Hereas Predictably, the Case Fatality Is Substantially Higher
Total Page:16
File Type:pdf, Size:1020Kb
ABSTRACTS RESUMEN RESUMOS RÉSUMÉS HOW TO USE THIS BOOK Abstracts are arranged in alphanumeric order based on the OP/PP (oral presentation/poster presentation) numbers displayed in the RITA2020 Program. If you’re looking for a specific abstract, please search on the OP/PP number. CÓMO USAR ESTE LIBRO Los resúmenes están dispuestos en orden alfanumérico basado en los números que aparecen en el Programa RITA2020 OP/PP (presentación oral/presentación del cartel). Si usted está buscando un resumen específico, por favor buscar en el número OP/PP. COMO USAR ESTE LIVRO Os resumos são dispostos em ordem alfanumérica com base no OP/PP (apresentação oral/poster) números exibidos no Programa RITA2020. Se você está procurando um resumo específico, por favor, procure no número OP/PP. COMMENT UTILISER CE LIVRE Les résumés sont classés par ordre alphanumérique en fonction des numéros OP / PP (présentation orale / présentation par affiche) affichés dans le programme RITA2020. Si vous recherchez un résumé spécifique, veuillez rechercher le numéro OP / PP. Name: Charles Rupprecht OP02 Email: [email protected] Session: Keynote Address: Human Rabies & Prophylaxis Country: United States Title: Rabies in the age of COVID: a complex global tableau in a positive, non-vacuum on current matters arising towards musing productively, collaborating ingeniously & communicating frankly… Authors: Charles E Rupprecht Affiliations: Lyssa LLC, Lawrenceville, Georgia, USA Abstract: Unlike selected other viral diseases, such as smallpox, riderpest, polio, measles, etc., rabies is not a candidate for true eradication. Nevertheless, the global elimination of human rabies caused via dogs (GEHRD) by the year 2030 (ZBT) is accomplishable within our lifetime and is one of the most ambitious plans of this decade. As exemplified by Mexico and most other countries in the Americas, as a regional model, the GEHRD is a feasible plan. Unfortunately, the COVID19 pandemic has affected substantially everyone’s professional and personal lives. While the actual objective, trans- disciplinary impacts upon all NTDs (including rabies) remain to be quantified, already several less than ideal attributes are obvious subjectively, related to time, talent, and treasure. Severe limitations on travel and social distancing requirements have affected the ability to engage directly (e.g., this RITA conference and many others; hands-on laboratory training; community educational outreach; etc.), staff priorities (e.g., zoonoses surveillance; diagnostic testing; canine vaccination; etc.) and policy outlays (e.g., Gavi arrangements for GEHRD; focal biologics production, supplies and distributions; financial support for PAHO/WHO; etc.). Yet, so-called emerging infectious diseases are a force of nature, just like rabies. Rising to this occasion is a clarion call to our collective inventiveness for evidence-based solutions. For example, positively viewed, political ruminations on current implicit disease causation has caused some to question seriously the sense of wildlife markets and the sensibility of dogs for human consumption. Moreover, at least in theory, situational awareness and spatial/temporal separation may lead to a temporary decrease in environmental exposures to rabid animals as well as animal translocations. Rather than isolate, novel health communications can bridge the gap to the ignored, as offered remotely by talk radio, broadcast public service announcements, brochures, loudspeakers, cell phones, social media outlets, etc., will still reach certain populations at risk. Even laboratory ‘wet labs’ could occur on-line, in near real-time or in an archived format (e.g., JoVE). As demonstrated by wildlife biologists and others, decentralized, point-of-care testing can contribute to case detection and program goals. Local canine immunizations should ever more be meticulously planned for the vaccinators and the care givers to their vaccinee, as PPE is now de rigueur. Routine utilization of a proper risk assessment should result in preservation of critical biologics, regardless of a health emergency. Consideration of dose- sparing routes and schedules will stretch vaccine availability. Thorough wound care, triaging and local infiltration of rabies immune globulin/monoclonal antibodies do promote patient survivorship. Beyond academic research, actualization of remote, needless delivery of rabies vaccines, for humans, domestic animals, and wildlife, needs to come to our table today. Coat-tails adaptation of any relevant anti-viral drugs or health care interventions for the severely ill can be re-purposed for the considered therapy of the rabies patient. Any predicted temporary drawbacks to the GEHRD might require a