Because there is no cure and death is almost certain, treatment for rabies involves supportive care. However, if a person is bitten by a rabid animal and has not yet experienced symptoms, there is an extremely effective post-exposure treatment, which includes an injection of rabies immune globulin and several containing rabies vaccine given over a 28-day period.
Treating Rabies: An Introduction
There is no treatment for rabies that can cure the disease once symptoms appear. Any treatment at that point involves managing symptoms and making the person comfortable (this is called supportive care). Death is almost certain once the rabies symptoms begin.
However, two decades ago, research scientists developed an extremely effective new rabies treatment regimen that provides protection from the disease when administered after an exposure (post-exposure prophylaxis). The treatment can also be used for protection before an exposure occurs (pre-exposure prophylaxis).
Post-Exposure Rabies Treatment
If a person is bitten by an animal, one of the most effective methods to decrease the chances for infection involves thoroughly washing the wound and scratches with soap and water.
In the United States, post-exposure treatment for rabies consists of a regimen of one dose of rabies immune globulin and five doses of the rabies vaccine over a 28-day period. Doctors administer the rabies immune globulin and the first dose of the vaccine as soon as possible after exposure. Normally, additional doses of rabies vaccine follow on days 3, 7, 14, and 28 after the first vaccination.
Rabies immune globulin contains antibodies from blood donors who were given rabies vaccine. The antibodies provide interim protection until an exposed person's own antibodies develop in response to the vaccine. In addition, injecting rabies immune globulin at the site of injury reduces the amount of virus that is able to enter the nerve cells and potentially initiate an active infection.
The rabies vaccine works by stimulating a person's immune system to produce antibodies that neutralize the virus. The person develops a protective immune response before the virus reaches the brain and begins to actively replicate.
Older rabies vaccines required painful, daily injections in the abdomen (stomach) for up to three weeks, and they could produce severe side effects. Current vaccines are relatively painless and are given in your arm, like a flu or tetanus vaccine.
Beginning post-exposure rabies treatment is a medical urgency, not a medical emergency. Physicians should evaluate each possible exposure to rabies and, as necessary, consult with local or state public health officials regarding the need for rabies prophylaxis.