Human rabies encephalitis prevention and treatment: progress since Pasteur's discovery.

Dacheux L; Delmas O; Bourhy H

摘要

Rabies remains one of the most ancient and deadly of human infectious diseases. This viral zoonosis is transmitted principally by the saliva of infected dogs, inducing a form of encephalomyelitis that is almost invariably fatal. Since the first implementation, by Louis Pasteur in 1885, of an efficient preventive post-exposure treatment, more effective protocols and safer products have been developed, providing almost 100% protection if administered early enough. However, this disease still represents a major, but neglected public health problem, with an estimated 55,000 human deaths due to rabies reported each year, mostly in Africa and Asia. Once the first clinical signs appear, there is no effective treatment. A ray of hope emerged in 2004, with the report of a patient recovering from rabies after aggressive, innovative treatment. However, this case was not clearly reproduced and the identification of targets for antiviral treatment in cases of rabies infection remains a major challenge. In this context, this review presents the state-of-the art in the prevention and curative treatment of human rabies. We begin by describing the viral etiological agent and the disease it causes, to provide an essential background to rabies. An overview of the post-exposure prophylaxis of rabies in humans is then given, from its initial implementation to possible future developments. Finally, an analysis of the various antiviral compounds tested in rabies in vitro, in animal models or in humans is presented, focusing in particular on potential new strategies.

机译：狂犬病仍然是人类最古老和最致命的传染病之一。这种病毒性人畜共患病主要通过受感染狗的唾液传播，诱发一种几乎总是致命的脑脊髓炎。自 1885 年路易斯·巴斯德（Louis Pasteur）首次实施有效的预防性暴露后治疗以来，已经开发了更有效的方案和更安全的产品，如果足够早地施用，可提供几乎 100% 的保护。然而，这种疾病仍然是一个重大但被忽视的公共卫生问题，据估计，每年有55,000人死于狂犬病，主要在非洲和亚洲。一旦出现第一个临床症状，就没有有效的治疗方法。2004年出现了一线希望，有报道称一名患者在积极、创新的治疗后从狂犬病中恢复过来。然而，该病例没有明确再现，确定狂犬病感染病例的抗病毒治疗靶点仍然是一个重大挑战。在此背景下，本综述介绍了人类狂犬病预防和治疗的最新进展。我们首先描述病毒病原体及其引起的疾病，以提供狂犬病的基本背景。然后概述了人类狂犬病暴露后预防，从最初的实施到未来可能的发展。最后，对在狂犬病体外、动物模型或人体中测试的各种抗病毒化合物进行了分析，特别关注潜在的新策略。

Human rabies encephalitis prevention and treatment: progress since Pasteur's discovery.

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