Among the approximately 3.9 billion people at risk of being exposed to rabies, 1.4 billion live in Asia (WHO). The World rabies burden has been estimated at over 60 000 deaths each year. Rabies is a lethal viral disease where no treatment is available for clinical confirmed cases. However, post-exposure prophylaxis where suspected rabies-infected individuals are vaccinated prevents clinical disease. However, data is lacking to assess the comparative effectiveness of various post-exposure protocols, especially in view of getting rid of the 4th session of the Thai Red Cross Modified Essen regimen, thereby reducing vaccine doses, protocol duration and associated vaccine and transportation costs for bite victims in Cambodia and beyond. In addition, evidence points to rabies virus inhibiting the normal immune response through suppression of intracellular interferon.
In addition, it has been show for other vaccines such as yellow fever 17D vaccine that vaccine response is dependent on immune microenvironment and can be different within different ethnical groups. Taken together, immune response to vaccination in patients bitten by confirmed rabid dogs may in differ from healthy controls.
Therefore, the aim of this project is to determine whether the 4th session of the Thai Red Cross Modified Essen regimen is needed in order to obtain protective adaptive immune responses (both B and T cell responses) in a cohort of Cambodian individuals after a dog bite from a confirmed rabid dog.
Picture: Arnaud Tarantola, Epidemiology and Public Health Unit, IPC