Enhanced antibody response to rabies virus in patients with neurologic complications following brain tissue-derived rabies vaccination.

Sera from 26 patients with major neurologic complications, 19 patients with minor complications and 23 patients with no complications induced by Semple rabies vaccine were assayed for neutralizing antibody to rabies virus. Seroconversion to the protective level (greater than or equal to 0.5 IU/ml) was found in 21 of 22 patients (95%) with major complications, and in 7 of 19 (37%) with minor complications, occurring during the first 14 days of vaccination. This was in contrast to 42% (5/12) seroconversion in uncomplicated recipients after 14 daily injections. After initiation of dexamethasone treatment, 13 of 18 patients with major complications showed a diminution in their rabies antibody levels on day 4 or 7.