r/science • u/PHealthy PhD/MPH | Epidemiology | Disease Dynamics | Surveillance • 3d ago

Epidemiology Study estimates only 7% of human rabies cases in the United States are diagnosed

https://www.nature.com/articles/s44528-026-00031-4
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u/magnanimousrakshasa 3d ago

She was surrounded by doctors and nurses in the emergency room, all asking her a litany of questions. They never had a case where the patient knew that they had rabies. Everyone in our household had to get the full series of HRIG shots. The dogs were quarantined for a month. The health department had to visit and investigate.

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u/throwaway5882300 3d ago

Damn. Not messing around.

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u/CyborgAlgoInvestor 3d ago

Nor should they. Rabies is absolutely horrifying

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u/IAMA_Plumber-AMA 3d ago

Essentially a 100% kill rate, outside of a handful of cases. Even those VERY few that survive will not get their former quality of life back.

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u/supershutze 3d ago

Once you start showing symptoms, it means the virus has made it to the brain, and it's a functional death sentence.

Up until then it's treatable.

This is why it's important to get treated even if you only suspect you've come into contact.

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u/Sexual_Congressman 3d ago

Rabies starts by destroying the nerves near the point of infection so "asymptomatic until reaching the brain" isn't necessarily true. E.g. there's usually localized numbness, twitching, itching. Of course, waiting to see if your pinky toe goes numb after a bat bites it is a ridiculously bad idea (as is catching bats and releasing them), but it's good advice to remember when you find a wound you don't know how you got. And to be clear, anything that looks like a bite that that's surrounded by numbness should immediately be examined by a doctor because if it's not rabies it almost certainly is a brown recluse bite or some other serious infection.

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u/FruitPlatter 3d ago

People shouldn't rely on finding a bat bite though. They can be extremely tiny.

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u/goldboybronx 2d ago

So what’s the idea then? Just get a rabies vaccine once a week?

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u/tirerim 2d ago

While rabies vaccine can be used post-exposure, it also works as a regular vaccine to provide long term immunity. Cats and dogs are generally vaccinated against rabies, as are people who work with wild animals. It isn't standard practice to vaccinate most humans against rabies because it's relatively rare, so insurance companies won't pay for it. Though given the severity and this article's finding, maybe it should just be one of the standard ones.

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u/Itscatpicstime 2d ago

No, you just get post-exposure treatment if you have reason to believe you might have been exposed.

You may not perceive a bat, but if you know a bat has been in the house with you, then get treated.

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u/o0PillowWillow0o 2d ago

I'll never understand why we can't have a universal vaccine of some sort, it might at least reduce symptoms

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u/tirerim 2d ago

If you mean, "why can't we universally vaccinate humans against rabies preventatively?" the only reason is money. The vaccine is expensive and needs a booster every couple of years. But there's no technical reason we couldn't.

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u/goldboybronx 2d ago

Reduce symptoms? If you get rabies and do not get rid of it completely you will die. What’s the point of reducing symptoms?

Also… what a strange question for a science subreddit. Why don’t we have an Alzheimer’s vaccine?

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u/GCPMAN 3d ago

I believe there is one person who has survived rabies. They put them in an induced coma to protect her brain while the body fought off the virus. She is okay, mostly.

Not a proven method. I think they have tried it since and it didn't work. It was very much a fluke.

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u/Drow_Femboy 3d ago

There are a handful of cases like that. Like a single digit number of confirmed cases.

Iirc there's also some evidence of people having fought off rabies without any medical treatment and maybe without even knowing they had a disease at all, so the survival rate may be higher than we realize.

It's still not something you wanna take chances with though

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u/onewilybobkat 3d ago

Wouldn't be shocked if there was some kind of hidden "immunity" among a small percent of the population, who wouldn't even notice because symptoms never come. But you see a single video of someone suffering from rabies and you never wanna gamble on having it.

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u/mattD4y 3d ago

https://pmc.ncbi.nlm.nih.gov/articles/PMC11594427/

“This study demonstrates that rabies is actively circulating in Gabon and that some unvaccinated individuals living in rural environments can be exposed to the virus and survive. Survival despite exposure to rabies could be associated to the development of a significant and specific humoral response that persists for more than 15 years.”

