biopreparatБИОпрепараты. Профилактика, диагностика, лечениеBiological Products. Prevention, Diagnosis, Treatment2221-996X2619-1156Scientific Centre for Expert Evaluation of Medicinal Products10.30895/2221-996X-2019-19-1-10-16biopreparat-208Research ArticleОБЗОРЫREVIEWSСовременные проблемы вакцинопрофилактики бешенстваCurrent Challenges of Preventive Vaccination Against Rabieshttps://orcid.org/0000-0003-2132-0962МовсесянцА. А.MovsesyantsA. A.

д-р мед. наук, профессор, начальник Испытательного центра экспертизы качества МИБП ФГБУ «НЦЭСМП» Минздрава России

Doctor of Medical Sciences, Professor, Head of the Testing Centre for Evaluation of Medicinal Immunobiological Products’ Quality of the Scientific Centre for Expert Evaluation of Medicinal Products

movsesyants@expmed.ruhttps://orcid.org/0000-0001-7652-4642ОлефирЮ. В.OlefirYu. V.

д-р мед. наук, старший научный сотрудник, генеральный директор ФГБУ «НЦЭСМП» Минздрава России

Doctor of Medical Sciences, Senior Research Associate, General Director of the Scientific Centre for Expert Evaluation of Medicinal Products

olefir@expmed.ruФедеральное государственное бюджетное учреждение «Научный центр экспертизы средств медицинского применения» Министерства здравоохранения Российской ФедерацииРоссияScientific Centre for Expert Evaluation of Medicinal ProductsRussian Federation2019250220191911016Copyright © Мовсесянц А.А., Олефир Ю.В., 20192019Мовсесянц А.А., Олефир Ю.В.Movsesyants A.A., Olefir Y.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.biopreparations.ru/jour/article/view/208

Актуальность проблемы бешенства для всего человечества, поиск новых путей искоренения инфекции привели к созданию новой глобальной системы для ликвидации бешенства – «Объединенные против бешенства», поставившей перед собой чрезвычайно амбициозную задачу по достижению нулевого уровня смертности людей от гидрофобии во всем мире к 2030 году. Принимая во внимание предыдущий многолетний мировой опыт уничтожения безнадзорных собак, на долю которых приходится 99 % случаев гидрофобии, что не привело к желаемому результату, в настоящее время взят курс на массовую вакцинацию собак (не менее 70 % популяции животных). Проблема бешенства комплексная, без усилия всех заинтересованных служб, серьезных финансовых затрат вряд ли удастся решить такую глобальную задачу. Материалы данной статьи являются результатом постоянного многолетнего анализа ситуации по бешенству в мире и в Российской Федерации, анализа современного состояния проблемы вакцинопрофилактики бешенства, которая играет огромную, если не ведущую, роль в предупреждении развития гидрофобии у людей, пострадавших от укусов больных бешенством животных. Сформулированы основные направления решения проблемы заболевания бешенством на современном этапе, а именно: массовая вакцинация собак; совершенствование схем и методов применения антирабических препаратов; изучение закономерностей образования иммунного ответа у лиц с ослабленным иммунитетом; постепенное внедрение в практику вакцинации людей, пострадавших от укусов больных бешенством животных, альтернативных методов введения препаратов; разработка экспресс-системы определения титров вируснейтрализующих антител; повышение уровня информированности населения об опасности заболевания.

The urgency of the rabies problem for all mankind and the search for new ways of eradicating the disease entailed the creation of a new global initiative for rabies elimination ‒ «United Against Rabies» which sets a highly ambitious goal of achieving zero rabies human deaths by 2030. The many years of international experience in elimination of street dogs, which account for 99 % of rabies cases, did not produce the desired results, therefore the focus was shifted to mass vaccination of dogs (minimum 70 % of dog population). The rabies problem is complex and global, it requires efforts from all the parties involved as well as hefty investment. The paper presents the results of a continuous long-term analysis of the rabies situation in Russia and across the world, as well as analysis of the current state of vaccination against rabies which plays an important, if not crucial, role in prevention of rabies in humans who got bitten by infected animals. The paper formulates the main currently existing ways of solving the rabies problem, namely: mass vaccination of dogs; improvement of dosing schedules and administration routes of medicines against rabies; analysis of immunity development mechanisms in immunocompromised patients; progressive implementation of vaccination of people who got bitten by infected animals, and alternative administration routes; development of an express method of the neutralising antibody titer determination; raising public awareness about disease hazards.

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The authors declare that there are no conflicts of interest present.