1.9. Can we prevent human rabies through human rabies prophylaxis instead?

Human rabies deaths can be substantially reduced by increasing availability and accessibility of human anti-rabies vaccines and rabies immunoglobulins as shown in this study. However, if this is the only strategy adopted, the financial costs are high and will continue to increase since human vaccines are much more expensive than animal vaccines and because the disease has not been eliminated at its source (in the dog population). Adequate provision of human rabies biologicals and appropriate training of medical professionals to avoid their unnecessary use are both essential when beginning a national canine rabies control programme. This strategy will help to prevent rabies in exposed people and protect workers involved in activities related to the control programme. It should be expected that at the beginning of the programme there might be an increase in the use of human biologicals due to improved accessibility and enhanced rabies surveillance. However, the eventual decline of human deaths that occurs by reducing rabies in dogs through effective canine rabies vaccination programmes generally leads to a decrease in the use of expensive biologicals for humans thus resulting in substantial savings to the public health.

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