Table 3 Paradigm shifts in rabies detection, prevention, control & treatment in the 21st century
Topic | Change | Reference |
|---|---|---|
Etiology | Classical rabies virus recognized as the most important member of the genus, but > 17 putative or recognized lyssaviruses, including highly divergent viral spp. | Fooks et al. 2021 |
Diagnosis | Since the early twentieth century, microscopic recognition of intracytoplasmic ‘viral factories’ within neurons, now supplemented by highly sensitive, specific, and economical tests for rapid ante- and postmortem laboratory confirmation and enhanced point-of-care field surveillance development | World Health Organization (WHO), 2018 |
Pathobiology | In addition to exposure via transdermal, mucosal and aerosol routes, transmission via solid organ and tissue transplantation | Srinivasan et al. 2005 |
Treatment | Survivors, without a history of prior vaccination | Willoughby et al. 2005 |
Safety | Abandonment of nerve tissue-based vaccines by safer alternatives | Gongal & Sampath 2019 |
Vaccine potency | In vitro alternates to the use of animal testing in the NIH test | Stokes et al. 2012 |
Passive immunity | Monoclonal antibodies used increasingly in humans | Sparrow et al. 2019 |
Improvement in biologics | Multiple novel biologics licensed or in human clinical trials | Ertl 2019 |
Prophylaxis | Efficacious and economical dose-sparing and 1-week strategies | WHO Rabies Modeling Consortium 2019 |
Wildlife rabies vaccination | Elimination of rabies in red foxes in western Europe, and Texas gray fox and coyote rabies virus variants in USA | |
One Health | Global program for elimination of human rabies caused via dogs by 2030 | Abela-Ridder et al. 2016 |
Advocacy | Inauguration of World Rabies Day | Centers for Disease Control Prevention (CDC), 2007 |