Materiały źródłowe

• #1 Treatment of rabies – UpToDate

  https://www.uptodate.com/contents/treatment-of-rabies

  Treatment of rabies […] There is no known effective treatment for rabies. […] Although rabies is usually preventable after recognized exposures with post-exposure rabies prophylaxis (eg, wound cleansing and administration of rabies vaccine and rabies immune globulin), the need for prophylaxis is not always recognized and may not be readily available in some areas. […] In patients with confirmed or suspected rabies, management options include a palliative or aggressive approach. […] Many factors influence the therapeutic approach in patients with rabies, including prognostic factors and the risks of treatment.

• #1 Rabies Post-exposure Prophylaxis | Rabies | CDC

  https://www.cdc.gov/rabies/hcp/prevention-recommendations/post-exposure-prophylaxis.html

  Rabies Post-exposure Prophylaxis (PEP) includes wound washing, human rabies immune globulin (HRIG), and a four-dose series of vaccines. […] Rabies PEP consists of wound washing, a dose of human rabies immune globulin (HRIG) and rabies vaccine given at the time of your first medical visit, and a dose of vaccine given again on days 3, 7, and 14 after the first dose. […] Wound cleansing is especially important in rabies prevention since, in animal studies, thorough wound cleansing alone without other medical treatments (e.g., PEP) has been shown to markedly reduce the likelihood of rabies. […] For people who have never been vaccinated against rabies, PEP should always include the administration of both HRIG and rabies vaccine. […] The combination of HRIG and vaccine is recommended for both bite and non-bite exposures, regardless of the interval between exposure and initiation of treatment, so long as the patient is not showing signs consistent with rabies.

• #1 Rabies: Symptoms, causes, vaccine, treatment, and prevention

  https://www.medicalnewstoday.com/articles/181980

  Rabies is a dangerous virus that causes brain inflammation. It can spread from animals to humans through bites and scratches. Vaccines and other medications can help treat and prevent infections. […] Without treatment, the rabies virus can be fatal. However, it is treatable if a person who has had exposure to rabies seeks immediate medical attention. […] If a person has a bite or scratch from an animal that may have rabies, or if the animal licks an open wound, the individual should immediately wash any bites and scratches for 15 minutes with soapy water, povidone iodine, or detergent. This might minimize the number of viral particles. They must then seek immediate medical attention. […] After exposure and before symptoms begin, a series of injections can treat potential rabies infections. Because healthcare professionals do not usually know whether the animal had rabies, it is safer to assume that they do and begin vaccination.

• #1 Rabies Treatment & Management: Approach Considerations, Preexposure Prophylaxis or Immunization, Postexposure Approach to Animal Bites and other Exposures

  https://emedicine.medscape.com/article/220967-treatment

  When the patient presents with a bite, the wound should be cleansed immediately with soap and water, flushing it thoroughly to remove saliva. Debridement and careful exploration for foreign body (eg, broken tooth) are essential; this should take at least 10 minutes. Generally, leave wounds to heal by secondary intention to permit drainage of wound fluids and prevent infection. […] Inpatient care of patients with rabies may be needed if wounds are extensive or are on the face and hands, if surgical repair or replacement of blood loss is required, or if infection occurs. […] For a patient with an illness consistent with rabies, transfer to a tertiary care center with intensive care support and capability of providing timely diagnostic workup is essential. […] Preexposure, active prophylaxis or immunization is recommended for individuals who are exposed to rabies virus or who handle specimens considered high risk for rabies and persons who visit countries where rabies is a significant problem.

• #1 Rabies Post-exposure Prophylaxis | Rabies | CDC

  https://www.cdc.gov/rabies/hcp/prevention-recommendations/post-exposure-prophylaxis.html

  PEP for persons who have previously been vaccinated against rabies consists of two doses of vaccine, 3 days apart. […] HRIG is administered only once at the beginning of the PEP course, and only to previously unvaccinated persons. […] The recommended dose of HRIG is 20 IU/kg body weight. […] If possible, the full dose of HRIG should be thoroughly infiltrated into the area around and into the wounds. […] HRIG should never be administered in the same syringe or in the same anatomical site as the first vaccine dose. […] If HRIG was not administered when vaccination was begun, it can be administered up to the third dose of vaccine (Day 7). […] All PEP should begin with immediate thorough cleansing of all wounds with soap and water. […] If possible, the full dose should be infiltrated around any wound(s) and any remaining volume should be administered IM at an anatomical site distant from vaccine administration.

• #1 Rabies Treatment & Management: Approach Considerations, Preexposure Prophylaxis or Immunization, Postexposure Approach to Animal Bites and other Exposures

  https://emedicine.medscape.com/article/220967-treatment

  Two different inactivated rabies vaccines are licensed and produced in the United States, as follows: Human diploid cell vaccine (HDCV; Imovax) – Usual dosing for postexposure prophylaxis to be administered as IM injection; Purified chick embryo cell vaccine (PCEC; RabAvert) – Licensed in the United States in 1997 for IM use only. […] Mild local and systemic adverse reactions to these vaccines and immunoglobulin may occur but are usually treatable with supportive care, antihistamines, and anti-inflammatory medications. […] Symptomatic rabies cannot be managed in the outpatient setting. Intensive cardiopulmonary supportive care is the only treatment available for patients with symptomatic rabies. […] Regardless of treatment, symptomatic rabies is almost invariably fatal, with autonomic dysfunction leading to cardiac arrhythmia and hypotension. […] The safest, most effective treatment for rabies remains prevention through risk avoidance and pre-exposure and post-exposure immunization.

