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Heterogeneity of Rabies Vaccination Recommendations across Asia

GSK, 23 Rochester Park, Singapore 139234, Singapore
GSK, 20 Avenue Fleming, 1300 Wavre, Belgium
Author to whom correspondence should be addressed.
Trop. Med. Infect. Dis. 2017, 2(3), 23;
Received: 30 May 2017 / Revised: 27 June 2017 / Accepted: 29 June 2017 / Published: 6 July 2017
(This article belongs to the Special Issue Rabies Symptoms, Diagnosis, Prophylaxis and Treatment)
Asian countries bear the greatest burden of the disease, with a majority (59%) of rabies-related deaths occurring in Asia. In order to promote best practices, we summarized national human vaccination guidelines across this region, to highlight differences and similarities and to discuss the aspects that would benefit from updates. National management guidelines for rabies were retrieved from various sources to extract information on rabies pre- and post-exposure prophylaxis (PrEP, and PEP), booster vaccination, and route of administration. Rabies guidelines recommendations for wound management and PrEP across Asia are broadly aligned to the World Health Organization (WHO) guidelines. For PEP, the 5-dose Essen, and the 4-dose Zagreb are the regimens of choice for intramuscular (IM), and the Thai Red Cross regimen for intradermal (ID), administration. Several national guidelines have yet to endorse ID vaccine administration. Most guidelines recommend rabies immunoglobulin in category III exposures. Booster recommendations are not included in all guidelines, with limited clarity on booster requirement across the spectrum of risk of rabies exposure. In conclusion, national recommendations across Asian countries differ and while some guidelines are closely aligned to the WHO recommendations, resource-saving ID administration and use of rational abbreviated schedules have yet to be endorsed. View Full-Text
Keywords: Asia; guidelines; prevention and control; rabies; vaccination Asia; guidelines; prevention and control; rabies; vaccination
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Buchy, P.; Preiss, S.; Singh, V.; Mukherjee, P. Heterogeneity of Rabies Vaccination Recommendations across Asia. Trop. Med. Infect. Dis. 2017, 2, 23.

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