Webinar broadcasts RITA's 2nd international rabies symposium

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On October 9, 2015, as a part of the Rabies in the Americas (RITA) conference, Dr. Charles Rupprecht, Professor (adjunct) at the Wistar Institute, and Peter Costa, Associate Executive Director, One Health Commission, hosted a team of international rabies experts from academia and private and public health institutions to speak at the Symposium on Human Rabies Prevention and Treatment. This symposium provided a forum for discussing current and future directions in the fields of human rabies surveillance, diagnosis, prevention, and treatment, in the context of One Health. The presentations were broadcast globally as a webinar, providing continuous education credits and extending the benefits of the international conference in real time to many public health professionals around the globe.

Dr. Rupprecht, the outgoing President of the RITA international steering committee, opened the symposium with a brief summary of the current knowledge of rabies pathobiology, epidemiology, epizootiology and expanded on the existing state of human rabies prevention tools. He emphasized the critical need for evaluation and implementation of shorter, lower-dose prophylactic regimens (including alternative routes of administration), as well as the importance of escalating the development of affordable, efficacious novel biologics (particularly via emerging local producers in developing countries) within the next decade.

The intricacies of public health challenges in rabies prevention and animal management as well as effective approaches to overcome them were discussed using practical examples from the field by Dr. Jennifer House, a State Public Health Veterinarian from Colorado.

Dr. Robin Lewis, Deputy Director of the Office of Vaccine Research and Review at the United States Food and Drug Administration, presented on benefits, drawbacks, and limitations of human rabies vaccines and potency assays used for their evaluation. Dr. Lewis reported on ongoing studies and future strategies that were agreed upon during a recent EPAA rabies working group workshop. An ELISA-based potency assay that measures the rabies virus G glycoprotein was suggested as the most promising alternative to the current NIH potency test.

Two major directions for the future development of rabies laboratory diagnostic technologies were elaborated on by Dr. Richard Franka, Director of the OIE Reference Laboratory for Rabies at the Centers for Disease Control and Prevention (CDC). First, there is a critical need for rapid, low-tech field tests with high specificity and sensitivity, such as the direct rapid immunohistochemistry test (DRIT) and lateral flow assays, to be validated and distributed widely in canine rabies-endemic countries to promote continuous enhanced surveillance and rapid laboratory-based PEP decision-making. Second, high-throughput technologies for detection of viral RNAs, other indicators of infection, and rabies-virus-specific antibodies are essential for enhanced characterization of pathogen distribution, monitoring for variants potentially not neutralized by commercially available biologics, vaccination status confirmation, and early identification of human rabies cases.

The uneasy path of trial and error in human rabies experimental treatment approaches was eloquently summarized by Dr. Rodney Willoughby, of the Children’s Hospital of Wisconsin. Dr. Willoughby emphasized that the time is right for randomized clinical trials to properly evaluate various biological drug, thermal, pharmacological, immunotherapeutic, and molecular-biology-standardized strategies for human rabies treatment.

Dr. Zhen Fu, discussed the role of virus-neutralizing antibodies in clearing rabies virus from the CNS and their potential use as a part of therapy.

The Symposium on Human Rabies Prevention and Treatment uniquely combined the most recent developments and innovations in the field with practical approaches for rabies prevention readily transferrable to every village, town, or city where rabies remains a daily scare.

Overall, 855 participants from 52 countries from Africa, Asia, Europe, and North and South America attended the symposium either in person (60 participants) or online (795 participants). In addition, 353 participants have viewed the archived recording. Afterwards, 94.7% of attendees confirmed that the webinar significantly contributed to their professional knowledge, and 94.4% indicated their interest in attending more rabies webinars.

Given the success of this webinar, the global nature of rabies and the challenges of attending international conferences for most public health professionals, globally broadcasted symposiums may be the future of rabies conferencing and we, the organizing committee, will do our best to make it happen again in 2016.

Contributed by Richard Franka (CDC), Peter Costa (One Health Commission) and Charles Rupprecht (Wistar Institute). More information about the presenters and abstracts are available on the One Health Commission website, and you can view the webinar recording using this link. The organizers wish to thank the webinar sponsors: Colorado State University, Grifols, Kedrion Biopharma and Merial.