A nearly always fatal viral disease transmitted through animal bites. Effective post-exposure prophylaxis and pre-exposure vaccination are available.
Rabies is a preventable viral disease most often transmitted through the bite of an infected animal. The rabies virus infects the central nervous system, ultimately causing disease in the brain and death. Once symptoms appear, rabies is nearly always fatal (CDC, 2024).
Globally, rabies causes approximately 59,000 deaths annually, with 95% of cases in Asia and Africa. Most deaths occur from dog bites in areas where canine rabies is not controlled. In the U.S., wildlife (bats, raccoons, skunks, foxes) are the main sources of rabies exposure.
Rabies is preventable through timely post-exposure prophylaxis (PEP) and pre-exposure vaccination for high-risk groups.
Pre-exposure vaccination is available for high-risk individuals. Once symptoms appear, rabies is almost universally fatal — Post-Exposure Prophylaxis (PEP) is the only effective intervention and must begin immediately after exposure.
PEP consists of three steps: (1) Immediate and thorough wound washing with soap and water — most critical first step; (2) Human Rabies Immune Globulin (HRIG) at 20 IU/kg, infiltrated around the wound site on Day 0 — provides immediate passive immunity; (3) Four-dose rabies vaccine series on Days 0, 3, 7, and 14. Immunocompromised patients receive a fifth dose on Day 28. Previously vaccinated individuals receive only 2 vaccine doses (Days 0 and 3) and do NOT receive HRIG. PEP should begin as soon as possible after exposure regardless of time elapsed. Once clinical rabies develops, treatment is palliative.
Disclaimer: This information is for educational purposes only. Treatment decisions must be made by a qualified healthcare provider.