Henry Wilde, Pakamatz K, Thiravat H.
Rabies in Asia: 2004.
Infect Dis J Jan ;13(1):14-7.
Rabies remains a public health problem in spite of the fact that we have the knowledge and tools to eliminate this disease as a human threat. Lack of motivation by governments, cultural issues and lack of funding are remaining barriers. This is amazing since the number of human rabies deaths worldwide is greater than that from polio, meningococcal meningitis, Japanese encephalitis, yellow fever, SARS, bird flu and other scourges that attract more public attention. Safe and effective tissue and avian culture vaccines are now widely available. Reduced dose WHO approved, effective and economical post-exposure treatment regimens have helped eliminate nerve tissue vaccines in Thailand, Philippines and Sri Lanka. Immediate wound cleansing and the use of a potent vaccine will save the majority of infected persons. Human or equine rabies immunoglobulin, injected into and around bite wounds, provides added safety for the severely exposed. The high cost of rabies biologicals is still a problem, but new manufacturers and the use of intradermal vaccination schedules should bring down expenses. Ultimately, it is the need to control rabies in dogs that should occupy most of our attention. Here, the tools are also available but attitudes must change before they can be applied. There have been many new developments since publication of the last WHO rabies expert committee report in 1992. This essay will review some that have practical applications.
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