Rabies

Rabies is a viral zoonosis and carnivores such as foxes and racoons, as well as many bat species, are wildlife hosts of the rabies virus in nature. Globally, in terms of human disease, dogs represent the most important reservoir. Infection of humans usually follows bites by rabid animals and is almost invariably fatal once signs of disease occur. More than 2.5 billion people live in regions where rabies is endemic. It is estimated that each year at least 50000 people die from rabies, and more than 10 million received post-exposure vaccination against this disease. Children aged 5-15 years are at particular risk. More than 99% of all human deaths from rabies occur in Asia, Africa and south America; India alone reports 30 000 deaths annually.

For more than 100 years, rabies vaccines of nerve tissues origin have been used for vaccination of humans following exposure to rabid animals. These vaccines are considered inexpensive, but are of relatively low potency per dose, and those produced on sheep or goat brain are frequently associated with serious adverse events. Many of the poor populations most at risk of contracting rabies still depend on nerve tissue vaccines, whereas in affluent populations safe and highly efficacious rabies vaccines produced in cell culture (hereafter referred to as cell-derived rabies vaccines) have been available for 20-30 years. Cell-derived vaccines are used not only for post-exposure treatment, but also for pre-exposure (pre-emptive) protection of persons at risk.

In many countries very potent veterinary rabies vaccines are produced and widely applied for immunization of domestic animals (mostly dogs and cats), and in industrialized countries oral vaccines are used for the immunization of wildlife hosts of rabies virus. So far, however, attempts at controlling animal rabies have largely failed in most poor regions of the world.

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