Who should receive rabies prophylaxis?
What are the presenting symptoms for rabies?
Rabies is transmitted by animal bites and is most commonly carried by bats in the developed world and by dogs in Africa and Southeast Asia, where the disease is far more prevalent.
Patients may present with encephalitic rabies characterized by psychosis, autonomic instability, and pain following a prodrome of paresthesias at the site of inoculation. Some may present with “paralytic rabies,” a clinical syndrome of acute flaccid paralysis followed by encephalopathy.
Patients with either recent animal bites in developing countries or bat exposure in developed countries should receive postexposure prophylaxis with rabies immunoglobulin followed immediately by rabies vaccine, which is given in several doses over 2 to 4 weeks.
While nearly universally fatal once symptomatic, this regimen is highly effective when administered promptly following exposure.
