[Rabies in France, 100 years after Pasteur].

Pasteur's vaccination, a huge step forward in infectiology, remains the fundamental element in the fight against rabies. Since 1968, when rabid foxes reappeared in France there have been no domestic cases of human rabies, but from 1970 to 1993, 14 patients contaminated in enzootic areas (usually Africa) died from rabies in France. The new circulation conditions created by the European Union emphasizes the importance of the inactivated Pasteur vaccine cultivated on Vero cell lines. The classic protocol for post-exposure vaccinations is based on 5 intramuscular injections on day 0, 3, 7, 14 and 30. In 1988, the World Health Organization established new recommendations: the 2-1-1 schedule for post-exposure vaccination. Two injections are given on day 0 at two different sites followed by boosters on day 7 and day 21. Tested worldwide by independent laboratories, this schedule has been shown to effectively induce seroconversion when modern cell-culture vaccines are used. Although there is still a certain amount of debate on the new schedule, no failures have been recorded. The Centers for Disease Control in Atlanta recommend preventive vaccination for exposed professions based on primary and booster injections on day 0, 7, 28 and 365. Protection lasts for 3 years and may be prolonged with supplementary vaccinations. One hundred years ago, Pasteur taught us that we could protect the human population by fighting against animal contamination. Today's progress is the reward of such foresight--and a challenge to both human and veterinary medicine.