An Important Public Health Problem as yet Unsolved in the World and Our Country: Rabies

Rabies, a fatal viral zoonotic infectious disease, persists in both developed and developing countries worldwide in spite of successful preventive public health measures and postexposure therapies. Each year, an estimated 55.000 people die of rabies in Africa and Asia where infection is endemic in dogs. The World Health Organization (WHO) has indicated that approximately 45% of these victims are children under the age of 15 years. The incidence of rabies has decreased significantly in developed countries, following mandatory vaccination of all domestic animals. Rabies is an acute, progressive, viral encephalitis usually resulting in death. The causative agents are neurotropic RNA viruses of the Rhabdoviridea family, genus Lyssa virus. The virus is present in saliva and is transmitted by bites or, rarely, by contamination of mucosa or skin lesions by saliva or other potentially infectious material (eg, neural tissue). In addition, the transmission of rabies has been described in patients receiving organ transplants (eg, corneal transplant). Prevention of the disease is very important because most human cases of rabies are fatal and no specific therapy is available. Rabies postexposure prophylaxis, which is highly effective if given promptly, includes wound cleansing, immunization with modern cell culture vaccine, and administration of human rabies immunoglobulin (HRIG). The aim of this review is to review the current concept of the epidemiology, diagnosis, prevention, and control of rabies.