PREEXPOSURE RABIES PROPHYLAXIS FOR TRAVELERS - ARE THE BENEFITS WORTH THE COST

被引:36
作者
BERNARD, KW [1 ]
FISHBEIN, DB [1 ]
机构
[1] CTR DIS CONTROL,CTR INFECT DIS,DIV VIRAL & RICKETTSIAL DIS VIRAL & RICKETTSIAL ZOONOSES BRANCH,ATLANTA,GA 30333
关键词
RABIES; PROPHYLAXIS; PREEXPOSURE; POSTEXPOSURE;
D O I
10.1016/0264-410X(91)90221-Q
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Pre-exposure rabies prophylaxis is recommended by the Immunization Practices Advisory Committee of the US Public Health Services (PHS) as a safe and effective method for reducing the risk of rabies in international travellers. The United States Peace Corps provides pre-exposure prophylaxis with human diploid cell rabies vaccine (HDCV) to over 2000 new volunteers each year going to rabies-endemic countries. During the year November 1987 through October 1988, 175 rabies exposures (and no deaths) were documented in Peace Corps Volunteers serving in 31 rabies-endemic countries, for an overall postexposure treatment rate of 43.6/1000 volunteers per year. Although PHS treatment protocols were strictly followed, the postexposure prophylaxis rate for these Peace Corps Volunteers was 550 times higher than that for the US general population, and 55 times higher than the average rate for 30 developing countries. The use of pre-exposure prophylaxis in travellers was not cost-effective and will not become so until the price of a dose of vaccine declines substantially to $7.00 for the Peace Corps, and even lower for groups with less rabies exposure. However, despite the high vaccine cost, pre-exposure prophylaxis continues to be recommended in the Peace Corps for important non-economic reasons which may also be applicable to other groups of travellers.
引用
收藏
页码:833 / 836
页数:4
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