Laboratory techniques in rabies
Rabies has an enormous impact on both agriculture and conservation biology, but its greatest burden is undeniably on public health. As such, routine methods for rapid risk assessment after human exposures to rabies as well as applications for laboratory-based surveillance, production of biologicals and management of this infectious disease are critical. Given its mandate to improve human health and control disease among its Member Sates, WHO has led the production of its fifth edition of Laboratory techniques in rabies.
During the more than 60 years that have elapsed since the publication of the first edition, enormous progress has been made in methods of viral diagnosis, characterization of pathogens and production of biologicals. At that time, only a single etiological agent was recognized as causing rabies. Detection of Negri bodies was the standard for diagnosis. Nerve tissue-based vaccines were the norm. Combination use of vaccines and rabies immunoglobulins in human prophylaxis was not standard. Global elimination of canine rabies was merely a dream. Rabies in wildlife was managed via population reduction. All of that has changed for the better.
In the ensuing decades, further advancements in detection, prevention and control of lyssaviruses have been monitored by regular meetings of WHO experts, international research groups and countries in which rabies is endemic. The second edition of the manual was published in 1966, the third in 1973 and the fourth in 1996. The late Martin Kaplan and Hilary Koprowski were instrumental in editing the previous editions, as was input on the fourth edition by François-Xavier Meslin, now retired from WHO. Initial plans for preparation of this edition were made in 2016 and its contents were discussed at the WHO Expert meeting on rabies (Bangkok, Thailand) and modified in response.
This fifth edition contains 44 detailed chapters written by more than 85 authors from Africa, the Americas and Eurasia. Emphasis is placed on the basic methods for detection of lyssavirus antigens, antibodies and nucleic acids and the relevance of their use under different operating conditions, from the basic to the advanced. The chapters on older, less sensitive techniques used to detect Negri bodies have been removed, as have those chapters on methods of vaccine production given the progress made in the commercial use of tissue culture products in human and veterinary medicine. Recommendations for the preparations of antibodies by homologous or heterologous production have been replaced by newer methods in an effort to promote a next generation of less expensive and more readily available immunoglobulins in the future. Other basic chapters have been retained and updated and more than a dozen added. Each of the protocols described are prescriptive and should be followed point by point in the laboratory.