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Home / Equine Research Bank / PLoS Negl Trop Dis / Rabies post-exposure prophylaxis in the Philippines: health ...
PLoS neglected tropical diseases2008; 2(5); e243; doi: 10.1371/journal.pntd.0000243

Rabies post-exposure prophylaxis in the Philippines: health status of patients having received purified equine F(ab’)(2) fragment rabies immunoglobulin (Favirab).

Abstract: 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 outcomes in the Philippines. Methods: This was a case series involving 7,660 patients (4 months to 98 years of age) given purified equine RIG (pERIG) at the Research Institute for Tropical Medicine (Muntinlupa, Philippines) from July 2003 to August 2004 following Category II or III exposures. Data on local and systemic adverse reactions (AR) within 28 days and biting animal status were recorded; outcome data were obtained by telephone or home visit 6-29 months post-exposure. Results: Follow-up data were collected for 6,464 patients. Of 151 patients with laboratory-confirmed rabies exposure, 143 were in good health 6-48 months later, seven could not be contacted, and one 4-year-old girl died. Of 16 deaths in total, 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, and an 8-year-old boy who only received rabies PEP on the day of exposure. Conclusions: This extensive review of outcomes in persons with Category III exposure shows the recommended treatment schedule at RITM using pERIG is well tolerated, while survival of 143 laboratory-confirmed rabies exposures confirms the intervention efficacy. Two PEP intervention failures demonstrate that sustained education and training is essential in rabies management.
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Publication Date: 2008-05-28 PubMed ID: 18509475PubMed Central: PMC2386244DOI: 10.1371/journal.pntd.0000243Google Scholar: Lookup
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  • Journal Article

Summary

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This research investigates the effectiveness of a purified equine rabies immunoglobulin treatment, known as pERIG, in post-exposure prophylaxis against rabies in the Philippines. Results show it is well tolerated and effective, though two failures show the need for sustained education and training in the management of rabies.

Methodology:

  • The study was conducted as a case series involving 7,660 patients, ranging from 4 months to 98 years old.
  • These patients had been given purified equine RIG (pERIG) at the Research Institute for Tropical Medicine (RITM) within the period of July 2003 to August 2004.
  • The patients had suffered Category II or III exposures, which are classified as moderate or severe exposure to rabies.
  • Data on adverse reactions, either local or systemic, within 28 days and the biting animal status were recorded.
  • Outcome data were then tracked by telephone or home visit 6 to 29 months post-exposure.

Results:

  • Follow-up data were collected for 6,464 patients.
  • Of 151 patients with laboratory-confirmed rabies exposure, 143 were in good health up to 48 months later.
  • Out of 16 total deaths, only two were considered as PEP (Post-Exposure Prophylaxis) intervention failures.
  • The two PEP failures comprised a 4-year old girl with multiple wounds from a rabid dog and an 8-year old boy who only received rabies PEP on the day of exposure.
  • Seven patients could not be contacted while the remaining 14 deaths were unrelated to rabies exposure or treatment.

Conclusions:

  • The recommended treatment schedule using pERIG at RITM showed good tolerance.
  • Survival of 143 out of 151 patients with laboratory-confirmed rabies exposure confirms the effectiveness of the intervention.
  • The two PEP intervention failures underline the importance of sustained education and training in the management of rabies.

Cite This Article

APA
Quiambao BP, Dytioco HZ, Dizon RM, Crisostomo ME, Laot TM, Teuwen DE. (2008). Rabies post-exposure prophylaxis in the Philippines: health status of patients having received purified equine F(ab’)(2) fragment rabies immunoglobulin (Favirab). PLoS Negl Trop Dis, 2(5), e243. https://doi.org/10.1371/journal.pntd.0000243

Publication

PLoS neglected tropical diseases
ISSN: 1935-2735
NlmUniqueID: 101291488
Country: United States
Language: English
Volume: 2
Issue: 5
Pages: e243

Researcher Affiliations

Quiambao, Beatriz P
  • Research Institute for Tropical Medicine, Alabang, Manila, Philippines.
Dytioco, Hazel Z
    Dizon, Ruby M
      Crisostomo, Marilyn E
        Laot, Thelma M
          Teuwen, Dirk E

            MeSH Terms

            • Adolescent
            • Adult
            • Aged
            • Aged, 80 and over
            • Animals
            • Cats
            • Child
            • Child, Preschool
            • Dogs
            • Female
            • Horses
            • Humans
            • Immunoglobulin Fragments / administration & dosage
            • Immunoglobulin Fragments / adverse effects
            • Immunoglobulin Fragments / therapeutic use
            • Infant
            • Male
            • Middle Aged
            • Philippines
            • Post-Exposure Prophylaxis / methods
            • Rabies / drug therapy
            • Young Adult

            Conflict of Interest Statement

            BPQ and MEC received educational grants from Sanofi Pasteur for the post marketing surveillance study. HZD, RMD, and DET are full-time employees of Sanofi Pasteur.

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