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The Immunological Basis for Immunization Series: Module 17: Rabies

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The Immunological Basis for Immunization Series: Module 17: Rabies The Immunological Basis for Immunization Series Module 17: Rabies Immunization, Vaccines and Biologicals The Immunological Basis for Immunization Series Module 17: Rabies Immunization, Vaccines and Biologicals WHO Library Cataloguing-in-Publication Data The immunological basis for immunization series: module 17: rabies. (Immunological basis for immunization series ; module 17) 1.Rabies - immunology. 2.Rabies virus - immunology. 3.Rabies vaccines - therapeutic use. 4.Immunization. I.World Health Organization. II.Series. ISBN 978 92 4 150108 8 (NLM classification: WC 550) © World Health Organization 2011 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to repro- duce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; e-mail: [email protected]). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The Department of Immunization, Vaccines and Biologicals thanks the donors whose unspecified financial support has made the production of this document possible. This module was produced for Immunization, Vaccines and Biologicals, WHO, by: Dr Deborah J Briggs, Executive Director Global Alliance for Rabies Control Manhattan Kansas, USA. The Department of Immunization, Vaccines and Biologicals, WHO, also gratefully acknowledges the kind assistance and contribution of the Department of Control of Neglected Tropical Diseases in the preparation and review of this module. Printed in February 2011 Copies of this publication as well as additional materials on immunization, vaccines and biological may be requested from: World Health Organization Department of Immunization, Vaccines and Biologicals CH-1211 Geneva 27, Switzerland • Fax: + 41 22 791 4227 • Email: [email protected] • © World Health Organization 2010 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 3264; fax: +41 22 791 4857; email: [email protected]). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; email: [email protected]). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The named authors alone are responsible for the views expressed in this publication. Printed by the WHO Document Production Services, Geneva, Switzerland ii Contents Abbreviations and acronyms .............................................................................................v Preface .............................................................................................................................. vii 1. Rabies virus and disease .........................................................................................1 1.1 Structure of the virus ...................................................................................1 1.2 Classification ................................................................................................1 1.3 Pathology ......................................................................................................2 1.4 Epidemiology................................................................................................2 2. Immunity to rabies .................................................................................................3 2.1. Preventing clinical disease ...........................................................................3 2.2 Rabies vaccines .............................................................................................4 2.3 Response to immunization ..........................................................................4 2.4 Role of passive immunity ............................................................................5 2.5 Routes of active immunization ...................................................................6 2.6 Immune response in different populations .................................................6 3. Duration of immunity after immunization .......................................................8 3.1 Development of immunity ..........................................................................8 3.2 Duration of rabies virus-neutralizing antibody .......................................8 3.3 Anamnestic response ..................................................................................10 3.4 Timeliness of routine booster vaccination ................................................11 4. Techniques to measure the immune response .................................................12 4.1 Choosing the test to fit the purpose ...........................................................12 4.2 Virus neutralization assays ........................................................................12 4.3 Binding assays ............................................................................................13 4.4 Measuring cell-mediated immunity .........................................................13 5. Innocuity and efficacy of rabies biologicals ......................................................14 6. Future prospects ...................................................................................................15 References ........................................................................................................................16 iii iv Abbreviations and acronyms ABLV Australian bat lyssavirus ARAV Aravan virus CCV cell culture rabies vaccine CNS central nervous system dRIT direct rapid immunohistochemical test DTP-IPV combined diphtheria, tetanus, whole cell pertussis and inactivated poliomyelitis vaccine DUVV Duvenhage virus EBLV-1 European bat lyssavirus type 1 EBLV-2 European bat lyssavirus type 2 ELISA enzyme-linked immunosorbent assay ERIG equine rabies immune globulin FAT fluorescent antibody test FAVN fluorescent antibody virus neutralization GBS Guillain-Barré syndrome HAART highly active antiretroviral therapy HDCV human diploid cell vaccine HIV human immunodeficiency virus HRIG human rabies immune globulin ICTC International Committee on Taxonomy of Viruses ID intradermal Ig immunoglobulin IM intramuscular IRKV Irkut virus JEV Japanese encephalitis vaccine v KHUV Khujand virus LBV Lagos bat virus MHCII major histocompatibility complex class II MNT mouse neutralization test MOKV Mokola virus NTV nerve tissue vaccines PCECV purified chick embryo cell vaccine PCR polymerase chain reaction PDEV purified duck embryo cell vaccine PEP post-exposure prophylaxis PrEP pre-exposure vaccination PVRV purified Vero cell rabies vaccine RABV rabies virus RFFIT rapid fluorescent focus inhibition test RIDT rapid immunodiagnostic test RIG rabies immune globulin RNA ribonucleic acid RTCIT rabies tissue culture infection test RT-PCR reverse transcription-polymerase chain reaction RVNA rabies virus-neutralizing antibody SHIBV Shimoni bat virus WCBV West Caucasian bat virus WHO World Health
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