Rabies virus transmission via solid organs or tissue allotransplantation

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infectious disease 5 infectiousdiseases
lymphocytic choriomeningitis 1 infectiousdiseases
meningitis 1 infectiousdiseases
rabies 127 infectiousdiseases
Chagas disease 1 infectiousdiseases

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Chagas disease 7808 patients with fever which is the typical symptom of rabies, mainly because pre-transplant screening for Chagas disease .Table 1Related reports and basic information of rabies virus transmission via solid organ or tissue
infectious disease 2992 misdiagnosed inflammatory conditions of meningoencephalitis were reported [[4]–[6]].Rabies is an age-old infectious disease , but it remains an important public health problem today. Each year, approximately 59 000 individuals
infectious disease 5442 focus sufficient attention on ROTA.Rabies virus transmission via ROTA occurs worldwideRabies is an infectious disease with a worldwide distribution. In Europe and other developed countries and regions, because of the large-scale
infectious disease 11314 wound care and PEP. Individuals with immune dysfunction or immunodeficiency are more likely to develop infectious disease . A higher incidence of rabies has been observed among organ transplant recipients infected with rabies
infectious disease 18240 decreased, and the occurrence of rabies in low-incidence areas has increased. Rabies remains the third major infectious disease -causing death in China. China will continue to be one of the countries where rabies is rampant for many
infectious disease 22136 limitations regarding social, biological, and technical aspects. First, in humans, rabies is a rare infectious disease that can be caused by organ transplantation, which is under-detected. There is currently no country
lymphocytic choriomeningitis 20161 Many infectious pathogens can be transmitted through solid organ transplants, e.g., West Nile virus, lymphocytic choriomeningitis virus, Balamuthia mandrill Aris amebae, and HIV [[33]]. Rabies virus is the only one that can lead to
meningitis 20179 pathogens can be transmitted through solid organ transplants, e.g., West Nile virus, lymphocytic chorio meningitis virus, Balamuthia mandrill Aris amebae, and HIV [[33]]. Rabies virus is the only one that can lead to
rabies 439 disease that can be transmitted via solid organs or tissue allotransplantation. Dozens of deaths from rabies via solid organs or tissues allotransplantation (ROTA) have been documented during the last decades.
rabies 578 allotransplantation (ROTA) have been documented during the last decades. In 2015 and 2016, two cases of rabies virus transmission via solid organs or tissue allotransplantation were reported in China, which further
rabies 748 allotransplantation were reported in China, which further underscore the risk and importance of this special type of rabies for organ transplant recipients.Main textFrom 1978 to 2017, at least 13 cases of ROTA, causing dozens
rabies 948 causing dozens of deaths, have been reported worldwide, whether in the high-risk or low-risk countries of rabies . The reported incubation period of ROTA ranges from 11 days to more than 17 months, while the historical
rabies 1083 period of ROTA ranges from 11 days to more than 17 months, while the historical incubation period of rabies is generally considered to range from ~ 1 week to several years. The pathogenesis of ROTA is not
rabies 1401 We also summarize reports about ROTA in China, combined with the actual situation regarding work on rabies surveillance and elimination, and suggest countermeasures for the prevention and control of ROTA in
rabies 2627 transmission but are still transplanted [[2], [3]]. Many of the ‘uncommon’ disease transmissions such as rabies have come with the use of organs from a previously healthy person who subsequently died with an undiagnosed/misdiagnosed
rabies 2783 previously healthy person who subsequently died with an undiagnosed/misdiagnosed neurologic event. Dozens of rabies virus transmissions to recipients via organs or tissues from donors with either undiagnosed or misdiagnosed
rabies 3158 problem today. Each year, approximately 59 000 individuals worldwide may die from an infection due to rabies virus, despite the existence of effective prophylaxis [[7], [8]]. Rabies is a zoonosis, associated with
rabies 3408 by neurotropic RNA viruses in the family Rhabdoviridae, genus Lyssavirus [[7]]. Classically, human rabies manifests in either the encephalitic (furious) or paralytic (dumb) form. Diagnosis is extremely difficult
rabies 3546 encephalitic (furious) or paralytic (dumb) form. Diagnosis is extremely difficult in the case of paralytic rabies and when the patient lapses into coma. Human-to-human transmission of rabies has never been confirmed,
rabies 3623 the case of paralytic rabies and when the patient lapses into coma. Human-to-human transmission of rabies has never been confirmed, except extremely rarely as a result of infected organ or tissue transplantation.
