RABIES IN FRANCE 100 YEARS AFTER PASTEUR

Pasteur's vaccination, a huge step forward in infectiology, remains th e fundamental element in the fight against rabies. Since 1968, when ra bid foxes reappeared in France there have been no domestic cases of hu man rabies, but from 1970 to 1993, 14 patients contaminated in enzooti c areas (usually Africa) died from rabies in France. The new circulati on conditions created by the European Union emphasizes the importance of the inactivated Pasteur vaccin cultivated on Vero cell lines. The c lassic protocol for post-exposure vaccinations is based on 5 intramusc ular injections on day 0, 3, 7, 14 and 30. In 1988, the World Health O rganization established new recommendations: the 2-1-1 schedule for po st-exposure vaccination. Two injections are given on day 0 at two diff erent sites followed by boosters on day 7 and day 21. Tested worldwide by independent laboratories, this schedule has been shown to effectiv ely induce seroconversion when modern cell-culture vaccins are used. A lthough there is still a certain amount of debate on the new schedule, no failures have been recorded. The Centers for Disease Control in At lanta recommend preventive vaccination for exposed professions based o n primary and booster injections on day 0, 7, 28 and 365. Protection l asts for 3 years and may be prolonged with supplementary vaccinations. One hundred years ago, Pasteur taught us that we could protect the hu man population by fighting against animal contamination. Today's progr ess is the reward of such forsight - and a challenge to both human and veterinary medicine.