Assessment of Texas Medical Providers Concerning Rabies Vaccines

Rabies is an important zoonotic disease in Texas and thousands of people each year either request or require rabies prophylaxis because they have ‘high risk’ jobs or are exposed to the disease. After experiencing difficulty in receiving rabies prophylaxis from physicians, we conducted a survey of Texas medical providers to assess their knowledge of rabies vaccine procedures and their experience with rabies vaccines. Most providers in Texas (>95% of 297) rarely saw patients for rabies prophylaxis; therefore, providers have minimal, if any, experience with the procedures of acquiring and administering the vaccine. Providers varied greatly in their responses to our questions of where to acquire the vaccine, how and where to administer the vaccine, and where to acquire information about the vaccine. State and local health departments should target medical clinics and physician associations as outlets to disseminate information regarding rabies, rabies prophylaxis, and treatment.

Rabies in Experimentally Infected Bears, Ursus spp., with Epizootiologic Notes

Ten black bears, Ursus americanus Pallas, and three brown bears, U. arctos Linnaeus, were inoculated with rabies virus from naturally infected foxes in Alaska. The bears were more resistant than canine species, requiring at least 1,000 MLD50 of virus for infection. Low titres or negative results were obtained in salivary glands titrated in mice. Clinical course of the disease, post mortem findings, and microscopic lesions are described. Microscopic lesions were more· severe in brown bears, in which the inflammatory response was distinguished by the presence of numerous eosinophils in the perivascular infiltrate and among cells diffusely infiltrating the parenchyma. In both species, inclusion bodies were found only in the Purkinje cells of the cerebellum. Rabies is discounted as a factor in unprovoked attacks by bears on man at high latitudes. The epizootiology of rabies in a region where bears are numerous is discussed, with the conclusion that rabid foxes usually do not excrete sufficient quantities of virus in the saliva to infect bears. German title: Tollwut bei experimentell infizierten Bären, Ursus spp., mit epizootiologischen Anmerkungen German abtract: Zehn Schwarzbären, Ursus americanus Pallas, und drei Braunbären, U. arctos Linnaeus, wurden mit einem von Füchsen in Alaska isolierten Feldstamm des Tollwutvirus infiziert. Die Untersuchungsergebnisse lassen erkennen, daß Bären eine größere Resistenz gegenüber Tollwutinfektion aufweisen als hundeartige Karnivoren, und zwar konnten sie nicht mit weniger als 1000 MLD50 des Tollwutvirus infiziert werden. Das Virus war selten nachweisbar in den Speicheldrüsen der tollwuterkrankten Bären. Klinik und Pathologie der Tollwut bei Bären wurden kurz beschrieben. Die im Gehirn vorkommenden entzündlichen Veränderungen waren bei Braunbären besonders schwer und unterschieden sich durch die Häufigkeit der eosinophilen Leukozyten in den perivasculären und Gewebs-Infiltraten. Bei beiden Arten wurden Einschlußkörperchen nur in den Purkinje-Zellen beobachtet. Die Epizootiologie der Tollwut auf der Alaska-Halbinsel, wo Bären häufig vorkommen, wurde besprochen. Die Ergebnisse deuten an, daß Füchse wenig Virus mit dem Speichel ausscheiden, und selten soviel, daß es für die Infektion von Bären ausreicht. French title: La rage expérimentale chez les ours, Ursus spp., avec observations épizootiologiques French abstract: Dix ours noirs, Ursus americanus Pallas, et trois ours bruns, U. arctos Linnaeus, ont été inoculés avec de virus rabique provenant des renards infectés naturellement dans l'Alaska. Les ours Ont été plus résistants au virus que des espèces canines, et pour produire l'infection chez les ours, au moins 1000 MLD50 ont été requis. La titration des glandes salivaires chez des souris a données des titres peu éléves ou des résultats négatifs. La course clinique de la maladie, les observations des autopsies, et les lésions microscopiques sont decrites. Les lésions microscopiques les plus sévères ont été observées chez les ours bruns, dans lesquels la réponse inflammatoire a été distinguée par la présence de nombreux éosinophiles dans l'infiltration périvasculaire et parmi les cellules infiltrées diffusément dans Ie parenchyme. Chez les deux espèces des ours, des corps d'inclusion ont été trouvés seulement dans les cellules de Purkinje du cervelet. On a discuté l'épizootiologie de la rage dans une région où des ours sont nombreux, avec la conclusion qu'il y a dans la salive des renards rabiques une quantité de virus insuffisante pour infecter les ours. é ó í á ú Spanish title: Rabia en osos, Ursus spp., infectados experimentalmente, con anotaciones epizootológicas Spanish abstract: Diez osos negros, Ursus americanus Pallas, y tres osos pardos, U. arctos Linea, se infectaron con una estirpe campal de virus rábico aislada de zorros en Alasca. Los resultados de la experiencia permiten reconocer que los osos presentan una resistencia mayor frente a la infección rábica que los carnívoros cánidos, pues no se pudieron infectar con menos de 1.000 DML50 de virus rábico. El virus era muy raras veces identificable en las glándulas salivales de los osos enfermos de rabia. Se describen sucintamente la clínica y patología de la rabia en los osos. Las modificaciones inflamatorias en el cerebro eran muy graves en el oso pardo y se distinguían por la frecuencia de los leucocitos eosinófilos en los infiltrados perivasculares e hísticos. En ambas especies solo se hallaron corpúsculos de inclusión en las células de Purkinje. Se discute la epizootología de la rabia en la península de Alasca, donde es frecuente Ia presencia de osos. Los resultados señalan que los zorros eliminan poco virus con la saliva y casi nunca en cantidad tal que fuese suficiente para infectar los osos.