• #1 Rabies Post-Exposure Prophylaxis Regimen Animal Bites and Rabies Risk: A Guide for Health Professionals – MN Dept. of Health

  https://www.health.state.mn.us/diseases/rabies/risk/postexposure.html

  Wound cleansing is especially important in rabies prevention. In animal studies, thorough wound cleansing alone without other medical treatments (e.g., PEP) has been shown to markedly reduce the likelihood of rabies. […] The rabies PEP regimen involves administration of human rabies immune globulin (HRIG), which is given only once, and a series of four 1 mL rabies vaccinations. […] HRIG must be infiltrated into and around the bite wound site(s), and provides immediate, passive immune protection until the patient produces antibodies through the PEP vaccine series. […] A 1 mL dose of rabies vaccine is given IM in the deltoid area of adults or the anterolateral thigh of young children on Days 0, 3, 7, and 14 of the rabies PEP regimen. […] Two inactivated, cell culture rabies vaccines are currently available in the United States: human diploid cell vaccine (HDCV) or purified chick embryo cell vaccine (PCEC).

• #1 Human Rabies Treatment—From Palliation to Promise

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10819634/

  For now, the most accepted treatment of rabies encephalitis is palliation. […] Several measures can ameliorate the suffering of patients. […] The authors surprisingly reported that all of the patients who received haloperidol (n = 22) had considerable symptom control or improvement with regards to agitation and anxiety at relatively low doses (10 to 20 mg in 24 h). […] We believe that the Starfish treatment model should be prioritized for rabies palliative treatment. […] The future of rabies encephalitis treatment is not entirely bleak. […] Newer research has shown that there could be useful therapeutic efficacy for some mAbs in established CNS infection. […] The development of an effective rabies treatment would probably take the shape of a protocol wherein a backbone of supportive care allows a framework to provide directly acting antivirals combined with neuroprotective and possibly functional neuronal therapies. […] A renewed attention to rabies treatment is needed to restimulate efforts to develop effective therapies.

• #1 Rabies – Wikipedia

  https://en.wikipedia.org/wiki/Rabies

  People who have previously been vaccinated against rabies do not need to receive the immunoglobulin—only the post-exposure vaccinations on days 0 and 3. The side effects of modern cell-based vaccines are similar to the side effects of flu shots. The old nerve-tissue-based vaccination required multiple injections into the abdomen with a large needle but is inexpensive. It is being phased out and replaced by affordable World Health Organization intradermal-vaccination regimens. In children less than a year old, the lateral thigh is recommended. […] Thoroughly washing the wound as soon as possible with soap and water for approximately five minutes is effective in reducing the number of viral particles. Povidone-iodine or alcohol is then recommended to reduce the virus further. […] Once rabies develops, death almost certainly follows. Palliative care in a hospital setting is recommended with administration of large doses of pain medication, and sedatives in preference to physical restraint. Ice fragments can be given by mouth for thirst, but there is no good evidence intravenous hydration is of benefit.

• #1 Rabies – Wikipedia

  https://en.wikipedia.org/wiki/Rabies

  A treatment known as the Milwaukee protocol, which involves putting people with rabies symptoms into a chemically induced coma and using antiviral medications in an attempt to protect their brain until their body has had time to produce rabies antibodies, has been occasionally used. It was initially attempted in 2004 on Jeanna Giese, a teenage girl from Wisconsin, who subsequently became the first human known to have survived rabies without receiving post-exposure prophylaxis before symptom onset. Giese did require extensive rehabilitation afterward, and her balance and neural function remained impaired. The protocol has been enacted on many rabies victims since, but has been adjudged a failure; some survivors of the acute initial phase later died of rabies. Concerns have also been raised about its monetary costs and its ethics. […] Antiviral therapy to combat the effects of rabies has also been researched; favipiravir, for example, has shown potential at inhibiting the development of encephalitis. It has been suggested that such therapy in combination with immunotherapy and neuroprotective measures could be beneficial.

• #1 Therapy of human rabies – PubMed

  https://pubmed.ncbi.nlm.nih.gov/21601055/

  Preventive therapy for rabies, including wound cleansing and active and passive immunization after a recognized exposure, is highly efficacious. […] Unfortunately, there is no established therapy that is effective for patients who develop rabies encephalomyelitis. […] Aggressive approaches to therapy of human rabies may be appropriate in certain situations. […] There is no scientific rationale for the use of therapeutic coma, and there are many reports of failures using this approach. […] Therapeutic coma should be abandoned for the therapy of rabies. […] New approaches such as therapeutic hypothermia should be evaluated, in combination with other therapeutic agents. […] More basic research is needed on the mechanisms involved in rabies pathogenesis, which will hopefully facilitate the development of new therapeutic approaches in the future for this ancient disease.