re- evaluation of priorities in both the short and long term, but not abandoned in toto. Decision makers need reminding that epidemiologically, the R0 for rabies is lower than COVID19, whereas predictably, the case fatality is substantially higher. Now more than ever, in this pessimistic perception of the worst of times, the rabies community writ large needs to do what it has always done in a true One Health context, demonstrate to the world that such posed challenges may actually be the best of times using the occasion, expertise and resources in a cost-effective manner to accomplish even more with less towards the task at hand. Name: Huy-Binh Nguyen (presented by Nicholas Hobart-Porter) OP03 Email: [email protected] Session: Human Rabies & Prophylaxis Country: United States Title: Safety and efficacy of rabies post-exposure prophylaxis with human rabies immunoglobulin (HRIG150; KEDRAB) and active vaccination in pediatric patients with suspected or confirmed rabies virus exposure: A Phase 4 Open-label Single- Arm Clinical Trial Authors: Nicholas Hobart-Porter, Michal Stein, Naveh Toh, Novinyo Amega, Huy-Binh Nguyen, James Linakis Affiliations: Kedrion Biopharma Inc., Fort Lee, New Jersey, USA Abstract: Rabies is a deadly viral zoonosis with a global disease burden. Following exposure to a rabid animal, post- exposure prophylaxis (PEP) that includes human rabies immunoglobulin has become the standard of care for unvaccinated persons, based on evidence in adults that it prevents death when given appropriately. Despite the large proportion of pediatric cases, limited safety and efficacy data from clinical trials currently exist for use in pediatric patients. We report here the safety, efficacy, and immunogenicity results of a phase 4, prospective, two-center, open-label, single-arm clinical trial evaluating the use of a human rabies immunoglobulin (HRIG150; KEDRAB 150 IU/ml) as part of PEP in pediatric patients under 17 years of age with suspected or confirmed rabies exposure, in whom PEP was indicated following exposure to a suspected rabid animal. Thirty participants received 20 IU/kg HRIG150 infiltrated into detectable wound site(s), with any remainder injected intramuscularly, concomitantly with the first of a 4-dose (days 0, 3, 7, 14) rabies vaccine series. Rabies virus neutralizing antibody titers and tolerability were assessed on day 14 following administration, and participants were followed for safety up to 84 days in total. Efficacy in preventing rabies disease was 100%, with no (0%) participants developing rabies disease at any time during the study period. No serious adverse events or deaths were recorded. Twenty-one (70.0%) participants experienced 57 treatment-emergent adverse events (TEAEs) within 14 days following administration of HRIG150. Twelve (40.0%) participants experienced 12 study treatment-related adverse events, all of which were mild in severity. On day 14, 28 of 30 (93.3%) participants had RVNA levels of ≥0.5 IU/ml (mean ± SD: 18.89 ± 31.61). This study is the first to investigate pediatric safety and efficacy of any rabies immunoglobulin available in the United States, and the data establish safety and efficacy profiles for the pediatric population studied. Name: Gabriela Koike OP04 Email: [email protected] Session: Human Rabies & Prophylaxis Country: Brazil Title: Comparing the glycosylation patterns of IgG1 antibodies induced after pre-exposure rabies prophylaxis Authors: Gabriela Koike, Iana Suly santos Kayz, Elaine Raniero Fernandes, Fernanda Guedes, Sandriana dos Ramos Silva Affiliations: Pasteur Institute, Sao Paulo, Brazil Abstract: Rabies lyssavirus (RABV) neutralizing IgG antibodies confer protection after rabies vaccination, although how the RABV-specific antibodies neutralize the virus is still unknown. As changes in the antibody`s carbohydrate chain can interfere with its effector functions, we compared the glycosylation patterns of both neutralizing and non-neutralizing IgG1 induced by pre-exposure prophylaxis to human rabies and analyzed their influence on in vitro antibody neutralizing activities. Specific IgG1 were purified from human serum using affinity chromatography. Purity and avidity were analyzed by SDS-PAGE and indirect ELISA using NH4SCN respectively. The N-linked oligosaccharide chain of the purified IgG antibody was evaluated using a lectin-based ELISA assay with a panel of seven lectins. Neutralizing activity of purified IgG1 and neutralizing IgG1 deglycosylated by PNGase F enzyme were analyzed using the rapid fluorescent focus inhibition test. The purified IgG1 showed an electrophoretic pattern compatible with human IgG. All of the antibodies recognized RABV, although neutralizing IgG1 had a higher avidity (RAI =80%) than non-neutralizing IgG1 (RAI=30%). The neutralizing IgG1 also showed higher binding