Mass rabies exposure of veterinary health care workers in Germany: Management, immune response, and tolerability of post exposure-prophylaxis
Background: Rabies is a fatal zoonotic disease caused by Rabies lyssavirus, primarily transmitted through dog bites. In 2008, Germany was declared free from terrestrial rabies by the WOAH. However, illegal pet imports can still lead to rabies exposure, as seen in the 2021 case of a rabid puppy illeg...
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Elsevier
2025-06-01
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| Series: | One Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S235277142500014X |
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| author | Lennart Lemmermann Jonathan Remppis Sabine Bélard Florian Steiner |
| author_facet | Lennart Lemmermann Jonathan Remppis Sabine Bélard Florian Steiner |
| author_sort | Lennart Lemmermann |
| collection | DOAJ |
| description | Background: Rabies is a fatal zoonotic disease caused by Rabies lyssavirus, primarily transmitted through dog bites. In 2008, Germany was declared free from terrestrial rabies by the WOAH. However, illegal pet imports can still lead to rabies exposure, as seen in the 2021 case of a rabid puppy illegally imported to Germany, resulting in a mass exposure incident. Methods: This retrospective study assessed the post-exposure management of 39 veterinary clinic staff exposed to the rabid puppy, focusing on the practicability, immunogenicity, and tolerability of post-exposure prophylaxis (PEP). Data was collected from patient records and for follow-up by phone using standardized case record forms, entered into an Excel database, and analyzed descriptively. Ethics approval was obtained from the Ethics Committee of the University of Tübingen (8452022BO2). Results: Exposed individuals received varying PEP regimens based on vaccination status and exposure level, including possible aerosol exposure. Most followed the Essen-Scheme, with some receiving human rabies immune globulin (hRIG). All developed protective antibody titers, and adverse reactions were generally mild. Conclusion: This case highlights challenges in rabies mass exposure management and emphasizes needs for continued preparedness, resource allocation and education about rabies, even in regions considered rabies-free. |
| format | Article |
| id | doaj-art-06f08f87e26c4f9392e6a567911ea4ec |
| institution | Kabale University |
| issn | 2352-7714 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | One Health |
| spelling | doaj-art-06f08f87e26c4f9392e6a567911ea4ec2025-01-24T04:45:23ZengElsevierOne Health2352-77142025-06-0120100978Mass rabies exposure of veterinary health care workers in Germany: Management, immune response, and tolerability of post exposure-prophylaxisLennart Lemmermann0Jonathan Remppis1Sabine Bélard2Florian Steiner3Institute of Tropical Medicine, University of Tübingen, Tübingen, Germany; Department of Dermatology, Venereology and Allergology, Bundeswehrkrankenhaus, Hamburg, GermanyInstitute of Tropical Medicine, University of Tübingen, Tübingen, Germany; German Center for Infection Research (DZIF), Partner Site Tübingen, Tübingen, Germany; Department of Pediatric Neurology, General Pediatrics, Diabetology, Endocrinology and Social Pediatrics, University Children's Hospital Tübingen, Tübingen, GermanyInstitute of Tropical Medicine, University of Tübingen, Tübingen, Germany; German Center for Infection Research (DZIF), Partner Site Tübingen, Tübingen, Germany; Corresponding author at: Institute of Tropical Medicine, University of Tübingen, Wilhelmstr. 27, 72074 Tübingen, Germany.Praxis Dr. Steiner, Tarmstedt, GermanyBackground: Rabies is a fatal zoonotic disease caused by Rabies lyssavirus, primarily transmitted through dog bites. In 2008, Germany was declared free from terrestrial rabies by the WOAH. However, illegal pet imports can still lead to rabies exposure, as seen in the 2021 case of a rabid puppy illegally imported to Germany, resulting in a mass exposure incident. Methods: This retrospective study assessed the post-exposure management of 39 veterinary clinic staff exposed to the rabid puppy, focusing on the practicability, immunogenicity, and tolerability of post-exposure prophylaxis (PEP). Data was collected from patient records and for follow-up by phone using standardized case record forms, entered into an Excel database, and analyzed descriptively. Ethics approval was obtained from the Ethics Committee of the University of Tübingen (8452022BO2). Results: Exposed individuals received varying PEP regimens based on vaccination status and exposure level, including possible aerosol exposure. Most followed the Essen-Scheme, with some receiving human rabies immune globulin (hRIG). All developed protective antibody titers, and adverse reactions were generally mild. Conclusion: This case highlights challenges in rabies mass exposure management and emphasizes needs for continued preparedness, resource allocation and education about rabies, even in regions considered rabies-free.http://www.sciencedirect.com/science/article/pii/S235277142500014XRabiesMass exposurePost-exposure prophylaxisIllegal pet tradeGermanyVaccination strategies |
| spellingShingle | Lennart Lemmermann Jonathan Remppis Sabine Bélard Florian Steiner Mass rabies exposure of veterinary health care workers in Germany: Management, immune response, and tolerability of post exposure-prophylaxis One Health Rabies Mass exposure Post-exposure prophylaxis Illegal pet trade Germany Vaccination strategies |
| title | Mass rabies exposure of veterinary health care workers in Germany: Management, immune response, and tolerability of post exposure-prophylaxis |
| title_full | Mass rabies exposure of veterinary health care workers in Germany: Management, immune response, and tolerability of post exposure-prophylaxis |
| title_fullStr | Mass rabies exposure of veterinary health care workers in Germany: Management, immune response, and tolerability of post exposure-prophylaxis |
| title_full_unstemmed | Mass rabies exposure of veterinary health care workers in Germany: Management, immune response, and tolerability of post exposure-prophylaxis |
| title_short | Mass rabies exposure of veterinary health care workers in Germany: Management, immune response, and tolerability of post exposure-prophylaxis |
| title_sort | mass rabies exposure of veterinary health care workers in germany management immune response and tolerability of post exposure prophylaxis |
| topic | Rabies Mass exposure Post-exposure prophylaxis Illegal pet trade Germany Vaccination strategies |
| url | http://www.sciencedirect.com/science/article/pii/S235277142500014X |
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