Cover -- Contents -- Introduction -- 1. The burden of rabies -- 1.1 Methods for estimating the burden of rabies -- 1.2 Estimated burden of rabies in the world -- 1.2.1 Countries that are free of canine rabies -- 1.2.2 Countries in which canine rabies is endemic -- 1.2.3 Vampire bat rabies -- 1.3 Global summary -- 1.4 References -- 2. Classification of lyssaviruses -- 2.1 Distinguishing features of lyssaviruses -- 2.2 Criteria for differentiating between lyssaviruses -- 2.3 Present structure of the Lyssavirus genus -- 2.4 References -- 3. Pathogenesis -- 3.1 References -- 4. Diagnosis -- 4.1 Standard case definitions for rabies -- 4.2 Clinical diagnosis -- 4.3 Biosafety, sampling and specimen transport for laboratory diagnosis -- 4.3.1 Biosafety -- 4.3.2 Sampling for intra-vitam diagnosis in humans -- 4.3.3 Sampling for post-mortem diagnosis in humans and animals -- 4.3.4 Transport of specimens -- 4.4 Laboratory techniques for post-mortem diagnosis of rabies -- 4.4.1 Viral antigen detection -- 4.4.2 Virus isolation -- 4.4.3 Viral RNA detection -- 4.5 Techniques for intra-vitam diagnosis of rabies in humans -- 4.5.1 Viral antigen detection -- 4.5.2 Viral antibody detection -- 4.5.3 Viral RNA detection -- 4.5.4 Virus isolation -- 4.6 Virus identification with molecular techniques: epidemiological considerations -- 4.7 References -- 5. Management of patients before and after death -- 5.1 Rabies survivors and treatment protocols -- 5.2 Clinical management of rabies patients -- 5.3 Transmission via organ transplantation -- 5.4 Recommendations for health care personnel and patients' family members -- 5.5 Management of the bodies of patients who have died of rabies -- 5.6 References -- 6. Vaccines and rabies immunoglobulin for humans -- 6.1 Vaccine types -- 6.1.1 Cell culture and embryonated egg-based rabies vaccines -- 6.1.2 Nerve tissue vaccines.

6.2 WHO prequalification of human rabies vaccines -- 6.3 Requirements for human rabies vaccines -- 6.3.1 Potency requirements, tests and standards -- 6.3.2 Characterization and evaluation of rabies vaccines -- 6.4 Routes of vaccine administration -- 6.5 Adverse events after active immunization -- 6.6 Duration of immunity -- 6.7 Rabies vaccine and full post-exposure prophylaxis failures -- 6.8 Rabies immunoglobulins -- 6.9 References -- 7. Vaccines for animals -- 7.1 Vaccine types -- 7.1.1 Vaccines for domestic animals -- 7.2 Potency requirements for animal rabies vaccines -- 7.2.1 Inactivated animal rabies vaccines -- 7.2.2 Animal rabies vaccines for oral vaccination -- 7.3 Safety of animal vaccines -- 7.3.1 Vaccines for parenteral use -- 7.3.2 Vaccines for oral use -- 7.4 Parenteral rabies vaccination -- 7.5 References -- 8. Prevention of human rabies -- 8.1 General considerations -- 8.2 Pre-exposure prophylaxis -- 8.3 Post-exposure prophylaxis -- 8.3.1 Local treatment of wounds -- 8.3.2 Categories of exposure and post-exposure prophylaxis (Annex 5) -- 8.3.3 WHO-recommended post-exposure prophylaxis regimens -- 8.3.4 Short post-exposure prophylaxis for previously vaccinated individuals -- 8.4 Requirements for periodic booster injections -- 8.5 Vaccination of immunocompromised individuals -- 8.6 Rabies immunoglobulin for passive immunization -- 8.7 Contraindications and precautions -- 8.8 Travellers to and residents of rabies-affected countries and areas, and indications for pre-exposure prophylaxis -- 8.9 References -- 9. National programmes for dog rabies control -- 9.1 Canine mass parenteral vaccination campaigns -- 9.2 Strategic planning and management of vaccination campaigns -- 9.2.1 Studies of dog ecology -- 9.2.2 Vaccination and immunization coverage -- 9.3 Implementing and monitoring dog vaccination campaigns.

9.3.1 Target animals and vaccination methods -- 9.3.2 Timing of campaigns -- 9.3.3 Monitoring vaccination campaigns -- 9.3.4 Cost-effectiveness of dog vaccination -- 9.3.5 Vaccines to be used -- 9.4 Increasing access to dogs for vaccination -- 9.5 Supplementary measure: humane dog population management -- 9.6 Main components of a dog rabies control programme -- 9.7 Operational research for dog rabies control -- 9.8 References -- 10. Prevention and control of rabies in wild animals -- 10.1 Epidemiology and ecology of rabies in carnivore species -- 10.1.1 Africa -- 10.1.2 Middle East and Asia -- 10.1.3 Europe -- 10.1.4 North America -- 10.1.5 South America -- 10.1.6 Caribbean islands -- 10.1.7 Eurasian and American arctic and subarctic regions -- 10.2 Epidemiology and ecology of rabies in bats -- 10.2.1 Lyssaviruses in Africa, Australia and Eurasia -- 10.2.2 Rabies in insectivorous bats in the Americas -- 10.2.3 Vampire bat rabies -- 10.3 Rabies in rodents -- 10.4 Wildlife species of special concern -- 10.5 Elimination of rabies in wild carnivores -- 10.5.1 Reduction of animal populations -- 10.5.2 Immunization -- 10.5.3 Planning, implementing and evaluating oral rabies vaccination programmes -- 10.6 Bat rabies control -- 10.7 Other public health measures -- 10.8 References -- 11. Rabies surveillance -- References -- 12. Rabies-free countries or areas -- References -- 13. International movement of animals -- 13.1 International transport of dogs, cats and ferrets from rabies-infected countries or areas -- 13.2 International transport of livestock and animals for zoos, research, shows and other activities from rabies-infected countries or areas -- 13.3 Special exemption of guide dogs for people with disabilities and of other service dogs -- 13.4 References -- 14. Global and regional activities on rabies -- 14.1 WHO global and regional activities.

14.1.1 WHO headquarters -- 14.1.2 WHO regional offices -- 14.1.3 WHO network of collaborating centres on rabies -- 14.2 Examples of activities by partners -- 14.2.1 Global activities -- 14.2.2 Regional activities -- 14.3 References -- 15. Research -- 15.1 Diagnostics -- 15.2 Epidemiology -- 15.3 Molecular, genetic and epidemiological characterization of new viral isolates -- 15.4 Biological medical products -- 15.5 Human rabies prophylaxis -- 15.6 Pathobiology -- 15.7 Host ecology -- 15.8 References -- Concluding remarks -- Acknowledgements -- Annex 1 List of participants -- Annex 2 Record form for cases of possible exposure to rabies -- Annex 3 Four steps for replacing nervous tissue vaccine by modern rabies vaccines produced on cell culture or embryonated eggs -- Annex 4 Technique for intradermal administration of rabies vaccine and precautions to be taken -- Annex 5 Recommended post-exposure prophylaxis according to type of exposure -- Annex 6 Suggested rabies vaccination certificates for humans -- Annex 7 International rabies vaccination certificate for dogs, cats and ferrets -- Annex 8 WHO collaborating centres on rabies, neurovirology, viral zoonoses and zoonoses control.