Current issues in human rabies immunization

Rabies infection in humans is still a major public health problem, causing upwards of 20,000 deaths per year. The prevalent vaccine is still the nerve-tissue vaccine, which, although improved, necessitates the use of long and painful application schedules and fails to provide safe and reaction-free protection. A new generation of low-cost, purified rabies vaccines released in the last 2 years promises a revolution in rabies immunization in less-developed, rabies endemic countries, providing protection comparable to that of human diploid cell vaccine at the cost of Semple-type vaccine. Devising an appropriate technology for human rabies immunization includes new regimens of administration, one of which, a revised intramuscular regimen requiring only four doses and three clinic visits, proved highly efficient for postexposure treatment.