Abstract
Rabies is a top-ten infectious killer and is newly re-emergent worldwide. Focusing on the unique aspects of the pathophysiology and immunology of rabies, we improvised a strategy that led to the first survivor of rabies without rabies prophylaxis. Our data support the long-standing speculation that rabies is a disorder of neurotransmission. Improvements in human survival have better delineated the immune and metabolic responses to rabies. We anticipate a new generation of rabies biologicals in the very near future, as well as the more remote possibility of rescue monoclonal antibodies engineered from several recent survivors of human rabies. The general approach to rabies treatment serves as a model for a more complex, physiological approach to treating infectious neurological disorders.
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