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Michael A. W. Hattwick, MD; Robert H. Rubin, MD; Stanley Music, MD; R. Keith Sikes, DVM; Jean S. Smith; Michael B. Gregg, MD

JAMA. 1974;227(4):407-410.

Abstract
Human rabies immune globulin (HRIG) was given in doses of 10,15, and 40 international units (IU)/kg of body weight to groups of volunteers. It was administered alone and in combination with 16 or 23 injections of duck embryo rabies vaccine (DEV). Administration of HRIG resulted in the early appearance of antibody but inhibited the development of active antibody in all groups receiving DEV. Forty-six percent of persons receiving HRIG at 40 IU/kg and 16 doses of DEV had serum rabies-neutralizing antibody titers of less than 1:5 at 70 days. This immunosuppression was overcome in the groups receiving 23 doses of DEV. Based on these data, post-exposure rabies prophylaxis series should consist of HRIG between 15 and 40 IU/kg plus a 23-dose course of DEV.

Author Affiliations
From the Viral Diseases Branch, Bureau of Epidemiology, Center for Disease Control, Atlanta (Drs. Hattwick, Rubin, and Gregg); the Georgia Division of Physical Health, Atlanta (Dr. Sikes); and the Laboratory Investigations Unit, Viral Diseases Branch, Bureau of Epidemiology, Center for Disease Control, Lawrenceville, Ga (Ms. Smith). Dr. Music was formerly a fellow in Infectious Diseases, University of Maryland, Baltimore.

Footnotes
Reprint requests to Center for Disease Control, 1600 Clifton Rd, Atlanta 30333 (Dr. Hattwick).

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