Overview of Rabies Vaccine Supply - 2005

C. E. RupprechtCenters for Disease Control & PreventionUSA

Rabies Vaccine Supplies - Objectives

- Describe current situation- Propose partial near term solutions- Discuss future strategies

Animal Rabies in the USA is Common (n=7560*)

RaccoonSkunkBatFoxCatCattleDogEquidsMongooseWoodchuckBobcatOther WildlifeSheep/GoatsOther Domestic* Current 5 year mean value

Usually 1-3 human cases per year

Human Rabies Via Transplanted Organs/Tissues – May/June 2004

Donor

Lung

Liver

Kidney

Kidney

Arterial Graft

(died during surgery)

Rabies is Episodic:Human Exposures To A Suspect Sheep – July, 2004

At a petting zoo more than ~600 persons were exposed to Cybill, a mature ewe (unvaccinated)…

Non-specific inclusions

Canine Rabies Translocations, 2004

Laredo, March

JuneMay

Rabies Continues to Evolve: Flagstaff, AZ, 2004-2005

A rabid skunk was reported in August and a gray fox during September with bat virus characteristics…

A previous outbreak in skunks (N=19) during 2001 was mediated by bat (Western Eptesicus fuscus) rabies…

Rabies Prophylaxis

- Wound care- Immune globulin (20 IU/kg)-Vaccination (days 0,3,7,14,28)

20,000-40,000 exposures per year

Estimated costs: $1200-$1500/per course

Rabies Biologicals

3 Vaccines:- HDCV- PCEC- RVA

2 Immune globulins: -Bayrab-Imogam

Human Rabies Vaccine Recall - March, 2004

CDC and the FDA were notified that a quality-assurance test of IMOVAX® Rabies Vaccine (Aventis Pasteur, Swiftwater, Pennsylvania) identified the presence of non-inactivated Pitman-Moore rabies virus in a single product lot. The vaccine lot containing non-inactivated virus was not distributed. As a precautionary measure, Aventis Pasteur initiated a voluntary recall of lots produced during the same period, with an expectation of additional vaccine availability in 2005…

Rabies Vaccine Needs

Consideration of RV stockpilesDevelopment of emergency INDsResolution of indigent concernsRenewed discussions w/FDAAdvocacy for research on RV biologicals