Rabies research in resource-poor countries.

Many cost-benefit/effective rabies research projects need to be carried out in less-developed canine-endemic regions. Among these are educational approaches directed at the public and governments. They would address effective primary wound care, availability, and proper use of vaccines and immunoglobulins, better reporting of rabies, final elimination of dangerous nerve tissue-derived vaccines, and the recognition that rabies is still expanding its geographic range. Such efforts could also reduce deaths in victims who had received no or less than adequate postexposure prophylaxis. There is a need for new technology in canine population control and sustainable vaccination. We have virtually no workable plans on how to control bat rabies, particularly that from hematophagous bats. Preexposure vaccination of villagers in vampire rabies-endemic regions may be one temporary solution. Current efforts to reduce further the time required and vaccine dose required for effective postexposure vaccination need to be encouraged. We still have incomplete understanding of the transport channels from inoculation site to rabies virus antibody generating cells. The minimum antigen dose required to achieve a consistently protective and lasting immune response has been established for intramuscular vaccine administration, but is only estimated for intradermal use. Greater knowledge may have clinical benefits, particularly in the application of intradermal reduced dose vaccination methods. Curing human rabies is still an unattained goal that challenges new innovative researchers.