Wednesday, 19 December 2007
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POST 01204E : WHO POSITION PAPER / RABIES 19 December 2007 ___________________________________ Please note that a revised WHO position paper on rabies vaccines was published in the WHO Weekly Epidemiological Record of 7 December. The paper is available in English and French. It will shortly be translated into Arabic, Chinese, Russian and Spanish. The revised paper reflects recent epidemiological data, scientific developments and accrued programmatic experience in the field of rabies immunization. As compared with the 2002 position paper, the current document puts more emphasis on the need to replace the reactogenic and less potent nerve tissue-based rabies vaccines by modern, safe and efficacious cell culture-based vaccine products. It is strongly recommended that the production and use of nerve tissue vaccine for human prophylaxis be discontinued and replaced as soon as possible by modern cell culture vaccines. The current position paper also underlines that cell culture-based rabies vaccines that have been specifically authorized for intradermal immunization represent an acceptable alternative to standard administration by the intramuscular route. The use of the dose-saving intradermal route for both pre-exposure and post-exposure prophylaxis should be considered in settings where modern rabies vaccines are unaffordable and/or in short supply. In several countries the introduction of the intradermal route for post-exposure prophylaxis has permitted discontinuation of the production and use of nerve tissue-based vaccines. Finally, the revised position paper emphasises that periodic booster injections of rabies vaccine are recommended only for persons whose occupation puts them at continuous or frequent risk of rabies exposure. In such cases, a booster dose should preferably be given at intervals dictated by regular testing for antibodies to rabies virus. Where facilities for serological testing are unavailable, booster vaccination every five years may be an acceptable alternative. ----------------- The updated position paper includes a limited number of additional key references with abstracts ----------------- The 7 December 2007 position paper on rabies vaccines replaces the corresponding paper published in the Weekly Epidemiological Record on 5 April 2002 (2002, 77, 109-120). It conclusions and recommendations are in line with those of the WHO Expert Consultation on Rabies (TRS 931, 2005). The final text was reviewed and endorsed by WHO’s Strategic Advisory Group of Experts on Immunization at its meeting of 6-9 November 2007. Kind regards. Mrs [log in to unmask]">Alison Brunier, MBA Communications Officer Immunization, Vaccines and Biologicals World Health Organization ______________________________________________________________________________ All members of the TechNet21 e-Forum are invited to send comments on any posting or to use the forum to raise a new discussion or request technical information in relation to immunization services. The comments made in this forum are the sole responsibility of the writers and do not in any way mean that they are endorsed by any of the organizations and agencies to which the authors may belong. ______________________________________________________________________________ Visit the TECHNET21 Website at http://www.technet21.org You will find instructions to subscribe, a direct access to archives, links to reference documents and other features. ______________________________________________________________________________ To UNSUBSCRIBE, send a message to : [log in to unmask]">[log in to unmask] Leave the subject area BLANK In the message body, write unsubscribe TECHNET21E ______________________________________________________________________________ The World Health Organization and UNICEF support TechNet21. The TechNet21 e-Forum is a communication/information tool for generation of ideas on how to improve immunization services. It is moderated by Claude Letarte and is hosted in cooperation with the Centre de coopération internationale en santé et développement, Québec, Canada (www.ccisd.org _____________________________________________________________________________
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