<?xml version="1.0" encoding="UTF-8"?><xml><records><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Patrick Soentjens</style></author><author><style face="normal" font="default" size="100%">Mieke Croughs</style></author><author><style face="normal" font="default" size="100%">Christophe Burm</style></author><author><style face="normal" font="default" size="100%">Steven Declerq</style></author><author><style face="normal" font="default" size="100%">Jan Clerinx</style></author><author><style face="normal" font="default" size="100%">Ula Maniewski</style></author><author><style face="normal" font="default" size="100%">Steven Van Den Brouck</style></author><author><style face="normal" font="default" size="100%">Caroline Theunissen</style></author><author><style face="normal" font="default" size="100%">Ralph Huits</style></author><author><style face="normal" font="default" size="100%">Isabel Brosius</style></author><author><style face="normal" font="default" size="100%">Florence, Eric</style></author><author><style face="normal" font="default" size="100%">Chris Kenyon</style></author><author><style face="normal" font="default" size="100%">Johan Van Griensven</style></author><author><style face="normal" font="default" size="100%">Sabrina Van Ierssel</style></author><author><style face="normal" font="default" size="100%">Lut Lynen</style></author><author><style face="normal" font="default" size="100%">Katleen Balliauw</style></author><author><style face="normal" font="default" size="100%">Steven Van Gucht</style></author><author><style face="normal" font="default" size="100%">Van Esbroeck, Marjan</style></author><author><style face="normal" font="default" size="100%">Vlieghe, Erika</style></author><author><style face="normal" font="default" size="100%">Bottieau, Emmanuel</style></author><author><style face="normal" font="default" size="100%">Yven Van Herrewege</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Time of administration of rabies immunoglobulins and adequacy of antibody response upon post-exposure prophylaxis: a descriptive retrospective study in Belgium.</style></title><secondary-title><style face="normal" font="default" size="100%">Acta Clin Belg</style></secondary-title></titles><keywords><keyword><style  face="normal" font="default" size="100%">rabies; prophylaxis;</style></keyword></keywords><dates><year><style  face="normal" font="default" size="100%">2019</style></year><pub-dates><date><style  face="normal" font="default" size="100%">2019 Sep 04</style></date></pub-dates></dates><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">&lt;p&gt;: Data on rabies post-exposure prophylaxis (PEP) and the use of human rabies immunoglobulins (HRIG) in Belgium are scarce. The main objective of this study was to evaluate the timely administration of HRIG after rabies exposure. The secondary objective was to evaluate the adequate antibody response following PEP. : We reviewed all medical records from July 2017 to June 2018 of patients seeking care at, or referred to, the Institute of Tropical Medicine and the University Hospital, Antwerp for the administration of human rabies immunoglobulins following potential rabies exposure abroad or in Belgium. A timely response was defined as starting HRIG with a delay of ≤48 h and rabies vaccination in the first 7 days after exposure. Adequate antibody response was defined as a titer of &amp;gt;5.0 IU/mL in case of bat-related exposure and &amp;gt;3.0 IU/mL in case of exposure to other animals. Titers were measured 10 days after the last PEP vaccine dose, using the rapid fluorescent focus inhibition test (RFFIT). : Of the 92 cases treated with HRIG, 75 were evaluated. The majority of injuries were acquired in Asia (n = 26,34%) and in Western Europe (n = 18, 24%), of which 17 in Belgium. The five most frequently recorded countries overseas were Indonesia (n = 13), Thailand (n = 7), Morocco (n = 4), Peru (n = 3) and Costa Rica (n = 3). Administration of immunoglobulins was related to injuries by dogs (36%), monkeys (25%) or bats (22%). A timely response was observed in 16 (21,33%) and in 55 (73,33%) of subjects receiving HRIG (≤48 h) or rabies vaccine (&amp;lt;7days) respectively. The mean time between exposure and the first administered dose of rabies vaccine and HRIG was 7.7 and 8.7 days, respectively. The mean delay for HRIG administration was 9.6 days and 6 days for abroad and inland risks, respectively. In 15 of 16 (94%) bat-related cases the antibody titer after full PEP was &amp;gt;5.0 IU/ml. In 38 of 47 (81%) cases related to other animals the RFFIT titer was &amp;gt;3.0 IU/ml. All low-responders received additional rabies injections. : This study showed a substantial time delay between the animal-related risk and the administration of HRIG, in particular when the injury occurred abroad. More targeted communication about the risks of rabies and preventable measures may reduce this delay. Furthermore, the antibody response was inadequate in some cases following full PEP administration according to the Belgian recommendation.&lt;/p&gt;
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