摘要：

Rabies in humans most often results from the bite of an infected animal; other modes of transmission are extremely rare. There is a long incubation period, and once the disease becomes clinically apparent, with signs and symptoms that may include hydrophobia, hyperactivity, and hypersalivation, it is virtually always fatal. In the US today, human rabies is relatively rare, owing in part to highly successful vaccination and animal control campaigns that have virtually eliminated the disease among dogs. However, as rabies among dogs, the traditional source of rabies in humans, has declined, rabies among wildlife, including raccoons, skunks, bats, and foxes, has risen. Rabies among bats has had the greatest impact on humans: Since 1980, rabies virus variants circulating in bats have been identified in 26 of the 42 cases of human rabies reported in the US and in all but three cases of human rabies acquired in the US. Greater public awareness of the potential risk of rabies following contact with bats and other wildlife will be an important step in further reducing the incidence of rabies among humans. Highly effective cell culture vaccines for preexposure and postexposure prophylaxis have been major weapons in the fight against rabies among humans. Although all cell culture rabies vaccines available in the US today are considered equally effective when used correctly, duration and magnitude of the antibody response, unit cost of the vaccine, frequency and cost of booster vaccination, and the potential for adverse reactions must be considered in the selection of a vaccine. Booster vaccinations with HDCV have been associated with a risk of type III hypersensitivity reactions, whereas booster doses of PCECV have not. Therefore, PCECV has advantages for persons at high risk of exposure to the rabies virus.

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