ABSTRACT
A retrospective cohort study of current rabies antibody titres from adults who received pre-exposure immunisation administered intradermally between 1994 and 2005, examining the decay in titre over time relative to the interval since last dose, and the total dose received. Participants receiving at least 0.6 ml total dose intradermally of vaccine over at least two clinic visits and all with three clinic visits, were shown to have an adequate titre with measurable levels of antibody indicating sero-conversion above 0.5 IU/ml, irrespective of the time interval since the last dose. No clear relationship was found between time interval since immunisation and the level of antibody. Using a schedule that administers 0.6 ml of rabies vaccine over three clinic visits the boosting interval could be extended towards ten years; substantially cheaper than the standard licensed intramuscular dosing schedule.
Subject(s)
Antibodies, Viral/blood , Rabies Vaccines/administration & dosage , Rabies Vaccines/immunology , Rabies/prevention & control , Adult , Aged , Aged, 80 and over , Cohort Studies , Female , Humans , Immunization, Secondary/methods , Injections, Intradermal , Male , Middle Aged , Retrospective StudiesABSTRACT
BACKGROUND: A new multidrug-resistant (MDR) strain of Salmonella serotype Newport, Newport-MDRAmpC, has recently emerged. We sought to identify the medical, behavioral, and dietary risk factors for laboratory-confirmed Salmonella Newport infection, including that with Newport-MDRAmpC. METHODS: A 12-month population-based case-control study was conducted during 2002-2003 in 8 sites of the Foodborne Diseases Active Surveillance Network (FoodNet), with 215 case patients with Salmonella Newport infection and 1154 healthy community control subjects. RESULTS: Case patients with Newport-MDRAmpC infection were more likely than control subjects to have taken an antimicrobial agent to which Newport-MDRAmpC is resistant during the 28 days before the onset of diarrheal illness (odds ratio [OR], 5.0 [95% confidence interval {CI}, 1.6-16]). Case patients with Newport-MDRAmpC infection were also more likely to have eaten uncooked ground beef (OR, 7.8 [95% CI, 1.4-44]) or runny scrambled eggs or omelets prepared in the home (OR, 4.9 [95% CI, 1.3-19]) during the 5 days before the onset of illness. International travel was not a risk factor for Newport-MDRAmpC infection but was a strong risk factor for pansusceptible Salmonella Newport infection (OR, 7.1 [95% CI, 2.0-24]). Case patients with pansusceptible infection were also more likely to have a frog or lizard in their household (OR, 2.9 [95% CI, 1.1-7.7]). CONCLUSIONS: Newport-MDRAmpC infection is acquired through the US food supply, most likely from bovine and, perhaps, poultry sources, particularly among persons already taking antimicrobial agents.
