Postexposure prophylaxis for rabies in resource-limited/poor countries.

Abstract Human rabies is essentially a fatal disease once clinical signs develop. Rabies postexposure prophylaxis (PEP) consists of thorough wound care in combination with administration of rabies immunoglobulin and rabies vaccine. This is highly effective in rabies prevention if carried out diligently. Preexposure rabies prophylaxis simplifies PEP in the event of an exposure by eliminating the need for immunoglobulin. Shortened and more convenient and economical PEP regimens are being developed with promising results. They reduce the cost of PEP as well as travel expenses for the often very poor patients. The intradermal PEP regimen can now reduce the vaccine cost by ~ 60–70%. Although PEP in humans can prevent death, controlling the canine vector by sustained vaccination remains the mainstay of rabies elimination.