• #1

  https://news.usuhs.edu/2023/09/usu-researchers-develop-potential-cure.html

  USU researchers have developed a potential cure for rabies infection, offering hope for an effective treatment for human rabies. […] USUs Drs. Brian Schaefer and Christopher Broder, professors in the Department of Microbiology and Immunology, published a study Sept. 28 – World Rabies Day – in EMBO Molecular Medicine, along with scientists in their lab, that demonstrates an effective treatment for combating lyssavirus infection (rabies). The research teams findings suggest that this single-dose treatment could be easily administered for symptomatic rabies. […] Currently, there is no validated treatment in humans that prevents death following symptomatic rabies. […] Ultimately, the researchers suggest that the F11 monoclonal antibody could prove to be a successful cure for human rabies. […] Taken together, these findings suggest that the F11 antibody, or similar antibodies, could potentially be translated into a treatment for humans infected with rabies.

• #1 Human Rabies Treatment—From Palliation to Promise

  https://www.mdpi.com/1999-4915/16/1/160

  Perhaps the most formidable challenge in developing an effective rabies encephalitis treatment is our limited understanding of RABV pathogenesis and its mechanism of neuronal injury. […] In the clinical setting with patients, a number of factors also confound efforts for treatment. […] For now, the most accepted treatment of rabies encephalitis is palliation. Several measures can ameliorate the suffering of patients. […] The authors surprisingly reported that all of the patients who received haloperidol (n = 22) had considerable symptom control or improvement with regards to agitation and anxiety at relatively low doses (10 to 20 mg in 24 h). […] We believe that the Starfish treatment model should be prioritized for rabies palliative treatment. […] The development of an effective rabies treatment would probably take the shape of a protocol wherein a backbone of supportive care allows a framework to provide directly acting antivirals combined with neuroprotective and possibly functional neuronal therapies.

• #1 Rabies – Wikipedia

  https://en.wikipedia.org/wiki/Rabies

  Treatment after exposure can prevent the disease if given within 10 days. The rabies vaccine is 100% effective if given before symptoms of rabies appear. Every year, more than 15 million people get vaccinated after potential exposure. While this works well, the cost is significant. In the US it is recommended people receive one dose of human rabies immunoglobulin (HRIG) and four doses of rabies vaccine over a 14-day period. HRIG is expensive and makes up most of the cost of post-exposure treatment, ranging as high as several thousand dollars. In the UK, one dose of HRIG costs the National Health Service 1,000, although this is not flagged as a „high-cost medication”. A full course of vaccine costs 120-180. As much as possible of HRIG should be injected around the bites, with the remainder being given by deep intramuscular injection at a site distant from the vaccination site.

• #1 Your Money or Your Life: The Ethics of the Expensive Rabies Treatment – Markkula Center for Applied Ethics

  https://www.scu.edu/ethics/healthcare-ethics-blog/your-money-or-your-life-the-ethics-of-the-expensive-rabies-treatment/

  The high cost of the expensive PEP would be beneficial for its developers. […] The high cost of the PEP is undoubtedly less favorable for patients who desperately need the vaccine in time in order to survive. Too often, many patients have to suffer an agonizing death because they are unable to afford the PEP. The high cost of the PEP fails to prevent harm in those who are financially struggling. […] Rep. Ami Bera MD of California has proposed a bill known as the Affordable Rabies Treatment for All Act of 2023 that will reduce the financial barriers of the PEP after he himself was bitten by a rabid fox and only survived through accessing prompt medical treatment.

• #1 Schedule Rabies Vaccine | Walgreens

  https://www.walgreens.com/topic/pharmacy/scheduler/rabies-vaccine.jsp

  Rabies is a serious disease caused by a virus carried in the saliva of infected domestic and wild mammals and is usually spread through a bite. […] The inactivated rabies vaccine can protect those at increased risk of rabies exposure, but it can also prevent the disease if its given to a person after exposure to the virus. […] If vaccination is required and you havent previously received the rabies vaccine, preexposure vaccination consists of a series of 3 intramuscular injections given on days 0, 7, and 21 or 28 in the deltoid muscle in the arm. […] If you’ve been bitten by an animal and potentially exposed to rabies, clean the wound and seek medical attention to determine whether you should get the rabies vaccine. […] People who are likely to come in contact with the rabies virus or with rabid animals should get the rabies vaccine. […] Mild-to-moderate side effects of the rabies vaccine include soreness, redness or swelling at the injection site, headache, nausea, abdominal pain, muscle aches and dizziness. […] Severe side effects, although rare, may include serious allergic reactions.

