Rabies

Rabies is a fatal viral zoonotic disease caused by lyssaviruses, most commonly the rabies virus (RABV), belonging to the family Rhabdoviridae. The disease is transmitted to humans primarily through the bite or scratch of an infected animal, most often dogs, bats, raccoons, skunks, and foxes. The virus enters peripheral nerves at the wound site and travels to the central nervous system, where it causes progressive and almost invariably fatal encephalomyelitis. Rabies is classified under Orphanet code 770 and ICD-10 codes A82.0 (sylvatic rabies), A82.1 (urban rabies), and A82.9 (rabies, unspecified). The incubation period is highly variable, typically ranging from one to three months but can extend from days to over a year, depending on the site and severity of the bite and the viral load. The disease presents in two clinical forms: furious (encephalitic) rabies, which is more common and characterized by hyperactivity, hydrophobia (fear of water), aerophobia (fear of drafts), agitation, confusion, hallucinations, and autonomic dysfunction; and paralytic (dumb) rabies, which presents with ascending paralysis resembling Guillain-Barré syndrome. Both forms progress to coma and death, typically within days to weeks of symptom onset. Hydrophobia, caused by painful spasms of the pharyngeal and diaphragmatic muscles triggered by attempts to swallow, is considered pathognomonic for rabies. Once clinical symptoms appear, rabies is almost universally fatal, with only a handful of documented survivors worldwide. However, rabies is entirely preventable through timely post-exposure prophylaxis (PEP), which includes thorough wound washing, administration of rabies immunoglobulin, and a series of rabies vaccine doses. Pre-exposure prophylaxis vaccination is recommended for individuals at high risk, such as veterinarians, animal handlers, and travelers to endemic regions. Despite the availability of effective prevention, rabies causes an estimated 59,000 human deaths annually worldwide, predominantly in Asia and Africa, with most cases resulting from dog bites in resource-limited settings where access to PEP is inadequate.

Data sourced from FDA regulatory filings and ClinicalTrials.gov. Updated periodically.

Common questions about Rabies