rabies 3797 infected organ or tissue transplantation. Undiagnosed or misdiagnosed rabid donors are the reason for rabies virus transmission via solid organ or tissue allotransplantation [[9]–[11]]. In 2015 and 2016, two
rabies 3914 transmission via solid organ or tissue allotransplantation [[9]–[11]]. In 2015 and 2016, two cases of rabies virus transmission via solid organs or tissues allotransplantation (ROTA) were reported in China [[6],
rabies 4569 occurrence of ROTA.The epidemiological characteristics of ROTAThe pathway of human-to-human transmitted rabies virusMost cases of rabies are caused by the bite of rabid animals, among which the most common type
rabies 4595 epidemiological characteristics of ROTAThe pathway of human-to-human transmitted rabies virusMost cases of rabies are caused by the bite of rabid animals, among which the most common type is the dog, followed by other
rabies 4874 virus can infect all mammals, such as cattle, pigs, sheep, wildlife and humans. As a dead-end host of rabies , humans do not typically spread rabies in a human-to-human manner [[8], [13]–[16]]. Organ and tissue
rabies 4913 cattle, pigs, sheep, wildlife and humans. As a dead-end host of rabies, humans do not typically spread rabies in a human-to-human manner [[8], [13]–[16]]. Organ and tissue transplantation is the major way to
rabies 5029 human-to-human manner [[8], [13]–[16]]. Organ and tissue transplantation is the major way to transmit rabies virus from one human to another, which has been confirmed by laboratory results. The first case of tissue-transplant-related
rabies 5161 another, which has been confirmed by laboratory results. The first case of tissue-transplant-related rabies was reported in 1978, and similar events continue to be reported [[17]]. Once the disease process initiates,
rabies 5627 countries and regions, because of the large-scale use of animal vaccines, the perpetuation and spread of rabies is by wild carnivores and bats, and very few human rabies cases are reported yearly [[16], [18]]. Rabies
rabies 5685 vaccines, the perpetuation and spread of rabies is by wild carnivores and bats, and very few human rabies cases are reported yearly [[16], [18]]. Rabies remains a very serious illness in poor and developing
rabies 6084 increasing number of people can afford it in various rapidly-developing countries and regions. The first rabies case caused by corneal transplantation in the United States was reported in 1978. Since then, additional
rabies 6941 and organs included the corneas, kidneys, liver, heart, lungs, pancreas, and iliac artery. Similar to rabies , ROTA has a worldwide distribution (Fig. 1). ROTA has been reported in low-risk and high-risk areas;
rabies 7756 reported in Latin America, some measures can exclude patients with fever which is the typical symptom of rabies , mainly because pre-transplant screening for Chagas disease.Table 1Related reports and basic information
rabies 7871 because pre-transplant screening for Chagas disease.Table 1Related reports and basic information of rabies virus transmission via solid organ or tissue allotransplantationLocationReported DateTransplant organ
rabies 9012 diagnosisCorneal––YESsurvivalCorneal––YESsurvivalNote: - means no data reportedFig. 1the occurrence of ROTA and the risk of rabies worldwide. The depth of the blue background indicates the incidence risk of rabies, and the red triangle
rabies 9095 and the risk of rabies worldwide. The depth of the blue background indicates the incidence risk of rabies , and the red triangle shows the reported cases of ROTA. China and India are high-risk areas with the
rabies 9269 India are high-risk areas with the ROTA report. Europe and the United States are low - risk areas of rabies , however still with ROTA reports. Although the African region is also a high-risk area of rabies without
rabies 9366 of rabies, however still with ROTA reports. Although the African region is also a high-risk area of rabies without reports of ROTA, sufficient attention should be paid to prevent the occurrence of ROTA, including
rabies 9560 of ROTA, including enhanced surveillance. The background database came from WHO. http://www.who.int/ rabies /Global_distribution_risk_humans_contracting_rabies_2013.png?ua=1Rabies virus transmission via ROTA occurs
rabies 9611 background database came from WHO. http://www.who.int/rabies/Global_distribution_risk_humans_contracting_ rabies _2013.png?ua=1Rabies virus transmission via ROTA occurs in clusters and aggregates with casesThe occurrence
rabies 9728 http://www.who.int/rabies/Global_distribution_risk_humans_contracting_rabies_2013.png?ua=1Rabies virus transmission via ROTA occurs in clusters and aggregates with casesThe occurrence of rabies is characterized by aggregation and clustering. This is because a rabid animal may expose more than
rabies 9966 methods can be used to find identity between the viral variants. ROTA represents the transmission of rabies virus caused by human activities. Organ transplant recipients are a population with a set of obvious
rabies 10914 known that corneal transplantation, kidney transplantation, or even vascular transplantation, can cause rabies , and both the organ and the tissue can be used as a potential portal for rabies virus transmission.Susceptible
rabies 10994 transplantation, can cause rabies, and both the organ and the tissue can be used as a potential portal for rabies virus transmission.Susceptible population, incubation, and course of ROTAHumans are susceptible to rabies,
rabies 11100 virus transmission.Susceptible population, incubation, and course of ROTAHumans are susceptible to rabies , but the development of the disease depends on several factors, such as the bite, severity, viral dose,
rabies 11356 dysfunction or immunodeficiency are more likely to develop infectious disease. A higher incidence of rabies has been observed among organ transplant recipients infected with rabies virus, because of the use of
rabies 11429 disease. A higher incidence of rabies has been observed among organ transplant recipients infected with rabies virus, because of the use of immunosuppressive drugs, which may render them more susceptible to infection.
