1
|
Cravedi P, Schold JD, Safa K, Kates OS, Elfadawy N, Mannon RB, Shah MB, Hammond SP, Avery R, Guerrero Miranda C, Riella LV, Jowsey-Gregoire S, Akalin E, Camirand G, Alegre ML, Azzi J. The COVID-19 pandemic: A community approach. Clin Transplant 2020; 34:e14059. [PMID: 32762055 PMCID: PMC7435543 DOI: 10.1111/ctr.14059] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 07/29/2020] [Indexed: 12/23/2022]
Abstract
An unprecedented global pandemic caused by a novel coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) has quickly overwhelmed the health care systems worldwide. While there is an absence of consensus among the community in how to manage solid organ transplant recipients and donors, a platform provided by the American Society of Transplantation online community “Outstanding Questions in Transplantation,” hosted a collaborative multicenter, multinational discussions to share knowledge in a rapidly evolving global situation. Here, we present a summary of the discussion in addition to the latest published literature.
Collapse
Affiliation(s)
- Paolo Cravedi
- Department of Medicine, Translational Transplant Research Center, Icahn School of Medicine at Mount Sinai, New York City, NY, USA
| | - Jesse D Schold
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA
| | - Kassem Safa
- Transplant Center and Division of Nephrology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Olivia S Kates
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA
| | - Nissreen Elfadawy
- Division of Nephrology, Hypertension and Kidney Transplant, Department of Medicine, Case Western Reserve University and University Hospitals, Cleveland, OH, USA
| | - Roslyn B Mannon
- Division of Nephrology, Department of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Malay B Shah
- Division of Transplantation, Department of Surgery, University of Kentucky Medical Center, Lexington, KY, USA
| | - Sarah P Hammond
- Division of Infectious Diseases, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Robin Avery
- Division of Infectious Diseases, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | | | - Leonardo V Riella
- Transplanation Research Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Enver Akalin
- Albert Einstein College of Medicine, Montefiore Medical Center, New York City, NY, USA
| | - Geoffrey Camirand
- The Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical, Pittsburgh, PA, USA
| | | | - Jamil Azzi
- Transplanation Research Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
2
|
Epidemiology of rabies cases among international travellers, 2013-2019: A retrospective analysis of published reports. Travel Med Infect Dis 2020; 36:101766. [PMID: 32525075 DOI: 10.1016/j.tmaid.2020.101766] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/18/2020] [Accepted: 05/30/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Sixty cases of rabies in international travellers from 1990 to 2012 were previously reviewed. We present here an update of rabies cases in international travellers from 2013 to 2019. METHODS We systematically reviewed the existing literature and collected 23 cases of rabies in individuals who crossed an international border between the time of infection and diagnosis, or who were infected following expatriation or migration. RESULTS Most cases were in male adult travellers and diagnosed in Europe and the Middle East, with most exposures in Asia or in Africa. Migrants originating from rabies-endemic low-and-middle income countries and their descendants accounted for two thirds of cases. Other cases were in tourists, business travellers and expatriates. Median travel duration (excluding migration trip) was 60 days (range 7-240 days). Most cases were due to dog bites and most common clinical presentation was furious rabies. In most patients (74%), no rabies post-exposure prophylaxis (RPEP) was administered before rabies symptoms appeared. Other patients received incomplete RPEP series. CONCLUSION Rabies should be suspected in any patient with encephalitis or paralysis who travelled to, or migrated from a rabies-endemic country. Comprehensive information about a rabies risk should be given to travellers to rabies endemic countries, notably migrants visiting friends and relatives.
Collapse
|
3
|
Modern biologics for rabies prophylaxis and the elimination of human cases mediated by dogs. Expert Opin Biol Ther 2020; 20:1347-1359. [PMID: 32370562 DOI: 10.1080/14712598.2020.1766021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Introduction: Rabies is a major viral zoonosis and neglected tropical disease, with a global distribution. Humans, domestic animals, and wild mammals are susceptible to infection. Etiological agents reside in the Order Mononegavirales, Family Rhabdoviridae, Genus Lyssavirus. This acute, progressive encephalitis causes the highest case fatality of any conventional infectious disease. Tens of millions of humans become exposed annually to the bites of infected mammals, predominantly in Asia and Africa. Despite the existence of effective vaccines and immune globulins, tens of thousands of people, typically children in the developing world, succumb. Areas covered: Concentrating upon both historical and major published references from the peer-reviewed literature over the past 5 years, we describe current biologics for rabies prevention, newly recommended principles for prophylaxis, and relevant future products in the developmental pipeline. Expert opinion: Modern human rabies biologics are pure, potent, safe, and efficacious, when used in a timely and appropriate manner. Few individuals survive after clinical signs. Anti-viral compounds are not licensed. Experimental therapy, while obviously desirable, is highly controversial. Education on bite prevention and integrated risk management are critical. Access to affordable care, dose-sparing, and shortened regimens of human rabies biologics remain key.
Collapse
|