Desmodus rotundus and Artibeus spp. bats might present distinct rabies virus lineages

In Brazil, bats have been assigned an increasing importance in public health as they are important rabies reservoirs. Phylogenetic studies have shown that rabies virus (RABV) strains from frugivorous bats Artibeus spp. are closely associated to those from the vampire bat Desmodus rotundus, but little is known about the molecular diversity of RABV in Artibeus spp. The N and G genes of RABV isolated from Artibeus spp. and cattle infected by D. rotundus were sequenced, and phylogenetic trees were constructed. The N gene nucleotides tree showed three clusters: one for D. rotundus and two for Artibeus spp. Regarding putative N amino acid-trees, two clusters were formed, one for D. rotundus and another for Artibeus spp. RABV G gene phylogeny supported the distinction between D. rotundus and Artibeus spp. strains. These results show the intricate host relationship of RABV's evolutionary history, and are invaluable for the determination of RABV infection sources. (C) 2012 Elsevier Editora Ltda. All rights reserved.

Bacillus atrophaeus inactivated spores as a potential adjuvant for veterinary rabies vaccine

Rabies is a viral encephalitis, nearly always fatal, but preventable through vaccines. Rabid animal bite is the prime transmission act, while veterinary vaccination is one of the best strategies for rabies general prevention. Aluminum compounds and saponin are the commercial adjuvants used for this vaccine nowadays. Nevertheless, aluminum compounds can provoke undesired side effects and saponin has a narrow activity range without toxicity. B. atrophaeus inactivated spores (BAIS), with or without saponin, were then used as an alternative to boost the inactivated rabies virus response. BAIS was as effective as saponin in augmenting antibody titers, but combination of both adjuvants doubled the titers raised by them individually. The combined adjuvant formulation maintained viability for 21 months when stored at 4-8 degrees C. Overall, BAIS was demonstrated as a viable alternative to commercial adjuvants, while its combination with saponin resulted in even higher vaccine potency with good stability. (C) 2012 Elsevier Ltd. All rights reserved.

Rabies in southeast Brazil: a change in the epidemiological pattern

This epidemiological study was conducted using antigenic and genetic characterisation of rabies virus isolates obtained from different animal species in the southeast of Brazil from 1993 to 2007. An alteration in the epidemiological profile was observed. One hundred two samples were tested using a panel of eight monoclonal antibodies, and 94 were genetically characterised by sequencing the nucleoprotein gene. From 1993 to 1997, antigenic variant 2 (AgV-2), related to a rabies virus maintained in dog populations, was responsible for rabies cases in dogs, cats, cattle and horses. Antigenic variant 3 (AgV-3), associated with Desmodus rotundus, was detected in a few cattle samples from rural areas. From 1998 to 2007, rabies virus was detected in bats and urban pets, and four distinct variants were identified. A nucleotide similarity analysis resulted in two primary groups comprising the dog and bat antigenic variants and showing the distinct endemic cycles maintained in the different animal species in this region.