rabies 11998 and another three patients did not develop the disease and survived before using PEP. Patients with rabies usually die within seven to 10 days, while the duration of the disease in ROTA cases varies by organ
rabies 12126 seven to 10 days, while the duration of the disease in ROTA cases varies by organ transplantation of rabies . Once rabies manifests itself clinically, all cases will end in death. The shortest case occurred in
rabies 12139 10 days, while the duration of the disease in ROTA cases varies by organ transplantation of rabies. Once rabies manifests itself clinically, all cases will end in death. The shortest case occurred in 1994 in Iran:
rabies 12747 pathogenesis of ROTARabies is caused by infection with a lyssavirus, such as the type species of the genus, rabies virus, usually through skin wounds or mucous membrane damage. Rabies virus replicates in muscle tissues,
rabies 13218 the host that are innervated by the nervous system, such as the salivary glands. At the late stage of rabies , rabies virus can be observed in glandular cells and epithelial cells. According to clinical manifestations,
rabies 13226 that are innervated by the nervous system, such as the salivary glands. At the late stage of rabies, rabies virus can be observed in glandular cells and epithelial cells. According to clinical manifestations,
rabies 13334 virus can be observed in glandular cells and epithelial cells. According to clinical manifestations, rabies can be mainly divided into two types: furious and paralytic rabies [[7], [8], [13], [29]–[31]].In
rabies 13401 According to clinical manifestations, rabies can be mainly divided into two types: furious and paralytic rabies [[7], [8], [13], [29]–[31]].In organ transplant recipients, it is necessary to use immunosuppressants
rabies 13827 in heterologous organs. There are two main views on the molecular pathogenesis of ROTA. One is that rabies virus is neurotropic: donor organs contain the virus in the nerve endings at the late stage of disease,
rabies 14077 transplantation, and via the nervous system, it invades the central nervous system again and causes rabies . The other theory is that the virus exists not only in nerve endings, but also in gland cells and epithelial
rabies 14290 epithelial cells, which represent a reserve of a large amount of the virus in the transplanted organs. When rabies virus enters the recipient, it invades the nervous system to cause rabies in an environment where the
rabies 14364 transplanted organs. When rabies virus enters the recipient, it invades the nervous system to cause rabies in an environment where the host immune system is depressed. Studies have shown that rabies virus from
rabies 14456 to cause rabies in an environment where the host immune system is depressed. Studies have shown that rabies virus from bats can replicate in epithelial cells, which are predominantly paralytic [[30]]. It is a
rabies 14909 ROTA is unclear, and the two views described above are consistent with the medical characteristics of rabies virus. The divergence between these two theories is whether the virus carried by the donor exists in
rabies 15150 cells and gland cells. We believe that the two conditions are likely to occur. As a neurotropic virus, rabies virus is rare to replicate in epithelial cells.Traditionally, rabies virus is a quintessential neurotropic
rabies 15219 occur. As a neurotropic virus, rabies virus is rare to replicate in epithelial cells.Traditionally, rabies virus is a quintessential neurotropic pathogen, with replication and transmission in the nervous system.