• #1 Rabies Exposure | Rabavert

  https://rabavert.com/rabies-exposure/

  Rabies is 100% vaccine-preventable, if you act quickly. […] It is important to seek medical attention immediately for a potential rabies exposure, before symptoms appear. Once symptoms are present, the virus has spread into your central nervous system and it is too late. Untreated rabies is almost always fatal, but is 100% vaccine-preventable. […] Depending on the circumstances of your potential exposure, you may need to receive anti-rabies treatment. If it is necessary, and you have not been previously vaccinated, then treatment will begin with a dose of special antibodies called human rabies immune globulin (HRIG). This should be injected as close to the wound as possible, immediately providing antibodies to neutralize the virus at the site of exposure. […] Receiving rabies vaccination before you are exposed does not eliminate the need for additional treatment if you are bitten. But it can offer a level of protection, particularly against unrecognized exposures. Pre-exposure vaccination primes your immune response so treatment after exposure can be effective more quickly. It also reduces the number of post-exposure vaccine doses (2 doses instead of 4-5 doses) and simplifies treatment because no HRIG is needed.

• #1 Rabies Treatment: First Aid Information for Rabies

  https://www.webmd.com/first-aid/rabies-treatment

  If there is any risk of rabies infection, the healthcare provider will recommend anti-rabies treatment. This may include a series of shots. […] Do not wait for symptoms to appear. […] If possible, bring information about the animal. […] If the person was in an enclosed area with a bat, see a healthcare provider whether or not there is a bite wound. The person may have been bitten and not know it.

• #1 Rabies Post-Exposure Prophylaxis Regimen Animal Bites and Rabies Risk: A Guide for Health Professionals – MN Dept. of Health

  https://www.health.state.mn.us/diseases/rabies/risk/postexposure.html

  Following an exposure, previously vaccinated persons are given two 1 mL doses of vaccine intramuscularly in the deltoid area on Days 0 and 3. No HRIG is administered because it might inhibit the strength or speed of the expected anamnestic response. […] Once the decision to initiate rabies PEP has been made, the PEP regimen should be started as soon as possible. […] Rabies products are commercially available through pharmaceutical distributors or may be obtained directly from the manufacturers using the toll-free numbers listed below. […] In general, there is a very low frequency of serious adverse reactions to the rabies PEP regimen. Local pain, headache and low-grade fever may follow administration of HRIG.

• #1 Rabies vaccine – Wikipedia

  https://en.wikipedia.org/wiki/Rabies_vaccine

  Rabies vaccines are safe in all age groups. About 35 to 45 percent of people develop a brief period of redness and pain at the injection site, and 5 to 15 percent of people may experience fever, headaches, or nausea. Because of the certain fatality of the virus, receiving the vaccine is always advisable. […] Immunity following a course of doses is typically long lasting, and additional doses are usually not needed unless the person has a high risk of contracting the virus.

• #1 About Rabies | Rabies | CDC

  https://www.cdc.gov/rabies/about/index.html

  Rabies is a fatal but preventable viral disease. […] Immediate medical attention following suspected rabies exposure is critical. Medical care following a rabies exposure is called post-exposure prophylaxis or PEP. PEP includes wound care, a dose of human rabies immune globulin (HRIG), and a series of four or five rabies vaccines, which must be administered as soon as possible after exposure. This care is vital to prevent the disease from developing. It is nearly 100% effective if administered promptly. […] Each year, 60,000 Americans receive PEP after a potential rabies exposure. […] The best way you can prevent rabies is by: […] Washing bites or scratches immediately with soap and water; and […] Seeking medical care shortly after potential exposures. […] Rabies pre- and post-exposure prophylaxis.

• #2 Rabies Treatment – Superdrug Health Clinic

  https://healthclinics.superdrug.com/rabies-treatment/

  Rabies is a virus that infects the nervous system, usually through the infected saliva of a rabid animal. When a rabid animal bites or scratches you, the rabies virus will be transmitted through the saliva into the wound, where it will travel up the nervous system towards the brain. If the rabies virus is able to infect the brain, it is almost always fatal. Because of how dangerous the rabies virus is, it is important to get the proper pre-exposure treatment if you are travelling to a country with a risk of rabies, and prompt post-exposure treatment if you have been potentially exposed to rabies. […] The rabies vaccine is an effective way to protect yourself from the rabies virus. Rabies vaccines are ‘inactivated vaccines’, which means that they don’t contain any trace of the live rabies virus. This allows patients to develop resistance, and eventually immunity, to rabies without being put at risk of a full infection. This vaccine is given as an injection straight into the muscle, usually in the upper arm.

• #2 Rabies – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rabies/diagnosis-treatment/drc-20351826

  Once a rabies infection is established, there’s no effective treatment. Though a small number of people have survived rabies, the disease usually causes death. For that reason, if you think you’ve been exposed to rabies, you must get a series of shots to prevent the infection from taking hold. […] If you’ve been bitten by an animal that is known to have rabies, you’ll receive a series of shots to prevent the rabies virus from infecting you. […] Rabies shots include: A fast-acting shot (rabies immune globulin) to prevent the virus from infecting you. This is given if you haven’t had the rabies vaccine. This injection is given near the area where the animal bit you if possible, as soon as possible after the bite. […] A series of rabies vaccinations to help your body learn to identify and fight the rabies virus. Rabies vaccinations are given as injections in your arm. If you haven’t previously had the rabies vaccines, you’ll receive four injections over 14 days. If you have had the rabies vaccine, you’ll have two injections over the first three days.

