Rabies in the Face of the 21st Century

Abstract

Reference to an ancient Hindu picture of a snarling dog may be a convincing enough proof to consider the fact that rabies has been known in the world for the past 50 centuries. Prior to the monumental observation about rabies of Fracastoro in the 16th century, facts and fantasies were intermingled in the study of rabies. In the realm of fantasy, consider the statement of Aristotle (otherwise a great philosopher) that only animals and not humans die of rabies. It took 19 centuries before Fracastoro finally established that infection with rabies is lethal for all warm-blooded beings including humans. The new era of rabies dates from the time of Galtier who isolated the virus and Pasteur who was able to create a somewhat attenuated strain of virus fixe which became the tool of laboratory studies for many decades after Pasteur. During the last 50 years of the past century, our knowledge of rabies increased by leaps and bounds. First of all, using molecular biology as a tool, it was possible to ‘take the virus apart’, so to speak and describe and analyse all of its components. Establishment of multivariability among viruses as ‘de la rue’ permitted not only a construct of a genetic linkage among lyssa family but also solved some puzzles of pathogenesis of rabies which defied solution when all work concentrated on one laboratory strain of the virus. As an example, we know much more now about the genetic background regulating virulence of the virus. In addition, it is now possible to use rabies as a vector of biological materials such as vaccines or sera. There is no progress in the treatment of the uniformly lethal disease. Perhaps, optimistically speaking, the 21st century will bring us a glimmer of hope for the successful treatment of human rabies.