rabies 15340 quintessential neurotropic pathogen, with replication and transmission in the nervous system. However, rabies virus undergoes rapid replication and can replicate in selected epithelial or glandular cells. Rabies
rabies 15647 replication and transmission has been confirmed. It has also been reported that significant replication of rabies virus replication occurs in the kidneys. The transplanted organs contain viruses in epithelial cells
rabies 15811 organs contain viruses in epithelial cells and nerve terminals, and, under appropriate conditions, rabies virus replicates in many locations and eventually causes the disease [[15]].Reports of rabies virus
rabies 15905 conditions, rabies virus replicates in many locations and eventually causes the disease [[15]].Reports of rabies virus transmission via ROTA in ChinaIn 2015, a case of ROTA was reported for the first time in China.
rabies 16095 first time in China. In Beijing, two patients who received kidney transplantation were diagnosed with rabies after the organ transplantation surgery. The organs received by these two patients were from the same
rabies 16267 these two patients were from the same donor, a 6-year-old boy from Guangxi, where about ten cases of rabies are reported per year, thus representing a high-risk rabies region in China. The organ donor had not
rabies 16327 from Guangxi, where about ten cases of rabies are reported per year, thus representing a high-risk rabies region in China. The organ donor had not been diagnosed with rabies, but he appeared to have some symptoms
rabies 16395 year, thus representing a high-risk rabies region in China. The organ donor had not been diagnosed with rabies , but he appeared to have some symptoms of rabies, such as fever, continuous decline in neurological
rabies 16444 China. The organ donor had not been diagnosed with rabies, but he appeared to have some symptoms of rabies , such as fever, continuous decline in neurological condition, and progression to coma with progressive
rabies 16683 pathological reflexes. The recipients of the kidney transplants were diagnosed as being exposed to rabies virus using RT-PCR techniques in the laboratory. In 2016, the second case of ROTA was reported in China’s
rabies 16859 case of ROTA was reported in China’s Southern region, which is considered as a high-risk area for rabies . The organ donor was a boy under 2 years old. After treatment in the primary hospital for high fever,
rabies 17070 coma, and other symptoms, he was transferred to the municipal hospital, where the physician suspected rabies ; however, there was a misdiagnosis based on a false negative ELISA test for rabies virus antibody, which
rabies 17153 physician suspected rabies; however, there was a misdiagnosis based on a false negative ELISA test for rabies virus antibody, which is a test with poor sensitivity. Subsequently, his organs were transplanted to
rabies 17299 poor sensitivity. Subsequently, his organs were transplanted to three patients, two of whom developed rabies and eventually died. Another recipient died from other complications and was not tested for rabies.
rabies 17398 rabies and eventually died. Another recipient died from other complications and was not tested for rabies . ROTA has posed the serious threat to China’s public safety which should be a wake-up call for public
rabies 17597 for public health [[6], [12]].Rabies is present in China, which is an area that has a high risk of rabies virus infection, as the number of deadly rabies cases per year in this country has been ranked second
rabies 17645 in China, which is an area that has a high risk of rabies virus infection, as the number of deadly rabies cases per year in this country has been ranked second in the world. In China, the main route of transmission
rabies 17764 year in this country has been ranked second in the world. In China, the main route of transmission of rabies virus remains a dog bite, accounting for almost 90–95% of cases, followed by wildlife (about 3–5%
rabies 17954 wildlife (about 3–5% of cases). Although the association with domestic animals is better appreciated, rabies virus transmission among wildlife is less understood. The prevalence of rabies in China has changed
rabies 18033 better appreciated, rabies virus transmission among wildlife is less understood. The prevalence of rabies in China has changed in recent years; the prevalence of rabies in high-incidence areas has decreased,
rabies 18096 is less understood. The prevalence of rabies in China has changed in recent years; the prevalence of rabies in high-incidence areas has decreased, and the occurrence of rabies in low-incidence areas has increased.
