Real-World Effectiveness of Zamerovimab and Mazorelvimab and Vaccine for Rabies Grade III Exposure in Nanyang

Inclusion Criteria:

1. Adults aged ≥18 years at the time of screening.
2. Sustained a verified WHO Grade III rabies exposure from a traceable offending dog involved in a multi-person canine attack incident (defined as a single animal attacking multiple individuals within a clustered timeframe/location) in Nanyang City.
3. Time interval from Grade III exposure to post-exposure prophylaxis (PEP) initiation is less than 7 days.
4. Successfully completed standard wound debridement, anatomical infiltration of zamerovimab/mazorelvimab injection (0.3 mg/kg single full dose), and the first dose of rabies vaccine within 24 hours prior to screening.
5. Voluntarily provides signed written informed consent.
6. Patient is willing and able to comply with all sequential follow-up procedures (including serum collections if applicable) and intends to reside locally for the full 1-year study duration.

Exclusion Criteria:

1. Documented history of any separate animal bite or scratch (e.g., dog, cat, bat, or wild carnivore) within the past 12 months prior to the current exposure.
2. Documented complete pre-exposure or post-exposure rabies vaccination history within the past 12 months.
3. Concurrent presentation with life-threatening traumatic injuries requiring intensive care, or severe systemic immunodeficiency disorders that could impede immunogenicity or follow-up compliance.
4. Any other clinical or psychological condition deemed by the investigator as unsuitable for safe participation or reliable data registry.