Specific Therapies
Rabies vaccine. Intramuscular administration of rabies vaccine in an attempt to stimulate humoral and cellular immune responses has frequently been performed without apparent benefit. Rabies encephalitis survival among animals is associated with an immune response. Rabies immunization may therefore be a reasonable approach to use in combination with other therapies. Because immunization by the intramuscular route may take a week or more to produce detectable immune responses, multiple-site (e.g., 8 or 4 sites) intradermal immunization [20] should be considered to accelerate the response. Human rabies vaccines are inactivated and do not elicit a cytotoxic T cell response, which is observed with live attenuated or recombinant rabies vaccines for animal use and which may be important for virus clearance [21]. Experimental vaccines that induce potent cytotoxic T cell responses are undergoing preclinical testing and might provide treatment options for the future. No human live attenuated or recombinant rabies vaccine has been licensed for use in humans to date.