution of rabies in India suggests that a significant reduction in the number of human deaths or potentially even elimination of rabies deaths is possible, and this study serves as a baseline against which future gains may be measured.
--
Communicated by:
Ronan Kelly
[There has been an ongoing controversy in ProMED-mail (on-line and off-line) in the recent past concerning the veracity of the often repeated estimate that 5 000 of the 50 000 annual deaths from rabies virus infection occurs in India (see: Rabies - India (04): mortality estimates, archive no. 20120610.1163188, et seq.). Now, The Million Deaths Study Collaborators, using a verbal autopsy procedure, have arrived at an estimate of 12 700 symptomatically identifiable furious rabies cases in 2005. The overall rabies mortality rate was estimated by this methodology to be 1.1 deaths per 100 000 population. 1/3rd of the national rabies deaths were found in Uttar Pradesh (4 300), and nearly 3/4ths (8 900) were in 7 central and south-eastern states: Chhattisgarh, Uttar Pradesh, Odisha, Andhra Pradesh, Bihar, Assam, and Madhya Pradesh. This localisation of rabies virus infection suggests that reduction or even elimination of rabies deaths in India is an achievable goal in the long term.
A map of the states of India can be accessed at: http://www.mapsofindia.com/maps/india/i ... al-map.htm. - Mod.CP
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1pSH.]
-
Birgitt
- Moderator
- Beiträge: 35199
- Registriert: Di 2. Aug 2005, 22:52
- Wohnort: NRW / Südl. Rheinland
- Kontaktdaten:
Tollwut in Indien - Entwicklung im Gesundheitswesen
RABIES - INDIA (11): PUBLIC HEALTH DEVELOPMENTS
***********************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Mon 8 Oct 2012
From: Merritt Clifton [edited]
re: Rabies - India (10): verbal autopsy mortality estimate 20121007.1329262
-----------------------------------------------
While the authors of this paper caution that their estimate of 12 700 furious rabies deaths in India in 2005 may be low because the verbal autopsy method does not identify deaths with atypical and paralytic symptoms, an estimate projected from 2005 data is almost certainly much too high in 2012, for 2 major reasons:
- The Indian government's Vaccine Institute in Vadodara only stopped producing the old Semple nerve tissue culture vaccine (NTV) at the end of 2004. The existing stocks of the Semple vaccine remained in use until exhausted. Thus, the introduction of the much safer and more effective tissue culture vaccine (TCARV) was not completed until at least midway through 2005.
- The major mechanism for vaccinating street dogs in India is the Animal Birth Control program, managed by the federally funded Animal Welfare Board of India. As of 2005, the national ABC program had been receiving federal subsidies for less than 2 years. According to AWBI chair Major General (Ret.) R M Kharb, the ABC programs are now sterilizing and vaccinating about 150 000 street dogs per year.
Incidentally, the Supreme Court of India on 3 Sep 2012 weighed the ecological and public health role of street animals in a case brought by the nonprofit organization Safai Karmachari Andolan on behalf of the poorest of the poor. Describing itself as "a national movement committed to the total eradication of manual scavenging and the rehabilitation of all scavengers for dignified occupations," Safai Karmachari Andolan extracted data from the 2011 national census to show that of 2.6 million public dry latrines still in use in India, 1.3 million discharge illegally into open drains, 794 000 are cleaned manually by humans, and 497 000 are cleaned entirely by animals, mostly dogs and pigs.
This suggests that while the presence of the dogs and pigs is associated with at least 2 major public health problems, rabies and Japanese encephalitis, the absence of the dogs and pigs could produce some much larger public health problems.
--
Merritt Clifton
Editor, Animal People
PO Box 960
Clinton, WA 98236
USA
[ProMED-mail thanks Merritt Clifton for his commentary on developments in India since 2004 affecting the prospects for control of rabies virus infection.
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1pSH. - Mod.CP]
***********************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Mon 8 Oct 2012
From: Merritt Clifton [edited]
re: Rabies - India (10): verbal autopsy mortality estimate 20121007.1329262
-----------------------------------------------
While the authors of this paper caution that their estimate of 12 700 furious rabies deaths in India in 2005 may be low because the verbal autopsy method does not identify deaths with atypical and paralytic symptoms, an estimate projected from 2005 data is almost certainly much too high in 2012, for 2 major reasons:
- The Indian government's Vaccine Institute in Vadodara only stopped producing the old Semple nerve tissue culture vaccine (NTV) at the end of 2004. The existing stocks of the Semple vaccine remained in use until exhausted. Thus, the introduction of the much safer and more effective tissue culture vaccine (TCARV) was not completed until at least midway through 2005.
