Rabies history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

History and Symptoms

Micrograph with numerous rabies virions (small dark-grey rod-like particles) and Negri bodies, larger pathognomonic cellular inclusions of rabies infection

• The period between infection and the first flu-like symptoms is normally two to twelve weeks, but can be as long as two years.
• The first symptoms of rabies may be nonspecific flu-like signs — malaise, fever, or headache, which may last for days.
• There may be discomfort or paresthesia at the site of exposure (bite), progressing within days to symptoms of cerebral dysfunction, anxiety, confusion, agitation, progressing to delirium, abnormal behavior, hallucinations, and insomnia.
• The acute period of disease typically ends after 2 to 10 days (6).
• Once clinical signs of rabies appear, the disease is nearly always fatal, and treatment is typically supportive. Disease prevention is entirely prophylactic and includes both passive antibody (immune globulin) and vaccine.
• Non-lethal exceptions are extremely rare.
• To date only six documented cases of human survival from clinical rabies have been reported and each included a history of either pre- or postexposure prophylaxis.
• The few humans who are known to have survived the disease were all left with severe brain damage, with the recent exception of Jeanna Giese (see below).