rabies 18164 recent years; the prevalence of rabies in high-incidence areas has decreased, and the occurrence of rabies in low-incidence areas has increased. Rabies remains the third major infectious disease-causing death
rabies 18336 major infectious disease-causing death in China. China will continue to be one of the countries where rabies is rampant for many years to come [[18], [32]].Many misdiagnoses have occurred in clinical practice
rabies 18494 misdiagnoses have occurred in clinical practice because of the use of sedatives, which conceal the rabies -specific furious phenomenon, thus affecting the diagnosis of rabies. The patients’ personal habits
rabies 18562 of sedatives, which conceal the rabies-specific furious phenomenon, thus affecting the diagnosis of rabies . The patients’ personal habits also affect the diagnosis of rabies, such as the situation observed
rabies 18631 thus affecting the diagnosis of rabies. The patients’ personal habits also affect the diagnosis of rabies , such as the situation observed for a case reported in Germany in 2004. Because the organ donor had
rabies 18894 the patient’s mental problem was a delusion caused by drug abuse [[22]]. A clinical diagnosis of rabies should be considered in around one-third of patients with paralytic symptoms. Although the rabies detection
rabies 18992 of rabies should be considered in around one-third of patients with paralytic symptoms. Although the rabies detection network has been established to cover the whole country, China’s vast territory implies
rabies 19142 cover the whole country, China’s vast territory implies that economic development is not balanced; rabies cannot be diagnosed in many areas at present, which has led to the under-diagnosis of this condition.
rabies 19272 many areas at present, which has led to the under-diagnosis of this condition. In China, only 1% of rabies cases are confirmed by laboratory tests.Measures for the prevention and control of ROTA in the futureStrengthen
rabies 19446 and control of ROTA in the futureStrengthen publicity and education and improving the diagnosis of rabies It is necessary to strengthen public and health-care professionals’ awareness of tissue and organ-transplant-related
rabies 19571 strengthen public and health-care professionals’ awareness of tissue and organ-transplant-related rabies , to improve the screening of organ donors, and to promote the appropriate prophylaxis of donors with
rabies 19689 the screening of organ donors, and to promote the appropriate prophylaxis of donors with suspected rabies for all types of transplant surgery. There should be awareness of the fact that any suspected animal
rabies 19823 surgery. There should be awareness of the fact that any suspected animal bites are likely to cause rabies , which can also be transmitted through organ transplantation. China remains a country with a serious
rabies 19943 also be transmitted through organ transplantation. China remains a country with a serious epidemic of rabies , and organ transplant patients and health-care professionals at all levels should recognize this possibility.
rabies 20569 transplantation. Concomitantly, it has been proven that timely administration with PEP can prevent and control rabies . In tissue and organ transplant recipients, the use of PEP will also have a preventative effect [[28],
rabies 21073 screening of organ donors should include epidemiological surveys of exposure history and laboratory rabies virus tests.Rabies has typical clinical symptoms, such as hydrophobia, aerophobia, pharyngeal muscle
rabies 21235 as hydrophobia, aerophobia, pharyngeal muscle spasms, and progressive paralysis. Some patients with rabies present mainly with paralysis as the clinical manifestation, accompanied by symptoms of encephalitis,
rabies 21542 convulsions, limb muscle flaccidity, and even paralytic symptoms appear. Therefore, donors who exhibit typical rabies symptoms must be screened for virus infection before organ transplantation. If the donor has symptoms
rabies 21721 transplantation. If the donor has symptoms of encephalitis, regardless of the presence or absence of exposure to rabies , screening should be performed before transplantation. Donors who have no encephalitis symptoms and
rabies 21951 epidemiological studies show an absence of recent exposure to suspected sources of infection can be exempted from rabies screening [[5], [12], [37], [38]].The screening of organ donors presents many limitations regarding
rabies 22119 donors presents many limitations regarding social, biological, and technical aspects. First, in humans, rabies is a rare infectious disease that can be caused by organ transplantation, which is under-detected. There
rabies 22301 which is under-detected. There is currently no country or institution that requires the screening of rabies among donors before organ transplantation surgery. Second, during the incubation period, rabies virus
rabies 22397 of rabies among donors before organ transplantation surgery. Second, during the incubation period, rabies virus infection does not cause symptoms; thus, rabid humans cannot be distinguished from healthy individuals.