- The major mechanism for vaccinating street dogs in India is the Animal Birth Control program, managed by the federally funded Animal Welfare Board of India. As of 2005, the national ABC program had been receiving federal subsidies for less than 2 years. According to AWBI chair Major General (Ret.) R M Kharb, the ABC programs are now sterilizing and vaccinating about 150 000 street dogs per year.
Incidentally, the Supreme Court of India on 3 Sep 2012 weighed the ecological and public health role of street animals in a case brought by the nonprofit organization Safai Karmachari Andolan on behalf of the poorest of the poor. Describing itself as "a national movement committed to the total eradication of manual scavenging and the rehabilitation of all scavengers for dignified occupations," Safai Karmachari Andolan extracted data from the 2011 national census to show that of 2.6 million public dry latrines still in use in India, 1.3 million discharge illegally into open drains, 794 000 are cleaned manually by humans, and 497 000 are cleaned entirely by animals, mostly dogs and pigs.
This suggests that while the presence of the dogs and pigs is associated with at least 2 major public health problems, rabies and Japanese encephalitis, the absence of the dogs and pigs could produce some much larger public health problems.
--
Merritt Clifton
Editor, Animal People
PO Box 960
Clinton, WA 98236
USA
[ProMED-mail thanks Merritt Clifton for his commentary on developments in India since 2004 affecting the prospects for control of rabies virus infection.
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1pSH. - Mod.CP]
-
Günther Schulz
- Beiträge: 414
- Registriert: Mi 10. Mai 2006, 19:55
- Wohnort: Alsfeld-Hattendorf, Deutschland
Re: Tollwut - Impfung und mögliche Behandlung
Hallo Leute,
persönlich kann ich euch nur sagen, wer ein längeren Aufenthalt in Marokko hat, sollte sich gegen Tollwut impfen lassen! Selbst Kühe und Esel haben zur Zeit die Tollwut.
Eine noch sehr gefährliche Krankheit ist die Leishmaniose, sie wird hauptsächlich von Hunden und der Sandfliege übertragen, die hier auch sehr stark verbreitet ist.
Leishmaniose
Hätte ich fast vergessen, wenn ihr wirklich mal von einem Hund gebissen werdet, kann man sich hier in Marokko kostenlos gegen Tollwut impfen lassen.
Gruß aus Marokko
Günther
persönlich kann ich euch nur sagen, wer ein längeren Aufenthalt in Marokko hat, sollte sich gegen Tollwut impfen lassen! Selbst Kühe und Esel haben zur Zeit die Tollwut.
Eine noch sehr gefährliche Krankheit ist die Leishmaniose, sie wird hauptsächlich von Hunden und der Sandfliege übertragen, die hier auch sehr stark verbreitet ist.
Leishmaniose
Hätte ich fast vergessen, wenn ihr wirklich mal von einem Hund gebissen werdet, kann man sich hier in Marokko kostenlos gegen Tollwut impfen lassen.
Gruß aus Marokko
Günther
-
Barbara4x4
- Beiträge: 465
- Registriert: Fr 16. Nov 2007, 13:03
Re: Tollwut - Impfung und mögliche Behandlung
Leishmaniose wird definitiv nicht durch Hunde übertragen. Alleinige Überträger sind Sandmücken(Phlebotome). Hunde sind aber sehr gefährdet, weshalb ein Scalibor-Halsband für Aufenthalte am Mittelmeer wie auch in Afrika zur Grundausstattung gehört.Günther Schulz hat geschrieben: ↑Do 11. Okt 2012, 12:49Eine noch sehr gefährliche Krankheit ist die Leishmaniose, sie wird hauptsächlich von Hunden und der Sandfliege übertragen, die hier auch sehr stark verbreitet ist.
www.leishmaniose.de
Viele Grüße
Barbara
-
Birgitt
- Moderator
- Beiträge: 35199
- Registriert: Di 2. Aug 2005, 22:52
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- Kontaktdaten:
Tollwut - Impfungen in Indien
RABIES VACCINE, SERIOUS ADVERSE EVENTS - INDIA: (PUNJAB) FATALITY, RFI
**********************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Fri 7 Mar 2014
Source: Hindustan Times [edited]
http://www.hindustantimes.com/punjab/ja ... 92304.aspx
Two days after the death of a 10-year-old AK at the civil hospital in Samana [Punjab state], the state drug controller authority has shot a letter to the drug controller general of India (DCGI), urging it to immediately stop the use of anti-rabies vaccine in the country. A copy of the letter has been sent to all civil surgeons into the state, with an instruction to discontinue the use of the vaccine in the wake of this recent tragedy.
