The incurable wound revisited: progress in human rabies prevention?

Rabies is the most important viral zoonosis from a global perspective. Mode rn human postexposure prophylaxis consists of potent vaccines and local inf iltration of rabies immune globulins (RIGs), but the latter biologicals are not widely available or affordable. Monoclonal antibodies (Mabs) offer sev eral theoretical advantages over RIGs. To this end, several human and equin e RIGS. alone or in combination with vaccine, were investigated for postexp osure efficacy in a Syrian hamster model, compared with a single neutralizi ng murine Mab. Preliminary results suggest that: (1) animal models continue to provide utility as human surrogates in the demonstration of product eff icacy against rabies; (2) RIG preparations differ substantially in experime ntal effectiveness and clearance; and (3) relevant alternatives, such as Ma bs, should be pursued for future improvements to human rabies prevention. P ublished by Elsevier Science Ltd.