Epidemiology of vampire bat-transmitted rabies virus in Goiás, central Brazil: re-evaluation based on G-L intergenic region

Abstract Background Vampire bat related rabies harms both livestock industry and public health sector in central Brazil. The geographical distributions of vampire bat-transmitted rabies virus variants are delimited by mountain chains. These findings were elucidated by analyzing a high conserved nucleoprotein gene. This study aims to elucidate the detailed epidemiological characters of vampire bat-transmitted rabies virus by phylogenetic methods based on 619-nt sequence including unconserved G-L intergenic region. Findings The vampire bat-transmitted rabies virus isolates divided into 8 phylogenetic lineages in the previous nucleoprotein gene analysis were divided into 10 phylogenetic lineages with significant bootstrap values. The distributions of most variants were reconfirmed to be delimited by mountain chains. Furthermore, variants in undulating areas have narrow distributions and are apparently separated by mountain ridges. Conclusions This study demonstrates that the 619-nt sequence including G-L intergenic region is more useful for a state-level phylogenetic analysis of rabies virus than the partial nucleoprotein gene, and simultaneously that the distribution of vampire bat-transmitted RABV variants tends to be separated not only by mountain chains but also by mountain ridges, thus suggesting that the diversity of vampire bat-transmitted RABV variants was delimited by geographical undulations.

Molecular epidemiology of livestock rabies viruses isolated in the northeastern Brazilian states of Paraíba and Pernambuco from 2003 - 2009

Background Limited or no epidemiological information has been reported for rabies viruses (RABVs) isolated from livestock in the northeastern Brazilian states of Paraíba (PB) and Pernambuco (PE). The aim of this study was to clarify the molecular epidemiology of RABVs circulating in livestock, especially cattle, in these areas between 2003 and 2009. Findings Phylogenetic analysis based on 890 nt of the nucleoprotein (N) gene revealed that the 52 livestock-derived RABV isolates characterized here belonged to a single lineage. These isolates clustered with a vampire bat-related RABV lineage previously identified in other states in Brazil; within PB and PE, this lineage was divided between the previously characterized main lineage and a novel sub-lineage. Conclusions The occurrences of livestock rabies in PB and PE originated from vampire bat RABVs, and the causative RABV lineage has been circulating in this area of northeastern Brazil for at least 7 years. This distribution pattern may correlate to that of a vampire bat population isolated by geographic barriers.

Desmodus rotundus and Artibeus spp. bats might present distinct rabies virus lineages

In Brazil, bats have been assigned an increasing importance in public health as they are important rabies reservoirs. Phylogenetic studies have shown that rabies virus (RABV) strains from frugivorous bats Artibeus spp. are closely associated to those from the vampire bat Desmodus rotundus, but little is known about the molecular diversity of RABV in Artibeus spp. The N and G genes of RABV isolated from Artibeus spp. and cattle infected by D. rotundus were sequenced, and phylogenetic trees were constructed. The N gene nucleotides tree showed three clusters: one for D. rotundus and two for Artibeus spp. Regarding putative N amino acid-trees, two clusters were formed, one for D. rotundus and another for Artibeus spp. RABV G gene phylogeny supported the distinction between D. rotundus and Artibeus spp. strains. These results show the intricate host relationship of RABV's evolutionary history, and are invaluable for the determination of RABV infection sources.

