HomeIndiaTrials confirm efficacy of rabies vaccine

Trials confirm efficacy of rabies vaccine

Virus neutralizing antibodies found in anti-mortem sample of 12-year-old boy

Virus neutralizing antibodies found in anti-mortem sample of 12-year-old boy

Even as the efficacy of the anti-rabies vaccine currently administered in the state has been questioned, the presence of virus neutralizing antibodies in anti-mortem samples of blood and cerebrospinal fluid collected from a 12-year-old child has been questioned. It turns out that he had died. Public health experts say the rabies in Pathanamthitta indicates that the vaccine has indeed been effective against the rabies virus.

The samples were tested at the National Institute of Virology (NIV), Pune.

The RT-PCR test on the samples detected the presence of rabies virus, while the Rapid Fluorescent Focus Inhibition test indicated the presence of rabies virus neutralizing antibodies.

wound management

“The fact that virus neutralizing antibodies were found in the baby’s serum and cerebrospinal fluid samples indicates that the anti-rabies vaccine had started to work. However, it is highly likely that the concentration of antibodies was not sufficient to counteract the virus as the virus had already found its way to the nerve fibers. This again points to the nature of the wound (deep wound near the eye) and delay in wound management (washing of the wound and administration of immunoglobulin serum at the wound site) as potential vulnerabilities, which may have allowed early entry of the virus can. nerve fibers,” said a public health expert.

If the effectiveness of biologic drugs is to be doubted, it should be confirmed by the efficacy of immunoglobulin serum, assuming that a sufficient amount of serum was properly infiltrated into the wound. The recommended dose of rabies immunoglobulin is 20 IU/kg body weight.

Some physicians have raised doubts whether the antibody response or virus neutralizing antibodies found in the samples were actually induced by the vaccine or if it is possible that it was produced by the body in response to the virus.

“We cross-checked this with the NIV and according to experts, in a severe disease like rabies, the neutralizing antibodies present in the anti-mortem samples are unlikely to be caused by the wild virus as there is a window between the onset and the disease in the child. Is. Her death was very rare,” said TS Anish, associate professor of community medicine, Manjeri Government Medical College.

According to the literature, even though the innate immune system recognizes the rabies virus, the rabies-virus-specific immune response is triggered only when the virus infects the central nervous system. In human rabies cases, antibody responses are not detected until several days after the development of clinical signs and symptoms. However, the majority of cases in which the patient has died have not identified a protective antibody at the site of virus replication. Therefore, it is likely that the neutralizing antibodies detected in the samples of the child who died of rabies in Pathanamthitta were generated by the vaccine and not the antibody response induced by the virus.

Vaccine batch withdrawn

Meanwhile, the uproar over the “low efficacy” of the vaccine has prompted the Kerala Medical Services Corporation to immediately withdraw a batch of anti-rabies vaccine (KB 210002) from hospitals and godowns. This was also in response to the government’s decision to double-check the quality of the vaccine. The government has also constituted an expert committee to look into all aspects of the five human rabies deaths, which occurred in the state despite the victims being given anti-rabies vaccine and serum.

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