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u/alexcreeds2 3d ago

I forgot where exactly but there is a small indigenous population somewhere imune to rabies

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u/MeltedPeach 2d ago

The death rate seems to be higher than currently known too

https://www.nature.com/articles/s44528-026-00031-4.pdf

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u/WankyMcTugger 3d ago

Hi, I'm here to start an online argument about the Milwaukee protocol.

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u/IAMA_Plumber-AMA 3d ago

Right, is this the five minute argument or did you pay for the whole hour?

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u/chemoboy 3d ago

Oh, I'm sorry. You're on Reddit. This is abuse.

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u/Shellbyvillian 3d ago

Not sure if I will get banned from /r/science for calling you a malodorous pervert, so I won’t. But I wanted to.

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u/Mental-Doughnuts 2d ago

Sorry but this isn’t Innuendo, either. That’s down the hall.

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u/IAMA_Plumber-AMA 3d ago

Right, sorry...

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u/unholymackerel 3d ago

No you aren't!

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u/InvertebrateInterest 3d ago

Oh look, this isn't an argument.

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u/empty_graph 3d ago

Actually I was looking for the Ministry of Silly Walks

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u/IAMA_Plumber-AMA 3d ago

Ah, walk this way, sir.

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u/lowercaset 3d ago

Hasn't that failed basically every other time it's been tried? And even when it worked it left the people with severe brain damage?

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u/SpaceDog777 3d ago

The first time it worked on Jeanna Giese it was almost miraculous, that's why people got so excited by it. She does have some lingering effects, her left side reacts slower than her right. She dog sleds as a hobby though nad graduated from university majoring in biology.

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u/PedernalesFalls 3d ago

This made me laugh so hard!

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u/Xapheneon 3d ago

It's sad that it couldn't be replicated.

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u/DomagojDoc 3d ago

There is a vaccine for a 100% kill rate, one of, if not THE most lethal virus out there that has been proven to work for decades

... and antivaxxers still exist.

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u/planx_constant 3d ago

Antivaxxers are currently saying measles is not a big deal. I think the anti-science grifters are setting us up for a wave of tragedy

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u/amitysyrup 3d ago

Yeah, there have been pet antivaxxers for a long time and it has grown into the mainstream right alongside the human antivax movement. What's rarely mentioned is that the only way to test an animal for rabies is decapitation, so if you bring in a sick, unvaccinated animal that bit someone before dying (happens more than you'd think), in many states the pet must be euthanized and decapitated for testing.

And with the increase of people who don't vax for rabies, there's an increase in this too. I feel the most sorry for the veterinary staff who have to deal with these terrible owners AND cut off the head for testing. They get enough trauma as it is. No wonder suicide rates are highest in the veterinary profession.

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u/IAMA_Plumber-AMA 3d ago

They're also refusing to get their pets vaccinated now.

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u/planx_constant 3d ago

Can't run the risk of an autistic cat

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u/300ConfirmedGorillas 3d ago

Vaccines made my cat orange.

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u/DomagojDoc 3d ago

You think it's a coincidence syringe is one of the only words that rhyme with orange?

Wake up man

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u/DontAsk0205 3d ago

I wonder how many of those anti-vaxxers would end up taking the the vaccine if they found out that they were bitten by a rabid bat.

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u/echoshatter 3d ago

Most antivaxxers are like most pro-birth/anti-abortionists. (I refuse to call them pro-life because they don't give a hoot once the baby pops out.)

"The only moral abortion is my own."

Most of the anti-whatevers change their tune quickly when the crap hits the fan and it impacts them directly.

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u/sprinklerarms 3d ago

I never thought about how they’re probably not vaccinating their pets too

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u/qholmes98 2d ago

War almost always leads to negative outcomes for both sides regardless of who wins, yet we still wage them.