The vaccine, AbhyaRab, has been manufactured by the Human Biological Institute, Tamil Nadu [state], which has supplied it to the entire state [Punjab]. The vaccine is available at all government hospitals in the state. However, with its quality coming under cloud now, the use of the vaccine has been suspended with immediate effect.
Apart from civil surgeons, the copy of this letter has also been sent to the manufacturing company, director of drug controller of Tamil Nadu, deputy drug controller of India, Ghaziabad on Friday [7 Mar 2014] by the state drug control.
Victim KA, who was a student of Class-5, died while 4 others fell ill after they were administered the anti-rabies vaccines at the civil hospital in Samana on [5 Mar 2014]. All the victims were given anti-rabies injections after which they complained of drowsiness and nausea. Following the death of Ankit, Patiala drug controller visited the Samana civil hospital and took samples of the vaccine. The samples were later sent to the Central Research Laboratory at Kasauli in Himachal Pradesh [state] for testing its quality.
The health officials who visited the Rajindra Hospital in Patiala, where 4 other victims were admitted, had stated that prima facie it seems to be a case of drug reaction that occurred after anti-rabies injections were administered to the victims.
Soon after receiving the letter from the state drug controller authorities, the pharmacists and doctors in the local civil hospital have been instructed not to administer the vaccine to anyone. Hospital officials said that [normally] around 30 anti-rabies injections were administered to dog-bite victims daily in the hospital free of cost. The patients, who were bitten by jackals, monkeys, foxes, cats, rats and bats, are given rabies vaccine. If the course is not started in time, a patient can suffer a painful death within 48-72 hours of the bite. [Normally the incubation period for rabies is around 21 days. - Mod.MHJ]
State drug controller Ajay Singla said, "We have informed DGGI and urged it to ensure steps to stop use of the vaccine. Also, civil surgeons have been instructed not to administer vaccines to anyone into the state till the final report of the samples comes."
[Byline: Jatinder Kohli]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[If this is a first bad reaction to this vaccine at this hospital, it is more likely to be a bad batch of vaccine contaminated with some product capable of killing within hours. If one vial is contaminated, others will be. We await clarification.
However this is not the first fatality with this company's rabies vaccine: see 20120829.1271575. To quote my expert colleague Craig about that incident: "The AbhyaRab vaccine is produced by Human Biological Institute. It is a purified Vero cell rabies vaccine. It is a freeze dried preparation that should be reconstituted with 0.5 mL of a diluent supplied with the vaccine. The reconstituted vaccine should be administered immediately and should not be stored for administration later. Abhayrab vaccine should be administered intra-muscularly in the deltoid region in both adults and children. Under no circumstances should it be administered intravenously.
[In the 2012 incident] the tolerance of the child to the 1st 3 inoculations followed by abrupt deterioration of his condition following the 4th administration of the vaccine suggests that there may been some error in preparation or administration of the vaccine rather than a defect in the vaccine itself. The outcome of the investigation of this incident is awaited."
To repeat Craig, "Under no circumstances should it be administered intravenously." Maybe this is what happened here. However we should also keep the following comments in mind. - Mod MHJ]
[Occasionally when there is a lyophilized vaccine that requires reconstitution with a diluent, an incorrect or contaminated diluent is used and leads to adverse events following receipt of the vaccine. This has unfortunately been seen with the childhood vaccines used by the EPI (Expanded Programme on Immunizations). Adverse reactions have ranged from local sterile or non-sterile abscesses to severe with fatal outcomes when toxic substances have been used. - Mod MPP]
[It would seem prudent there should be an investigation as to why there was a reaction to this particular lot of vaccine. Was the entire lot of vaccine contaminated or was this a contaminated diluent affecting only one vial? How exceptionally sad to remove all vaccines in the face of a rabies out break. An investigation may reveal the reason for the reaction. The investigation may extend into drug testing the vaccine. Was a drug used as a diluent for the vaccine? What about bacterial testing of the vaccine? Was this a reconstituted vaccine that was not held under refrigeration or held long after it should have been discarded? Bacterial swabbing of even the container may yield answers. Clearly, an investigation into this particular lot of vaccine and this particular vaccine vial is in order. - Mod.TG]
**********************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org
Date: Fri 7 Mar 2014
Source: Hindustan Times [edited]
http://www.hindustantimes.com/punjab/ja ... 92304.aspx
Two days after the death of a 10-year-old AK at the civil hospital in Samana [Punjab state], the state drug controller authority has shot a letter to the drug controller general of India (DCGI), urging it to immediately stop the use of anti-rabies vaccine in the country. A copy of the letter has been sent to all civil surgeons into the state, with an instruction to discontinue the use of the vaccine in the wake of this recent tragedy.
