_??_ Fig. 1. Annual number of subjects who were bitten by possibly rabid animals in the rabies endemic regions and thereafter visited our vaccine clin

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2 _??_ Fig. 1. Annual number of subjects who were bitten by possibly rabid animals in the rabies endemic regions and thereafter visited our vaccine clinic to receive the rabies post-exposure prophylaxis. =female; =male

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9 8) CDC: Human rabies - Virginia, MMWR 1999; 48: ) Smith JS, Seidel D: Rabies: a new look at an old disease. Prog Med Virol 1993; 40: ) WHO: Report of the 3rd International symposium on rabies in Asia. Geneva, 1997, p ) Winkler WG: Airborne rabies. In: Baer GM, ed. The natural history of rabies. vol.1. Academic Press, New York, 1975, 1) Fishbein DB, Robinson LE: Rabies. N Engl J Med 1993; 329: ) CDC: Human rabies diagnosed 2 months postmortem - Texas. MMWR 1985; 46: 700, ) CDC: Human rabies - New York, MMWR 1993; 42: 799, ) CDC: Human rabies - Montana and Washington, MMWR 1997; 46: p ) Winkler WG, Fashinell TR, Leffingwell L, et al: Airborne rabies transmission in a laboratory worker. JAMA 1973; 226: ) Afsher A: A review of non-bite transmission of rabies virus infection. Br Vet J 1979: 135; ) Houff SA, Burton RC, Wilson RW, et al: Human-to-human transmission of rabies virus by corneal transplant. N Engl J Med 1979; 300: ) CDC: Human-to-human transmission of rabies via a corneal transplant - France. MMWR 1980; 29; ) CDC: Human-to-human transmission of rabies via a corneal transplant - Thailand. MMWR 1981; 30: ) WHO: Two rabies cases following corneal transplantation. Wkly Epidemiol Rec 1994; 69: ) Javadi MA, Fayaz A, Mirdehghan SA, et al: Transmission of rabies by corneal graft. Cornea 1996; 15: ) Hattwick MAW, Gregg MB: The disease in man. In: Baer GM, ed. The natural history of rabies. vol.1, Academic Press, New York, 1975, p ) CDC: Imported human rabies. MMWR 1983; 32: 78-80, ) WHO: WHO expert committee on rabies (8th report). WHO technical report series 824. Geneva, 1992, p ) WHO: WHO recommendations on rabies post-exposure treatment and the correct technique of intradermal immunization against rabies. Geneva, 1997, p 5, 18-9.

10 ABSTRACT Actual Situation of Rabies Naohide Takayama Department of Pediatrics, Tokyo Metropolitan Komagome Hospital Rabies is a preventable, but incurable, infectious disease caused by the rabies virus that belongs to the genus Lyssavirus of the family Rhabdoviridae. Although no human or animal rabies cases have been reported in Japan since 1957, rabies is still endemic in many countries. The possibility that rabies may invade Japan must therefore be kept in mind. Recently, more than 16 million Japanese people travel abroad annually. Consequently rabies seems most likely to occur among travelers who return to Japan without proper post-exposure treatment after having been bitten by stray dogs or cats in rabies-endemic regions. Today in Japan, however, few medical institutions keep rabies vaccine in stock and thus cannot offer post-exposure vaccination to travelers bitten by animals in rabies-endemic areas. To ensure that deaths from rabies, especially imported rabies, improvement in the supply of post-exposure prophylaxis to travelers bitten by possibly rabid animals is strongly called for. (JJAAM 2002; 13: ) Key Words: imported rabies, rabies vaccine, post-exposure prophylaxis, pre-exposure immunization, zoonosis

1) Garner J. S.: The Hospital Infection Control Practices Advisory Committee, CDC, Guidelines for Isolation Precautions in Hospitals, 1996. http://wonder.cdc.gov/wonder/prevguid/ p0000419/p0000419.asp.

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