Rabies Vaccines, Prophylactic, Peru: Massive Rabies Pre-exposure Prophylaxis for High-Risk Populations

Recuenco S.E. · Rabies and Rabies Vaccines (2020) · DOI: 10.1007/978-3-030-21084-7_5

Resumen

Since 1975, Peru has reported human rabies outbreaks due to vampire bat transmission, among populations living in their Amazon Basin region. Responses with traditional rabies control tools, rabies postexposure prophylaxis for bitten individuals with suckling mouse brain vaccine (SMBV) and bat culling, failed to stop human deaths, which mainly were seen in children from native populations. Human outbreaks increased significantly from 2007 to 2010, and by 2011, Peru started a massive rabies pre-exposure prophylaxis (PreP) program targeted to populations living in high-risk areas for vampire bat rabies. Covering parts of the Peruvian Amazon rainforest region, the program started in Condorcanqui Province, the source of most of the human rabies cases. The country’s rabies prevention policy put in place for the PreP program mandate the exclusive use of cultured cell vaccines, including human diploid cell vaccine (HDCV), and purified Vero cell vaccine (PVCV). The campaign was progressively expanded from 5 provinces in 2011 to 20 provinces in 2016, and successfully prevented new human rabies cases, with zero reports among vaccinated population, while rabies virus circulation and bat bites to people is still ongoing. Massive Rabies PreP implemented as a national rabies prevention policy has no precedent and the Peruvian experience provides insights for further use of this strategy for other high-risk areas for rabies exposures. © Springer Nature Switzerland AG 2020.

Instituciones: Universidad Nacional Mayor de San Marcos