The vaccine, AbhyaRab, has been manufactured by the Human Biological Institute, Tamil Nadu [state], which has supplied it to the entire state [Punjab]. The vaccine is available at all government hospitals in the state. However, with its quality coming under cloud now, the use of the vaccine has been suspended with immediate effect.
Apart from civil surgeons, the copy of this letter has also been sent to the manufacturing company, director of drug controller of Tamil Nadu, deputy drug controller of India, Ghaziabad on Friday [7 Mar 2014] by the state drug control.
Victim KA, who was a student of Class-5, died while 4 others fell ill after they were administered the anti-rabies vaccines at the civil hospital in Samana on [5 Mar 2014]. All the victims were given anti-rabies injections after which they complained of drowsiness and nausea. Following the death of Ankit, Patiala drug controller visited the Samana civil hospital and took samples of the vaccine. The samples were later sent to the Central Research Laboratory at Kasauli in Himachal Pradesh [state] for testing its quality.
The health officials who visited the Rajindra Hospital in Patiala, where 4 other victims were admitted, had stated that prima facie it seems to be a case of drug reaction that occurred after anti-rabies injections were administered to the victims.
Soon after receiving the letter from the state drug controller authorities, the pharmacists and doctors in the local civil hospital have been instructed not to administer the vaccine to anyone. Hospital officials said that [normally] around 30 anti-rabies injections were administered to dog-bite victims daily in the hospital free of cost. The patients, who were bitten by jackals, monkeys, foxes, cats, rats and bats, are given rabies vaccine. If the course is not started in time, a patient can suffer a painful death within 48-72 hours of the bite. [Normally the incubation period for rabies is around 21 days. - Mod.MHJ]
State drug controller Ajay Singla said, "We have informed DGGI and urged it to ensure steps to stop use of the vaccine. Also, civil surgeons have been instructed not to administer vaccines to anyone into the state till the final report of the samples comes."
[Byline: Jatinder Kohli]
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[If this is a first bad reaction to this vaccine at this hospital, it is more likely to be a bad batch of vaccine contaminated with some product capable of killing within hours. If one vial is contaminated, others will be. We await clarification.
However this is not the first fatality with this company's rabies vaccine: see 20120829.1271575. To quote my expert colleague Craig about that incident: "The AbhyaRab vaccine is produced by Human Biological Institute. It is a purified Vero cell rabies vaccine. It is a freeze dried preparation that should be reconstituted with 0.5 mL of a diluent supplied with the vaccine. The reconstituted vaccine should be administered immediately and should not be stored for administration later. Abhayrab vaccine should be administered intra-muscularly in the deltoid region in both adults and children. Under no circumstances should it be administered intravenously.
[In the 2012 incident] the tolerance of the child to the 1st 3 inoculations followed by abrupt deterioration of his condition following the 4th administration of the vaccine suggests that there may been some error in preparation or administration of the vaccine rather than a defect in the vaccine itself. The outcome of the investigation of this incident is awaited."
