Rabies

David J. Weber David A. Wohl William A. Rutala

Microbiology Pathophysiology Epidemiology Preexposure Prophylaxis Postexposure Prophylaxis

Postexposure Prophylaxis }n. Special,Circumstances Prior, Rabies Immunization

ImmunocompromisedPersons

Travelers

Pregnancy

Children

Olinical.D.isea.se Diagnosis, and Treatment Chapter, References

Currently, rabies causes an estimated 40,000 to 100,000 deaths each year worldwide.1 In addition, millions of persons, primarily in developing countries, undergo costly postexposure treatment. In the United States, rabies continues to be endemic in many wild animals. Although human rabies is rare in the United States, postexposure rabies prophylaxis is likely provided to more than 35,000 persons per year.2 Prevention efforts in the United States are estimated to cost between $230 million and $1 billion dollars.1

This chapter briefly reviews the microbiology, epidemiology, clinical presentation, and treatment of rabies. Because animal bites and scratches are commonly seen by primary care and emergency medical physicians, the postexposure management of persons potentially exposed to a rabid animal is reviewed in detail. Comprehensive reviews of rabies have been published in the medical literature 3,4,5.,6 and 7 and in standard infectious disease or microbiology textbooks. 891 112 and i; Current information is available on the "rabies homepage" produced by the Centers for Disease Control and Prevention. 14

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