• #2 Rabies Post-Exposure Prophylaxis Regimen Animal Bites and Rabies Risk: A Guide for Health Professionals – MN Dept. of Health

  https://www.health.state.mn.us/diseases/rabies/risk/postexposure.html

  Wound cleansing is especially important in rabies prevention. In animal studies, thorough wound cleansing alone without other medical treatments (e.g., PEP) has been shown to markedly reduce the likelihood of rabies. […] The rabies PEP regimen involves administration of human rabies immune globulin (HRIG), which is given only once, and a series of four 1 mL rabies vaccinations. […] HRIG must be infiltrated into and around the bite wound site(s), and provides immediate, passive immune protection until the patient produces antibodies through the PEP vaccine series. […] A 1 mL dose of rabies vaccine is given IM in the deltoid area of adults or the anterolateral thigh of young children on Days 0, 3, 7, and 14 of the rabies PEP regimen. […] Two inactivated, cell culture rabies vaccines are currently available in the United States: human diploid cell vaccine (HDCV) or purified chick embryo cell vaccine (PCEC).

• #2

  https://www.who.int/news-room/fact-sheets/detail/rabies

  Rabies is a serious public health problem in over 150 countries and territories, mainly in Asia and Africa. […] However, rabies deaths are preventable with prompt post exposure prophylaxis (PEP) by stopping the virus from reaching the central nervous system. PEP consists of thorough wound washing, administration of a course of human rabies vaccine and, when indicated, rabies immunoglobulins (RIG). […] If a person is bitten or scratched by a potentially rabid animal, they should immediately and always seek PEP care. […] Effective vaccines are available to immunize people both before and after potential exposures. […] Note that PrEP does not replace the need for PEP. Any person exposed to a suspected rabid animal should still seek post exposure care. […] Post-exposure prophylaxis (PEP) is the emergency response to a rabies exposure. This prevents the virus from entering the central nervous system. A well performed wound risk assessment and PEP protocol consists of: extensive wound washing with water and soap for at least 15 minutes soon after an exposure; a course of rabies vaccine; and administration of rabies immunoglobulin or monoclonal antibodies into the wound, if indicated.

• #2 Rabies – Wikipedia

  https://en.wikipedia.org/wiki/Rabies

  People who have previously been vaccinated against rabies do not need to receive the immunoglobulin—only the post-exposure vaccinations on days 0 and 3. The side effects of modern cell-based vaccines are similar to the side effects of flu shots. The old nerve-tissue-based vaccination required multiple injections into the abdomen with a large needle but is inexpensive. It is being phased out and replaced by affordable World Health Organization intradermal-vaccination regimens. In children less than a year old, the lateral thigh is recommended. […] Thoroughly washing the wound as soon as possible with soap and water for approximately five minutes is effective in reducing the number of viral particles. Povidone-iodine or alcohol is then recommended to reduce the virus further. […] Once rabies develops, death almost certainly follows. Palliative care in a hospital setting is recommended with administration of large doses of pain medication, and sedatives in preference to physical restraint. Ice fragments can be given by mouth for thirst, but there is no good evidence intravenous hydration is of benefit.

• #2 What is the Treatment for a Rabies Exposure? | Rabies Watch?

  https://www.rabieswatch.com/en/families/what-is-the-treatment-for-rabies-exposure

  Theres no cure for rabies. But when you are exposed to the rabies virus, there is a rabies treatment for preventing the virus from spreading. […] Protective measures, known as postexposure prophylaxis or PEP, are the only proven way to avoid the onset of rabies. There are 3 parts to this process. All of them are necessary. […] This important step needs to be administered quickly before the rabies virus can take hold. […] An HRIG like HyperRAB (rabies immune globulin [human]) provides critical, immediate protection. Its given to individuals who have not been previously vaccinated. […] The HRIG is usually administered at the same time as the first dose of the vaccine but can be given up to 7 days later. […] In addition to the HRIG, which provides immediate protection, a vaccine is administered to build active, long-lasting immunity. The rabies vaccine is usually given as a series of 4 shots.

• #2 Rabies Treatment & Management: Approach Considerations, Preexposure Prophylaxis or Immunization, Postexposure Approach to Animal Bites and other Exposures

  https://emedicine.medscape.com/article/220967-treatment

  In the United States, the CDC recommends rabies postexposure prophylaxis only with intramuscular (IM) cell-cultured vaccines; intradermal (ID) formulations are not approved by the US Food and Drug Administration (FDA) for use in the United States. […] Passive immunization consists of the administration of human rabies immunoglobulin (HRIG) pooled from the sera of immunized human donors. […] Before the onset of rabies symptoms, optimal results require immediate, vigorous wound cleansing for at least 10 minutes; passive immunization with immunoglobulin, and active immunization with rabies vaccine. […] Administer HRIG to any person not previously vaccinated against rabies (or if primary series completed less than 14 days prior to exposure), at a dose of 20 IU/kg (for adults and children).

