Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Mary D. Nettleman, MD, MS, MACP
Mary D. Nettleman, MD, MS, MACP is the Chair of the Department of Medicine at Michigan State University. She is a graduate of Vanderbilt Medical School, and completed her residency in Internal Medicine and a fellowship in Infectious Diseases at Indiana University.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Rabies facts
- What is rabies?
- What are rabies symptoms and signs in humans?
- What is the history of rabies, and what is the cause of rabies?
- How is rabies transmitted?
- How soon after an exposure should a person seek medical attention?
- How is a rabies infection diagnosed?
- What is the treatment for rabies in humans?
- Should people get a preexposure vaccination before traveling outside the U.S.?
- Can rabies be prevented?
- What is the prognosis for people with rabies?
Should people get a preexposure vaccination before traveling outside the U.S.?
The CDC suggests people consider preexposure vaccination for rabies if planned activity will bring you into contact with wild or domestic animals, for example if
- you are a biologist, veterinarian, or agriculture specialist working with animals;
- you will visit remote areas where medical care is difficult to obtain or may be delayed, for example, hiking through remote villages where dogs are common;
- your stay is longer than one month in an area where dog rabies is common. The longer your stay, the greater the chance of an encounter with an animal.
What is the prognosis for people with rabies?
People who are treated early and appropriately when exposed to rabies have an excellent prognosis. As stated previously, no one who has begun this treatment within 48 hours of exposure and has followed it appropriately has ever developed a fatal case of rabies in the U.S. Some individuals with a debilitated immune system (for example, HIV or cancer patients) may require additional treatment and monitoring. An infectious-disease consultant should be consulted to optimize treatment and prognosis. Although some investigators report some treatment success in patients treated beyond 48 hours, the longer the delay in treatment, the more likely the person will develop a fatal infection due to rabies virus.
Unfortunately, untreated or inappropriately treated rabies is almost always fatal. Although heroic efforts have been attempted to save patients, success is very rare. Death usually occurs in about seven days from respiratory failure after the more severe rabies symptoms develop.
Manning, S., C. Rupprecht, D. Fishbein, et al. "Human Rabies Prevention -- United States, 2008: Recommendations of the Advisory Committee on Immunization Practices." MMWR 57.RR-3 (2008): 1-28.
McGettigan, J. "Experimental Rabies Vaccines for Humans." Expert Rev. Vaccines 9.10 (2010): 1177-1186.
United States. Centers for Disease Control and Prevention. "Imported Human Rabies -- New Jersey, 2011." MMWR 60.51 Jan. 6, 2012: 1734-1736. <http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6051a2.htm>.
United States. Centers for Disease Control and Prevention. "Rabies." Dec. 6, 2011. <http://www.cdc.gov/rabies/>.
United States. Centers for Disease Control and Prevention. "Rabies Around the World." Apr. 22, 2011. <http://www.cdc.gov/rabies/location/world/index.html>.
United States. Centers for Disease Control and Prevention. "Rabies Prevention." Apr. 22, 2011. <http://www.cdc.gov/rabies/prevention/index.html>.
United States. Centers for Disease Control and Prevention. "Use of a Reduced (4-Dose) Vaccine Schedule for Postexposure Prophylaxis to Prevent Human Rabies." MMWR 59(RR02) Mar. 19, 2010: 1-9. <http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5902a1.htm>.
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