RESUMO
Since its introduction to the market in 1985, mefloquine has been used for malaria chemoprophylaxis by more than 35 million travellers. In Europe, in 2014, the European Medicines Agency (EMA) issued recommendations on strengthened warnings, prescribing checklists and updates to the product information of mefloquine. Some malaria prevention advisors question the scientific basis for the restrictions and suggest that this cost-effective, anti-malarial drug will be displaced as a first-line anti-malaria medication with the result that vulnerable groups such as VFR and long-term travellers, pregnant travellers and young children are left without a suitable alternative chemoprophylaxis. This commentary looks at the current position of mefloquine prescribing and the rationale of the new EMA recommendations and restrictions. It also describes the new recommendations for malaria prophylaxis that have been adapted by Switzerland, Germany, Austria and Italy where chemoprophylaxis use is restricted to high-risk malaria-endemic areas.
Assuntos
Antimaláricos , Malária , Mefloquina , Antimaláricos/uso terapêutico , Quimioprevenção/métodos , Contraindicações , Europa (Continente) , Humanos , Malária/tratamento farmacológico , Malária/prevenção & controle , Mefloquina/uso terapêuticoAssuntos
Controle de Doenças Transmissíveis/organização & administração , Doenças Transmissíveis/epidemiologia , Surtos de Doenças/prevenção & controle , Saúde Global , Viagem , Dengue/epidemiologia , Países Desenvolvidos , Países em Desenvolvimento , Promoção da Saúde/organização & administração , Humanos , Virus da Influenza A Subtipo H5N1 , Influenza Humana/epidemiologia , Risco , Fatores de Risco , Síndrome Respiratória Aguda Grave/epidemiologiaRESUMO
Rabies is a zoonotic viral disease, transmitted only in mammals. Terrestrial rabies, predominantly transmitted by dogs, is the most important rabies cycle threatening humans. The causative neurotropic virus is a negative-stranded RNA virus of the family Rhabdoviridae, genus Lyssavirus. This genus contains several rabies-related viruses. All variants are known or suspected to cause rabieslike diseases. Transmission occurs by the virus entering through the skin or the mucosa after bites, scratches, or preexisting injuries contaminated by the saliva of an infected mammal. Only 51 human rabies cases that have not been transmitted by animal bites are described.