• #2 Rabies: Causes, Symptoms, Treatment & Prevention

  https://my.clevelandclinic.org/health/diseases/13848-rabies

  Rabies is preventable if you’re vaccinated quickly after exposure. […] Rabies is preventable if you clean the wound thoroughly and get vaccinated after you’ve been bitten. […] If you’ve been exposed to rabies (were bitten by or been in contact with an infected animal), contact a healthcare provider as soon as possible. […] Your provider will give you a series of shots (vaccinations) to prevent the virus from causing rabies. […] Medications prevent an infection from traveling to your brain if you’ve been exposed to rabies (post-exposure prophylaxis/PEP). […] Your healthcare provider will give you four shots over 14 days. […] The vaccine teaches your body to destroy the rabies virus before it enters your brain. […] You can survive rabies exposure if you’re treated within a few days of exposure, before you have symptoms. […] Without early vaccination and antibody treatment, rabies is nearly always fatal. […] Rabies exposure is an urgent situation. […] Rabies is a serious illness that’s almost always fatal. Fortunately, it’s completely preventable if you’re treated right away.

• #2 Human Rabies Treatment—From Palliation to Promise

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10819634/

  Rabies encephalitis has plagued humankind for thousands of years. Currently, the standard of care for management of rabies encephalitis is palliation. Heroic attempts to treat human rabies patients over the last few decades have yielded glimpses into our understanding of pathophysiology, opening the door to the development of new antiviral therapies and modalities of treatment. Researchers continue to investigate new compounds and approaches to therapy, yet there remain real challenges given the complexity of the disease. […] Palliative care makes up the mainstay of treatment if it is available. […] However, no therapy has consistently demonstrated efficacy in treating disease once symptoms develop. […] The issue, then, is that no effective treatment for rabies encephalitis is available if one of the diverse variants escapes the standard modalities of prevention leading to disease or if the opportunity for post-exposure prophylaxis is unfortunately missed and the patient now has a fulminant encephalitis.

• #2 Rabies: For health professionals – Canada.ca

  https://www.canada.ca/en/public-health/services/diseases/rabies/for-health-professionals.html

  Once clinical symptoms develop, rabies is almost always fatal. Death typically occurs within 7 to 14 days of symptom onset although critical care measures (supportive therapy) may delay the timing of death. […] Rabies in humans can be prevented through pre-exposure prophylaxis and prompt post-exposure prophylaxis combined with appropriate medical care. […] Rabies is a preventable disease. Pre-exposure and post-exposure prophylaxis is available. Additionally, proper wound care after an animal bite can significantly reduce the risk of rabies. […] There is no treatment for rabies once symptoms have begun. As such, efforts should focus on: prevention before the onset of symptoms, such as: wound care, post-exposure prophylaxis […] Almost all patients succumb to the disease or its complications within a few weeks of illness onset.

• #2 Human Rabies Treatment—From Palliation to Promise

  https://www.mdpi.com/1999-4915/16/1/160

  Perhaps the most formidable challenge in developing an effective rabies encephalitis treatment is our limited understanding of RABV pathogenesis and its mechanism of neuronal injury. […] In the clinical setting with patients, a number of factors also confound efforts for treatment. […] For now, the most accepted treatment of rabies encephalitis is palliation. Several measures can ameliorate the suffering of patients. […] The authors surprisingly reported that all of the patients who received haloperidol (n = 22) had considerable symptom control or improvement with regards to agitation and anxiety at relatively low doses (10 to 20 mg in 24 h). […] We believe that the Starfish treatment model should be prioritized for rabies palliative treatment. […] The development of an effective rabies treatment would probably take the shape of a protocol wherein a backbone of supportive care allows a framework to provide directly acting antivirals combined with neuroprotective and possibly functional neuronal therapies.

• #2 Adapted Milwaukee protocol for rabies treatment in a Brazilian indigenous child: case report | Virology Journal | Full Text

  https://virologyj.biomedcentral.com/articles/10.1186/s12985-024-02536-2

  This case report describes the treatment of a 12-year-old indigenous Brazilian girl from the Maxakali group with rabies using the adapted Milwaukee Protocol. […] The report highlights the inherent challenges in treating rabies due to the virus’s neurotropic nature and the difficulties in delivering antiviral drugs to the central nervous system. […] The findings suggest that while the Milwaukee Protocol offers some hope, significant obstacles remain in achieving successful outcomes in rabies cases. […] Despite the availability of safe and effective vaccines, the clinical stages of rabies encephalitis remain intractable, with few documented survivors. […] A major obstacle to treating rabies is the neurotropic nature of the virus, with the size exclusion limit of the blood-brain barrier making delivery of drugs and antiviral molecules to the central nervous system inherently problematic.

• #2 Therapy of human rabies – PubMed

  https://pubmed.ncbi.nlm.nih.gov/21601055/

  Preventive therapy for rabies, including wound cleansing and active and passive immunization after a recognized exposure, is highly efficacious. […] Unfortunately, there is no established therapy that is effective for patients who develop rabies encephalomyelitis. […] Aggressive approaches to therapy of human rabies may be appropriate in certain situations. […] There is no scientific rationale for the use of therapeutic coma, and there are many reports of failures using this approach. […] Therapeutic coma should be abandoned for the therapy of rabies. […] New approaches such as therapeutic hypothermia should be evaluated, in combination with other therapeutic agents. […] More basic research is needed on the mechanisms involved in rabies pathogenesis, which will hopefully facilitate the development of new therapeutic approaches in the future for this ancient disease.