rabies 22535 symptoms; thus, rabid humans cannot be distinguished from healthy individuals. Third, patients with rabies often use a variety of treatments, including sedatives, which mask the characteristic rabies symptoms,
rabies 22628 patients with rabies often use a variety of treatments, including sedatives, which mask the characteristic rabies symptoms, and drug addiction can also lead to a misdiagnosis.Among the laboratory-based diagnostic methods,
rabies 22831 diagnostic methods, RT–PCR is a rapid and sensitive method that has been used widely for the detection of rabies virus nucleic acids. A study reported that in cerebrospinal fluid, saliva, urine, and tear samples collected
rabies 22985 cerebrospinal fluid, saliva, urine, and tear samples collected at different times after the onset of rabies , this method did not detect 100% of rabies virus. With the progress of the disease, the specificity
rabies 23028 samples collected at different times after the onset of rabies, this method did not detect 100% of rabies virus. With the progress of the disease, the specificity of the detection decreased. In samples of paralytic
rabies 23144 With the progress of the disease, the specificity of the detection decreased. In samples of paralytic rabies , the detection rate was lower than that observed for furious rabies, and only one among 14 samples used
rabies 23212 decreased. In samples of paralytic rabies, the detection rate was lower than that observed for furious rabies , and only one among 14 samples used for testing was positive. In addition, as the presence of rabies
rabies 23313 rabies, and only one among 14 samples used for testing was positive. In addition, as the presence of rabies virus in biological fluids (such as saliva, spinal fluid, tears and urine) is intermittent, it is necessary
rabies 23553 samples of different types and at different time points. A reliable method to improve the diagnosis of rabies in the laboratory is needed [[39], [40]].In China, many patients are in urgent need of organ transplantation.
rabies 23919 time for testing the donors. Patients and medical personnel have a very superficial understanding of rabies virus transmission via solid organs or tissues allotransplantation and do not take rabies into account.
rabies 24009 understanding of rabies virus transmission via solid organs or tissues allotransplantation and do not take rabies into account. These factors render ROTA a more serious situation in China.We strongly appeal for the
rabies 24146 render ROTA a more serious situation in China.We strongly appeal for the improvement of screening for rabies among organ donors. We propose the establishment of a more reliable laboratory rabies diagnostic method
rabies 24232 screening for rabies among organ donors. We propose the establishment of a more reliable laboratory rabies diagnostic method and the addition of rabies testing to the mandatory list of organ transplant tests,
rabies 24277 propose the establishment of a more reliable laboratory rabies diagnostic method and the addition of rabies testing to the mandatory list of organ transplant tests, to improve the detection of rabies before organ
rabies 24369 addition of rabies testing to the mandatory list of organ transplant tests, to improve the detection of rabies before organ transplantation and avoid the occurrence of ROTA.Suspected cases were protected during
rabies 24517 the occurrence of ROTA.Suspected cases were protected during surgeryIn cases of donors with suspected rabies , an essential biosafety level will be required during the operation. In the course of surgery, medical
rabies 24748 in direct contact with body fluids (such as saliva, blood, and cerebrospinal fluid] of patients with rabies , which contain a large number of copies of virions, and can cause the spread of rabies. Surgical waste
rabies 24835 patients with rabies, which contain a large number of copies of virions, and can cause the spread of rabies . Surgical waste must be subjected to high-pressure sterilization procedures to ensure that rabies virus
rabies 24933 of rabies. Surgical waste must be subjected to high-pressure sterilization procedures to ensure that rabies virus does not pollute the environment [[1], [39]–[41]].Assess exposure risk and initiate PEP to protect
rabies 25330 personnel who are potentially at risk, and initiate the necessary PEP. In the United States, once a case of rabies has been reported, an epidemiological investigation and intervention by the Center for disease Control
rabies 25803 should learn from this example. The saliva, cerebrospinal fluid, urine, and tears of patients with rabies can contain virus. Contact with body fluids containing rabies virus can also cause transmission. After
rabies 25865 fluid, urine, and tears of patients with rabies can contain virus. Contact with body fluids containing rabies virus can also cause transmission. After viral infection, patients should be followed using an acute
rabies 26160 the community staff and relevant health-care workers. According to the exposure level, the risk of rabies among the personnel can be assessed, given the appropriate exposure to prevent the disposal. These steps
rabies 26659 in patients with organ transplantation is also effective [[1]]. In cases of immunosuppressed donors ( rabies immune globulin [RIG] should be used with vaccine), administration of RIG containing viral neutralizing
rabies 26943 [43]]. With the occurrence of corneal transplantation in France, when the donor was discovered to be a rabies patient, the timely removal of the cornea together with administration of RIG and rabies vaccination
rabies 27032 discovered to be a rabies patient, the timely removal of the cornea together with administration of RIG and rabies vaccination aided the survival of the recipient [[44], [45]]. In a case reported in the United States
rabies 27952 to the organ transplant population, which should garner sufficient attention in this field. Canine rabies elimination by mass dog vaccination is still the main way to prevent the happen of rabies in human or
rabies 28042 field. Canine rabies elimination by mass dog vaccination is still the main way to prevent the happen of rabies in human or ROTA. Currently, more direct measures can be taken to prevent the recurrence of ROTA. With

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