Posted by Andy Jagoda MD in: Brain Tease , trackback
Rabies is a rare, yet nearly universally fatal diagnosis, responsible for over 59,000 deaths worldwide annually. Appropriate use of pre- and postexposure prophylaxis can eliminate the risk of developing rabies if administered according to the United States Centers for Disease Control and Prevention Advisory Committee on Immunization Practices guidelines. Though rabies is very rare, rapid recognition of potential exposures is vital to patient care and protection of public health.
Our recent issue Management of Suspected Rabies Exposure in the Emergency Department focuses on the challenges of managing patients who are at risk for or have had a potential rabies exposure, indications and guidelines for administering pre- or postexposure prophylaxis, and requirements for reporting, testing, and monitoring.
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Here are a few key points:
- Worldwide, more than 95% of cases of rabies occur in Africa and Asia, with 35% in India alone. 99% of cases are from dog bites.
- The canine virus strain of rabies was eradicated in the U.S. in 2004, though rarely, dogs can acquire other strains from contact with wildlife.
- In the U.S., rabies is endemic in wild mammals, including foxes, coyotes, skunks, raccoons, and bats. Small rodents are rarely infected.
- In the U.S. from 1960 to 2018, 70% of cases of rabies were attributed to bats.