Rabies

On October 12, the Philadelphia Neurological Society held one of its regular meetings at The College of Physicians of Philadelphia and invited Paul A. Offit, MD, to speak to the membership. Offit, chief of infectious diseases at The Children’s Hospital of Philadelphia (CHOP), vaccine developer, and advisor to The History of Vaccines, greeted the membership with his first slide and title of his talk: “Why are neurologists scared of vaccines?”  Though Offit’s title was tongue-in-cheek, it spoke to a tension he has perceived between neurology and vaccinology. More

In honor of World Rabies Day, we’d like to draw attention to two rabies vaccines recently found in the collection of the Mütter Museum of The College of Physicians of Philadelphia. Museum curator Anna Dhody recently alerted us to a box of vaccines and other medical supplies she found in a little-visited storage area in the museum basement. The box belonged to a collection of medical equipment donated by James G. Kitchen II, MD (d. 1998), who was a Pocono Lake, Pennsylvania, physician and fellow of The College of Physicians of Philadelphia. Dr. Kitchen stocked the vaccine in his office supplies to address what was probably a fairly uncommon need in his practice: post-exposure rabies prophylaxis in humans. More

In the United States, the Advisory Committee on Immunization Practices (ACIP) issues written recommendations regarding scheduling and dosing of vaccinations for both children and adults. ACIP members are selected by the Secretary of the Department of Health and Human Services to provide advice on controlling vaccine-preventable diseases; the committee is the only federal unit to make these recommendations.

ACIP issues new and updated recommendations when the status of a given disease changes, or when new data suggests that a vaccine dosage or schedule should be changed. Recently, in response to rabies surveillance data, clinical studies, experimental work and other factors, the Committee issued new recommendations for prophylactic rabies vaccination after possible exposure to the virus.

Rabies is nearly always fatal after symptoms begin to appear. However, if an exposed individual is treated promptly (with proper wound care and the administration of rabies immune globulin and rabies vaccine), the disease can usually be prevented. The previous ACIP recommendations were for five doses of rabies vaccine following exposure; now, the ACIP has reduced the dosage schedule, recommending only four doses of the vaccine for exposed individuals without prior protection against the disease. The details of ACIP’s updated recommendations are available as part of the March 19, 2010 Morbidity and Mortality Weekly Report. More