New Rabies Test May Transform Animal-Bite Treatment

Modesto Morganelli
Mag 17, 2018

The US Centers for Disease Control and Prevention (CDC) announced today that they are developing a more accurate rapid diagnostic test for rabies that can deliver results in 2 hours.

The CDC-developed test - called LN34 - is highly accurate and produces results more quickly and cost-effectively than current methods, according to the agency.

Crystal Gigante, Ph.D., a microbiologist in CDC's Division of High-Consequence Pathogens and Pathology and the study's first author, said "The LN34 test has the potential to really change the playing field".

Quickly knowing who needs to receive rabies treatment - and who does not - will save lives and families' livelihoods. The disease is nearly always fatal once clinical signs of infection appear and supportive treatment is the only option.

The DFA test is now the gold-standard and only internationally-approved test for rabies; however, according to the CDC, the DFA, "can only be interpreted by laboratory workers with special skills, extensive training, and a specific type of microscope". In these countries, equipment for testing and rabies vaccine supplies are often held in centralized urban areas, several days' travel from where someone is bitten - and rabies vaccine can cost several months' salary.

Another advantage of the LN34 test: it doesn't require complex training. And it can produce reliable results whether the animal tissue probed is fresh, frozen or decomposed, the researchers said.

All samples testing positive with DFA were also positive with LN34, according to the CDC press release, which did not indicate the false-positive rate (those data were to be in a PLOS One paper to be released later Wednesday) but said it was lower than with DFA. Standard practice now is to vaccinate anyone who might possibly have been exposed to a possibly rabid animal.

A dog gets a rabies vaccination
GETTYA dog gets a rabies shot in India

Once symptoms appear, rabies is almost always fatal, claiming the lives of roughly 60,000 people worldwide each year.

During a pilot study, it produced no false negatives, fewer false positive, and fewer inconclusive results.

Moreover, LN34 could decrease the number of inconclusive and false positive tests, thus eliminating unnecessary vaccine use. "Only one sample was indeterminate using both tests", the CDC said.

The New York State Department of Health plans on implementing the new test in state labs after a few more cases are reviewed. About 40,000-50,000 people get rabies PEP in the United States annually.

Therefore, global organizations such as the World Health Organization and the World Organizations for Animal Health are in the process of considering the use of PCR-based tests as stand-alone tests for the diagnosis of rabies.

CDC is working with the Association of Public Health Laboratories to develop rabies testing guidance that will help clinicians and laboratory staff decide which tests to run in different scenarios and which tests can be used to confirm rabies, either singly or in combination with other tests.

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