Evaluates new knowledge from basic and applied research on rabies in terms of its relevance to the prevention and control of this disease. Noting the many new tools now available for both clinical and field application, the report issues advice and recommendations intended to help national control authorities bring their policies - whether concerning first-choice vaccines or procedures for quarantine - in line with the latest scientific knowledge. The report also identifies specific research problems that need to be solved in the drive to develop more sensitive diagnostic techniques, to improve the immunogenicity and cost-effectiveness of vaccines, and to eliminate rabies in canine and wild animal populations. Information is presented in eleven sections. The first reviews recent advances in rabies research, including progress in understanding the molecular structure and genetics of lyssaviruses, significant strides forward in methods for the production and delivery of vaccines, the development of several unique recombinant vaccines, and the potential use substances such as monoclonal antibodies, interferon, and interferon-inducers for post-exposure treatment. The second section, devoted to diagnosis, evaluates existing and evolving techniques for diagnosis in animals and humans and for the characterization of virus strains. Recent improvements in human and veterinary rabies vaccines are reviewed in the third section, which features extensive information on the quality controls that must be followed during production and the safety and potency tests that must be performed on each vaccine batch before its release. The report also strongly recommends that encephalitogenic vaccines derived from brain tissue be replaced, as soon as possible, with vaccines prepared in cell culture. Other sections bring readers up-to-date on the status of WHO reference materials for potency testing of vaccines and immunoglobulins, and outline procedures for the licensing and testing, prior to release, of inactivated tissue culture vaccines. In view of the extremely high fatality rate of human rabies, information on prevention is especially detailed. Practical advice includes recommended immunization schedules for the prtection of individuals at high risk of exposure, guidelines for post-exposure treatment, and an explanation of the factors to consider when deciding whether or not to initiate post-exposure treatment. The treatment of confirmed rabies in humans, although almost inevitably fatal, is also briefly discussed. Strategies for rabies prevention are further detailed in sections describing new approaches to the control of rabies in dogs and wild animal populations. Drawing upon lessons learned in several large mass immunization campaigns, the report explains how the recently developed oral vaccination technique can be used to control the disease in foxes, racoons, other wild animals, and possibly also in dogs. The report further concludes that the removal and destruction of dogs and wildlife should no longer be carried out on a large scale, as such an approach has never been shown to have a significant, long-term impact on either population densities or the spread of rabies. The final main section issues recommendations, in line with new knowledge, for the international transfer of animals, including guidelines for the possible reduction of quarantine procedures and a recommended special exemption for guide dogs for the blind. Further practical advice is set out in a series of eight annexes, which provide guidelines for the testing of vaccines, post-exposure treatment, the format of vaccination certificates, the use of a standard reporting form to record data on exposed humans, and the design of a national programme for the control of rabies in dogs.

eng fre rus spa.

nep por.

WHODOC

WHO monograph

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