• #2 Human Rabies Treatment—From Palliation to Promise

  https://www.mdpi.com/1999-4915/16/1/160

  One agent—favipiravir, also known as T-705—remains as a potential antiviral candidate for the treatment of rabies, albeit with reservations. […] Although many of the compounds and therapeutic efforts tried in the clinical setting thus far have failed to date, ongoing research continues. […] The future of rabies encephalitis treatment is not entirely bleak. […] A renewed attention to rabies treatment is needed to restimulate efforts to develop effective therapies.

• #2 Reddit – The heart of the internet

  https://www.reddit.com/r/science/comments/16w5vrp/potential_rabies_treatment_discovered_with_a/

  Potential rabies treatment discovered with a monoclonal antibody, F11. F11 therapy limits viral load in the brain and reverses disease symptoms.

• #2 Rabies – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rabies/symptoms-causes/syc-20351821

  Rabies is a deadly virus spread to people from the saliva of infected animals. […] For this reason, anyone who may have a risk of contracting rabies should receive rabies vaccinations for protection. […] Dr. Poland says that’s why if you wake up and find a bat in the room, you should get the rabies vaccine. […] Doesn’t matter. Rabies is such a severe disease with no cure, no treatment for it, that the safer thing to do is to give rabies vaccine. […] A typical series of rabies vaccines cost anywhere from three to seven thousand dollars. […] Seek immediate medical care if you’re bitten by any animal, or exposed to an animal suspected of having rabies. […] Based on your injuries and the situation in which the exposure happened, you and your doctor can decide whether you should receive treatment to prevent rabies. […] Consider the rabies vaccine if you’re traveling or often around animals that may have rabies. […] If you work as a veterinarian or work in a lab with the rabies virus, get the rabies vaccine.

• #2

  https://bera.house.gov/news/documentsingle.aspx?DocumentID=400212

  Representative Ami Bera, M.D. (CA-06) today released the following statement after re-introducing the Affordable Rabies Treatment for All Act of 2023. Although rabies is a fatal disease, it is completely preventable if treated quickly. Unfortunately, Americans are at risk of paying thousands of dollars in unexpected out-of-pocket costs for the same critical care. Access to necessary and life-saving rabies treatment should never break the bank. […] The CDC estimates around 55,000 Americans receive PEP each year with costs typically ranging from $1,200 to $6,500. However, when adding up the cost of delivery and other unexpected out-of-pocket costs, some patients have reported costs that exceed $25,000. Individuals should not have to bear the burden of unexpected costs for life-saving treatment. The Affordable Rabies Treatment for All Act of 2023 would require that the Secretary of the Department of Health and Human Services (HHS) establish a reimbursement program for health care providers when they provide rabies postexposure prophylaxis (PEP) and other rabies related services to uninsured individuals. The bill would also allow the Secretary of Health and Human Services to award grants for local health departments to maintain and stockpile PEP and related items and allow those departments to provide PEP and other rabies related services to patients.

• #2 Rabies… Vaccines & Post-Exposure Treatment | AfricaHunting.com

  https://www.africahunting.com/threads/rabies-vaccines-post-exposure-treatment.87314/

  Rabies prevention is attained with TWO shots of the Rabies Vaccine. Given on day 0 and day 7. […] If you want to be really sure, you can test titers, or you can just get a booster at 1 year and then every 2-3 years. […] The CDC has country specific recommendations for rabies pre-exposure vaccination. […] Generally speaking, if you are traveling to a country with rabies AND you are performing occupational or recreational activities that increase risk for exposure to potentially rabid animals AND you might have difficulty getting prompt access to safe post-exposure prophylaxis, then it is recommended that you get the Rabies Pre-Exposure Prophylaxis vaccinations. […] Rabies in the U.S. is very rare. Currently only about 10 people die from rabies in the U.S. each year. […] Reactions to rabies vaccine is actually quite high compared to other vaccines; however, the vast majority of reaction are very mild. Severe side effects from rabies vaccines are exceedingly rare.

• #2 Rabies: For health professionals – Canada.ca

  https://www.canada.ca/en/public-health/services/diseases/rabies/for-health-professionals.html

  Following wound care, health care providers will need to decide whether to administer rabies post-exposure prophylaxis (RPEP). RPEP is intended to neutralize any rabies virus that was introduced by the animal exposure before it can enter the nervous system. […] For people who have not been previously vaccinated against rabies, RPEP involves administering rabies immune globulin (RabIg) treatment and rabies vaccine. […] For people who have been previously vaccinated against rabies, only rabies vaccine is required for RPEP. […] Rabies vaccine provides active immunity which begins to develop within 2 weeks of initiating vaccination. Immunity from rabies vaccine lasts considerably longer than RabIg. […] RabIg should not be given to people who have been previously appropriately immunized. In previously appropriately immunized people who require post-exposure prophylaxis, only 2 vaccine doses are recommended on day 0 and 3 days later.

