Evidence favors use of rabies vaccine in rabies-endemic areas

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The highest burden of rabies occurs in Asia and Africa where almost all cases are due to exposure to rabies-infected dogs in rural and urban areas. In this issue of The Journal, Kamoltham et al report a phase II clinical trial of rabies vaccine in 5-8 year old children in Thailand. They point out the current irony that visitors to their country frequently are given pre-exposure rabies prophylaxis (PreP) while the most vulnerable population of young children living in this high-risk area is left unprotected. The study provides evidence that children can be protected against rabies-infected animals through the use of indradermal PreP vaccine. The bite incidence of children living in rabies endemic regions in Thailand is high enough to indicate that PreP can be as cost effective as post-exposure prophylaxis and can save lives.

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