To repeat Craig, "Under no circumstances should it be administered intravenously." Maybe this is what happened here. However we should also keep the following comments in mind. - Mod MHJ]
[Occasionally when there is a lyophilized vaccine that requires reconstitution with a diluent, an incorrect or contaminated diluent is used and leads to adverse events following receipt of the vaccine. This has unfortunately been seen with the childhood vaccines used by the EPI (Expanded Programme on Immunizations). Adverse reactions have ranged from local sterile or non-sterile abscesses to severe with fatal outcomes when toxic substances have been used. - Mod MPP]
[It would seem prudent there should be an investigation as to why there was a reaction to this particular lot of vaccine. Was the entire lot of vaccine contaminated or was this a contaminated diluent affecting only one vial? How exceptionally sad to remove all vaccines in the face of a rabies out break. An investigation may reveal the reason for the reaction. The investigation may extend into drug testing the vaccine. Was a drug used as a diluent for the vaccine? What about bacterial testing of the vaccine? Was this a reconstituted vaccine that was not held under refrigeration or held long after it should have been discarded? Bacterial swabbing of even the container may yield answers. Clearly, an investigation into this particular lot of vaccine and this particular vaccine vial is in order. - Mod.TG]
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Birgitt
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Impfköder für Hunde sollen die Tollwut besiegen
Nur durch einen Trick fanden Soa Fy Andriamandimby und ihr Team heraus, wie es um die Hunde in einem madagassischen Küstenörtchen steht. Die für Zoonosen zuständige Virologin des hiesigen Pasteur-Instituts ließ dort zunächst nur Proben von Nutztieren nehmen. Erst beim zweiten Termin kamen die Hunde dran. Andersherum hätte es keine Daten zu Rindern, Schweinen oder Schafen gegeben. Denn, wer hier einmal einen Hund berührt, wird »fady« – und künftig am Dorfrand abgewiesen. Dieses Tabu aus dem kulturell und ethnisch vielfältigen Land verdeutlicht: Ohne die Menschen vor Ort ist es schwer, eine Zoonose wie Tollwut zu tilgen. Deswegen bekämpft man derartige Seuchen weltweit mit dem One-Health-Ansatz, bei dem man die Gesundheit von Mensch, Tier und Umwelt als Ganzes betrachtet. Bis 2030, das haben die Weltgesundheitsorganisation (WHO) und andere Partner beschlossen, soll kein Mensch mehr an hundevermittelter Tollwut sterben. Derzeit sind es in den Endemiegebieten Asiens und Afrikas jährlich noch über 60 000 – meist Kinder. Sie stecken sich fast ausschließlich über infizierte Hunde an ...
Impfköder für Hunde sollen die Tollwut besiegen
02.04.2025 - spektrum
Gruß
Birgitt
Impfköder für Hunde sollen die Tollwut besiegen
02.04.2025 - spektrum
Gruß
Birgitt
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Birgitt
- Moderator
- Beiträge: 35199
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Tollwut | Impfstofffälschungen in Indien
In verschiedenen indischen Großstädten zirkulieren Ende 2025 gefälschte Tollwut-Impfstoffe (Abhayrab; Human Biologics Institute, Chargennummer KA24014).
Die Impfserie gegen Tollwut sollte vor Beginn der Reise abgeschlossen sein. Falls nach einem Tierkontakt eine postexpositionelle Prophylaxe in Indien notwendig wird, sollte ärztliche Hilfe möglichst in zertifizierten Schwerpunktkrankenhäusern der Maximalversorgung gesucht werden. Quelle: AA
Gruß
Birgitt
Die Impfserie gegen Tollwut sollte vor Beginn der Reise abgeschlossen sein. Falls nach einem Tierkontakt eine postexpositionelle Prophylaxe in Indien notwendig wird, sollte ärztliche Hilfe möglichst in zertifizierten Schwerpunktkrankenhäusern der Maximalversorgung gesucht werden. Quelle: AA
Gruß
Birgitt
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easynature12
- Beiträge: 2
- Registriert: Do 29. Mai 2025, 21:12
Re: Tollwut - Impfung und mögliche Behandlung
Moin in die Runde,
nur mal so nebenbei eine kleine Randbemerkung zum Thema "Tollwut-Impfung", die jeder für sich werten kann.
2014 hatte ich eine Dreifach-Impfung mit Rabipur. Aufgrund diverser Auslandstouren in den nächsten Jahren habe ich in 2025 den Titer bestimmen lassen (IgG-Ak). Das Ergebnis mit 3.15 EU/ml führte dazu, dass ich mich nicht gegen Tollwut impfen lasse.
Gleiches Spiel bei Hepatitis A/B:
Dreifach-Impfung in 2014 mit Twinrix bzw. Engerix. Titer in 2025 ist ausreichend, werde mich demnach nicht impfen.
Bleibt gesund!
Jörg
nur mal so nebenbei eine kleine Randbemerkung zum Thema "Tollwut-Impfung", die jeder für sich werten kann.
2014 hatte ich eine Dreifach-Impfung mit Rabipur. Aufgrund diverser Auslandstouren in den nächsten Jahren habe ich in 2025 den Titer bestimmen lassen (IgG-Ak). Das Ergebnis mit 3.15 EU/ml führte dazu, dass ich mich nicht gegen Tollwut impfen lasse.
Gleiches Spiel bei Hepatitis A/B:
Dreifach-Impfung in 2014 mit Twinrix bzw. Engerix. Titer in 2025 ist ausreichend, werde mich demnach nicht impfen.
Bleibt gesund!
Jörg
