Rabies Symptoms, Diagnosis, Prophylaxis and Treatment

Dear Colleagues,

Rabies is an acute progressive encephalitis, caused by highly neurotropic lyssaviruses, with the highest case fatality of any infectious disease, yet remains neglected at a global scale, particularly in poor rural areas of Asia, Africa and the Americas.

Recently, staff from FAO (Food and Agriculture Organization of the United Nations), OIE (World Organisation for Animal Health), WHO (World Health Organization) and global opinion leaders met to discuss a path forward for the elimination of human rabies mediated by dogs by 2030, employing a coordinated mass canine vaccination program. In a true One Health context, a transdisciplinary approach is necessary to fulfill such a goal. Not only will success be measured in the proportions of dog populations vaccinated, but also parameters to herald progress by a substantive decrease in human rabies cases.

Therefore, understanding how to better measure and monitor the human rabies burden, make salient progress with existing biologics in medical portfolio, ensure the health economics data remain positive and balance the prevention approach with the expectations and ethics of individual case intervention, are concomitant public health issue, as plans for canine rabies elimination unfold.

Despite being one of the oldest known diseases, questions about rabies abound in the 21st century. For example: Are we missing human rabies fatalities due to changes in clinical manifestations or is there another explanation for the paucity of confirmed cases? Why do people still die of rabies? Do diagnosticians in developed countries expect too much from laboratory workers in GAVI-eligible countries (GAVI: Global Alliance for Vaccines and Immunization)? How can pathogen detection be improved realistically in the field? Is the apparent virulence and pathogenesis of various lyssaviruses different? Can rabies prophylaxis be administered safely without the necessity of rabies-immune globulin? What is being missed in a more holistic approach to rabies treatment? Will the focus upon human rabies alter the prioritization and timetable of canine rabies elimination? Who are the new collective advocates and supporters to move the agenda forward by over the next decade?

In this Special Issue, we will focus upon basic research, clinical studies and case reports that contribute to translational improvements in laboratory-based surveillance, diagnostics, pathobiology, prophylaxis and experimental therapy of human rabies.

We look forward to your provocative contributions on this inter-related topic.

Dr. Charles Rupprecht
Prof. Dr. Bernhard Dietzschold
Guest Editors

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