Molecular epidemiology of animal rabies in the semiarid region of Paraíba, Northeastern Brazil

In the semiarid of the state of Paraíba, the anti-rabies vaccination is not common, most of the local inhabitants who deal with the animals do not know the incidence of the disease in the region. In this study, samples of foxes (Pseudalopex vetulus), insectivorous bats (Molossus molossus), raccoons (Procyon cancrivorous) and domestic animals brains were submitted to the diagnosis of rabies, by using the direct fluorescent antibody technique (d-FAT) and mouse inoculation test (MIT). Of the 581 examined materials, 50 (8.60 %) were positive for d-FAT and 47 (8.09 %) for MIT. From the positive samples for rabies, RNAs were extracted and transformed to cDNA, at the Laboratory of Rabies/Faculdade de Medicina Veterinária e Zootecnia/USP, SP. The phylogenetic characterization of the N gene was performed at the Universidade de São Paulo, Faculdade de Medicina Veterinária e Zootecnia, Departamento de Medicina Veterinária Preventiva e Saúde Animal, Universidade Nihon, Faculdade de Ciências Bioresource, Fujisawa, Kanagawa, Japão. Based on the results of genotyping and phylogenetic analyzes, it is concluded that the epidemiology of rabies is complex in the semiarid of Paraíba, with different viral variants being maintained in domestic dogs, foxes, insectivorous bats and vampire bats. All the isolates examined belong to the genotype I of the genus Lyssavirus and it is possible to state that in the region, foxes are important sylvatic reservoirs of the rabies virus.

Phylogenetic relation among bovine rabies cases from Minas Gerais and Sao Paulo States, Brazil: a possible common origin

Acknowledgements: CAPES, FAPESP process number 2011/06236-0

Experimental antiviral therapy against different rabies virus lineages using transfection with anti-rabies antibodies

Financial Support: FAPESP

Diagnosis of rabies and eastern and western equine viral encephalitides in equids by multiplex Hemi-Nested RT-PCR technique

Financial support: CNPq and Pasteur Institute of São Paulo

A review of the classification of rabies virus lineages maintained by insectivorous bats in Brazil

Trabalho apresentado à 23ª Revista de Educação Continuada em Medicina Veterinária e Zootecnia, 2012, São Paulo

Imported human rabies in Switzerland, 2012: a diagnostic conundrum

Human rabies is rare in Western Europe. It is not easily recognized in the absence of a history of exposure. We describe the clinical course, diagnosis and follow-up of an imported human rabies case in Switzerland. The patient, a U.S. citizen, presented at an outpatient clinic in Iraq with pain in his right shoulder on July 5, 2012. On July 8 he was transferred to a hospital in the United Arab Emirates, where he exhibited progressive encephalitis with coma. On July 29, he was transferred to a hospital in Switzerland, where he died on July 31, 2012. The autopsy showed severe encephalitis. Rabies was diagnosed by the rapid fluorescent focus inhibition test (RFFIT) and confirmed by fluorescence antibody testing (FAT) in brain smears and immunohistochemistry on paraffin-embedded brain sections. The viral strain was characterized by RT-PCR followed by sequencing and phylogenetic analysis as an American bat rabies strain associated with Tadarida brasiliensis. Close contacts and exposed health care workers received postexposure prophylaxis (PEP).

Canine rabies in Australia: a review of preparedness and research needs

Australia is unique as a populated continent in that canine rabies is exotic, with only one likely incursion in 1867. This is despite the presence of a widespread free-ranging dog population, which includes the naturalized dingo, feral domestic dogs and dingo-dog cross-breeds. To Australia's immediate north, rabies has recently spread within the Indonesian archipelago, with outbreaks occurring in historically free islands to the east including Bali, Flores, Ambon and the Tanimbar Islands. Australia depends on strict quarantine protocols to prevent importation of a rabid animal, but the risk of illegal animal movements by fishing and recreational vessels circumventing quarantine remains. Predicting where rabies will enter Australia is important, but understanding dog population dynamics and interactions, including contact rates in and around human populations, is essential for rabies preparedness. The interactions among and between Australia's large populations of wild, free-roaming and restrained domestic dogs require quantification for rabies incursions to be detected and controlled. The imminent risk of rabies breaching Australian borders makes the development of disease spread models that will assist in the deployment of cost-effective surveillance, improve preventive strategies and guide disease management protocols vitally important. Here, we critically review Australia's preparedness for rabies, discuss prevailing assumptions and models, identify knowledge deficits in free-roaming dog ecology relating to rabies maintenance and speculate on the likely consequences of endemic rabies for Australia.