World Health Organ Tech Rep Ser. 2005;931:1-88, back cover.
More than 99% of all human rabies deaths occur in the developing world, and although effective and economical control measures are available, the disease has not been brought under control throughout most of the affected countries. Given that a major factor in the low level of commitment to rabies control is a lack of accurate data on the true public health impact of the disease, this report of a WHO Expert Consultation begins by providing new data on the estimated burden of the disease and its distribution in the world. It also reviews recent progress in the classification of rabies viruses, rabies pathogenesis and diagnosis, rabies pre- and post-exposure prophylaxis, the management of rabies patients, and canine as well as wildlife rabies prevention and control. Considering the emergence of new lyssaviruses and changes in animal and human rabies epidemiology observed on different continents, the definition of a rabies-free country or area has been revised to assist public health authorities in better assessing the risk of human rabies resulting from contact with animals. Measures aiming at preventing the spread of rabies through the international transfer of animals, mainly with regard to pets, are discussed as well as the new systems in place within and outside WHO to share rabies data and information. As certain tools currently used in rabies prevention and control, such as biologicals, tests for intra vitam and postmortem diagnosis, vaccines and immunoglobulin quality control, need improvement, the report ends by outlining the priorities for basic research, as well as those for operational research for sustainable canine rabies control, including dog population management schemes complying with animal welfare principles. Such operational research is necessary for removing or alleviating the main constraints to rabies control in dogs, as these are the source of most human rabies cases worldwide.
超过99%的人类狂犬病死亡病例发生在发展中世界，尽管有有效且经济的控制措施，但在大多数受影响国家，该疾病仍未得到控制。鉴于对狂犬病控制投入不足的一个主要因素是缺乏关于该疾病对公共卫生真正影响的准确数据，世卫组织专家磋商的这份报告首先提供了关于该疾病估计负担及其在世界范围内分布的新数据。报告还回顾了狂犬病病毒分类、狂犬病发病机制与诊断、狂犬病暴露前和暴露后预防、狂犬病患者管理以及犬类和野生动物狂犬病预防与控制方面的最新进展。考虑到不同大陆出现了新的狂犬病病毒以及动物和人类狂犬病流行病学的变化，对无狂犬病国家或地区的定义进行了修订，以协助公共卫生当局更好地评估因接触动物而导致人类感染狂犬病的风险。讨论了旨在防止狂犬病通过动物国际转移（主要涉及宠物）传播的措施，以及世卫组织内部和外部用于共享狂犬病数据和信息的新系统。由于目前狂犬病预防和控制中使用的某些工具，如生物制品、生前和死后诊断检测、疫苗和免疫球蛋白质量控制等需要改进，报告最后概述了基础研究的优先事项以及可持续犬类狂犬病控制的运筹学优先事项，包括符合动物福利原则的犬类种群管理方案。这种运筹学对于消除或减轻犬类狂犬病控制的主要制约因素是必要的，因为犬类是全球大多数人类狂犬病病例的源头。
