Rabies].

Florence Ribadeau-Dumas, Laurent Dacheux, Hervé Bourhy

Institut Pasteur, centre national de référence de la rage, centre collaborateur de l'Organisation mondiale de la santé (OMS) de référence et de recherche pour la rage, unité dynamique des lyssavirus et adaptation à l'hôte, 25, rue du Docteur Roux, 75724 Paris Cedex 15, France. florence.ribadeau-dumas@pasteur.fr

Médecine sciences : M/S 2013 Jan

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Rabies virus, a neurotropic lyssavirus responsible for unavoidable fatal encephalitis, is transmitted by saliva of infected animals through bite, scratch or licking of broken skin or a mucous membrane. Infection can be prevented by timely prevention (wash for several minutes, antisepsis and vaccination completed by antirabies immunoglobulins [Ig] according to the severity of exposure). The 55,000 human deaths estimated annually worldwide result mainly from uncontrolled canine rabies in enzootic countries (particularly in Africa and in Asia), attributable to a lack of resources or interest for this disease. Bat rabies, henceforth first cause of human's rabies in many countries in America, affects a very small number of individuals but seems more difficult to control. Shortened vaccine protocols, rationalized use of Ig and development of products of substitution should enhance access of exposed patients to prevention. Finally, research on the biological cycle, the pathogeny and on escape of virus-induced mechanisms from the immune system should continue to pave the way for presently unknown treatments of clinical rabies. © 2013 médecine/sciences – Inserm / SRMS.