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[Rabies].

Perrine Parize1, Laurent Dacheux1, Hervé Bourhy1

  • 1Centre national de référence de la rage, centre collaborateur de l'Organisation mondiale de la santé de référence et de recherche pour la rage, unité « Lyssavirus, épidémiologie et neuropathologie », Institut Pasteur, Paris, France.

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Rabies is a deadly viral zoonosis. In France, terrestrial animal rabies is eliminated, making post-exposure prophylaxis (PEP) unnecessary except for bat exposures or travel to rabies-endemic areas like French Guiana.

Keywords:
Rabiesepidemiologyinfectious disease medicine

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Area of Science:

  • Veterinary Medicine
  • Infectious Diseases
  • Public Health

Background:

  • Rabies, a viral zoonosis, causes significant human mortality globally, particularly in regions with uncontrolled dog rabies and limited access to post-exposure prophylaxis (PEP).
  • France has experienced a favorable epidemiological shift, with terrestrial animal rabies eradicated since 2001.
  • This epidemiological change impacts the necessity and guidelines for rabies PEP administration.

Purpose of the Study:

  • To evaluate the current necessity of rabies post-exposure prophylaxis (PEP) in France.
  • To inform public health policies regarding rabies prevention in light of changing epidemiology.

Main Methods:

  • Review of rabies epidemiology in France over the past 20 years.
  • Analysis of rabies transmission risks associated with different animal species and geographical regions.

Main Results:

  • France has been declared free of terrestrial animal rabies since 2001.
  • The risk of rabies transmission from terrestrial animals within France is negligible.
  • Rabies risk persists in specific contexts, including exposure to bats and travel to rabies-endemic areas such as French Guiana (desmodin-type rabies).

Conclusions:

  • Routine post-exposure prophylaxis (PEP) for rabies is no longer justified for exposures to terrestrial animals in mainland France.
  • PEP remains indicated for bat exposures in France and for individuals traveling to or returning from rabies-endemic regions.
  • Updated guidelines are necessary to reflect the current rabies-free status of terrestrial animals in France.