• #2 About Rabies | Rabies | CDC

  https://www.cdc.gov/rabies/about/index.html

  Rabies is a fatal but preventable viral disease. […] Immediate medical attention following suspected rabies exposure is critical. Medical care following a rabies exposure is called post-exposure prophylaxis or PEP. PEP includes wound care, a dose of human rabies immune globulin (HRIG), and a series of four or five rabies vaccines, which must be administered as soon as possible after exposure. This care is vital to prevent the disease from developing. It is nearly 100% effective if administered promptly. […] Each year, 60,000 Americans receive PEP after a potential rabies exposure. […] The best way you can prevent rabies is by: […] Washing bites or scratches immediately with soap and water; and […] Seeking medical care shortly after potential exposures. […] Rabies pre- and post-exposure prophylaxis.

• #2 Rabies vaccine – Wikipedia

  https://en.wikipedia.org/wiki/Rabies_vaccine

  Rabies vaccines are safe in all age groups. About 35 to 45 percent of people develop a brief period of redness and pain at the injection site, and 5 to 15 percent of people may experience fever, headaches, or nausea. Because of the certain fatality of the virus, receiving the vaccine is always advisable. […] Immunity following a course of doses is typically long lasting, and additional doses are usually not needed unless the person has a high risk of contracting the virus.

• #2 Human Rabies Treatment—From Palliation to Promise

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10819634/

  For now, the most accepted treatment of rabies encephalitis is palliation. […] Several measures can ameliorate the suffering of patients. […] The authors surprisingly reported that all of the patients who received haloperidol (n = 22) had considerable symptom control or improvement with regards to agitation and anxiety at relatively low doses (10 to 20 mg in 24 h). […] We believe that the Starfish treatment model should be prioritized for rabies palliative treatment. […] The future of rabies encephalitis treatment is not entirely bleak. […] Newer research has shown that there could be useful therapeutic efficacy for some mAbs in established CNS infection. […] The development of an effective rabies treatment would probably take the shape of a protocol wherein a backbone of supportive care allows a framework to provide directly acting antivirals combined with neuroprotective and possibly functional neuronal therapies. […] A renewed attention to rabies treatment is needed to restimulate efforts to develop effective therapies.

• #3 Rabies and other lyssaviruses | The Australian Immunisation Handbook

  https://immunisationhandbook.health.gov.au/contents/vaccine-preventable-diseases/rabies-and-other-lyssaviruses

  The dose of rabies vaccine for pre- and post-exposure prophylaxis is 1.0 mL for Rabipur inactivated rabies virus vaccine and 0.5mL for Verorab inactivated rabies virus vaccine when given by intramuscular injection. […] The dose of HRIG (human rabies immunoglobulin) is 20 IU per kilogram of body mass. […] People who need HRIG should receive it at the same time as the 1st dose (day 0) of rabies vaccine. […] Do not give HRIG if it has been more than 7 days (168 hours) since the 1st dose of rabies vaccine. […] There are no absolute contraindications to use of either rabies vaccine or human rabies immunoglobulin as post-exposure prophylaxis in people who have potentially been exposed to rabies virus or other lyssaviruses.

• #3 Rabies – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/rabies/diagnosis-treatment/drc-20351826

  Once a rabies infection is established, there’s no effective treatment. Though a small number of people have survived rabies, the disease usually causes death. For that reason, if you think you’ve been exposed to rabies, you must get a series of shots to prevent the infection from taking hold. […] If you’ve been bitten by an animal that is known to have rabies, you’ll receive a series of shots to prevent the rabies virus from infecting you. […] Rabies shots include: A fast-acting shot (rabies immune globulin) to prevent the virus from infecting you. This is given if you haven’t had the rabies vaccine. This injection is given near the area where the animal bit you if possible, as soon as possible after the bite. […] A series of rabies vaccinations to help your body learn to identify and fight the rabies virus. Rabies vaccinations are given as injections in your arm. If you haven’t previously had the rabies vaccines, you’ll receive four injections over 14 days. If you have had the rabies vaccine, you’ll have two injections over the first three days.

• #3 Rabies | American Veterinary Medical Associationmultiple-users-1addaddaddadd

  https://www.avma.org/resources-tools/one-health/rabies

  Rabies is a deadly disease caused by a virus that attacks the nervous system. Once the outward signs of the disease appear, rabies is nearly always fatal. […] You can help prevent rabies infections by vaccinating your animals and keeping them away from wildlife that can spread the disease. Rabies is 100% preventable. Your local veterinary plays a key role in controlling rabies. […] Remember that rabies is entirely preventable through vaccination. Vaccination programs and control of stray animals have been effective in preventing rabies in most pets. Approved rabies vaccines are available for cats, dogs, ferrets, horses, cattle and sheep. […] Have your veterinarian vaccinate your dogs, cats, ferrets, and select horses and livestock. Your veterinarian will advise you on the recommended or required frequency of vaccination in your area. […] If you see a wild animal acting strangely, report it to the city or county animal control department. […] Prompt and appropriate treatment after being bitten and before the disease develops can stop the infection and prevent the disease.

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