Rabies vaccines: Journey from classical to modern era

Abstract

Rabies, caused by the neurotropic rabies virus, remains a significant public health concern worldwide. It remains a deadly zoonotic disease with a near 100 % fatality rate once clinical symptoms manifest, causing about 59,000 deaths annually, of which 59.6 % occur in Asia and 36.4 % in Africa. Dog-mediated rabies accounts for over 99 % of human cases. This review provides a comprehensive overview of rabies, covering its epidemiology, pathogenesis, Etiology, and developments in rabies vaccines. Once the virus enters the body through the bite of an infected animal it travels via peripheral nerves to the central nervous system, leading to fatal encephalitis if left untreated. Vaccination of domestic animals plays a pivotal role in preventing transmission to humans. Post-exposure prophylaxis (PEP) remains the cornerstone of rabies prevention in individuals exposed to potentially infected animals, comprising rabies vaccine and Rabies immunoglobulin administration. Advances in molecular virology have shed light on the pathogenesis of rabies, revealing the intricate interactions between the virus and the host immune system. Despite decades of research, treatment options for established rabies infection remain limited, emphasizing the importance of preventive measures. Experimental therapies, including monoclonal antibodies and novel antiviral agents, promise to improve outcomes in rabies patients. Regardless of the established efficacy of rabies vaccines, challenges remain in ensuring widespread accessibility and coverage, particularly in resource-limited regions. Strategies to enhance pre-exposure prophylaxis with affordable vaccine delivery are essential for achieving global rabies control and elimination goals, underscoring the need for sustained surveillance, vaccination, and public awareness efforts. Continued research into the virology and immunology of rabies is essential for the development of novel interventions to combat this deadly disease.