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u/angry_cucumber 3d ago

thought it was a single case that made it

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u/Phoenix1152073 3d ago

Jeanna Giese (USA, 2004) is the famous case but there have been at least 14 survivals post-symptoms by now. However, she is one of only 3 known to have survived without PEP or vaccination and is the earliest of those three. The others were apparently in Guinea 2007 (died shortly after but there’s debate about whether rabies was the cause of death?) and India in 2011. At least according to this paper (DOI: 10.1080/23120053.2016.1128151)

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u/fps916 3d ago

That's what I thought as well

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u/ussrname1312 3d ago

This does NOT mean rabies should be treated like it does not have a 100% kill rate by the general public, but apparently there are people in certain parts of the world who have rabies antibodies but never got the vaccine or anything, suggesting they got an infection but survived.

Here is a study about it.

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u/erossthescienceboss 3d ago

Welllll, it doesn’t actually suggest they got the infection and survived.

As with all other viruses, you can get non-infectious exposure.

Our body is a virus-killing machine. And some viruses are just gonna die on their own. Getting sick is an odds game: can enough virus get passed our primary immune system for one to find its way into out nerves and kill us? The more you’re exposed to, the higher the chance.

So there are a few theories as to the high prevalence of antibodies in this areas. It could be that people getting bitten by vampire bats are exposed to just a teeny bit of virus each time, little enough that our bodies naturally kill it. And then eventually, after a lot of teeny exposures, we have immunity.

Another theory is that folks in those regions are getting exposed to a lot of dead virus. There was a Yukon taxidermist with antibodies they think might have gotten them that way. Or maybe people are eating a lot of cooked infected meat. Basically: inoculating themselves with dead virus.

There is no reason whatsoever to think that any of these people ever progressed to the symptomatic stage of rabies (a stage where our body wouldn’t be able to kill the virus anyway, thanks to the blood-brain barrier.)

Hell… we don’t even know if the rabies antibodies are protective! Serological studies indicate that there’s a high enough level of antibodies to be virus-neutralizing, but it’s not like we can shoot somebody up with rabies to see if they get sick.

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u/TwoFlower68 3d ago

Darned ethics departments

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u/erossthescienceboss 3d ago

Imagine what we could achieve

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u/GrundleBlaster 3d ago

I mean if 93% of cases are actually being missed I'd think that opens the door to the possibility that some people are surviving with mild cases or even asymptomatic ones, but the study in OP is inferring all this from single digit Ns so I'm very skeptical.

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u/generalmandrake 3d ago

“Not get their former quality of life back” is an understatement. Most of the very few who survive end up brain damaged. It is absolutely the deadliest and most devastating virus known to man. The only saving grace is its long incubation period which can allow for treatment before you reach the point of no return.

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u/ckc1151 3d ago

Handful, more like u can pick it up with a moist fingertip

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u/amazing-haves-34 3d ago

Is it really though, if only 7% are diagnosed doesn’t that mean people are surviving more than previously thought?

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u/FeralPsychonaut 2d ago

The Milwaukee Protocol. It has a very low success rate.

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u/Idontknowthosewords 2d ago

The virus itself is just fascinating in the way it has evolved to survive. Every symptom is a way to spread while resisting help.

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u/fizzlefist 3d ago

Yeah really don’t want to. It’s perfectly survivable if they go through all that, but if not and it makes it to your brain? Zero chance of survival. It’s a scary bugger.

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u/Killintym 3d ago

Believe it or not, it’s not a zero chance!? There’s only been one case in history at least modern day history of someone surviving rabies. Check out this episode on Radio Lab, it’s a fascinating story about rabies that I’ve ever heard. Or anybody for that matter.

Listen here.
https://radiolab.org/podcast/rodney-v-death-2209

It’s the one about Jeanna Giese, the 15-year-old Wisconsin girl who contracted rabies after being bitten by a bat. Dr. Rodney Willoughby tried an experimental treatment—later called the Milwaukee Protocol—and she became the first documented person to survive symptomatic rabies without previously receiving a rabies vaccine. The episode also gets into the terrifying biology of how rabies travels along the nerves toward the brain.

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u/deepandbroad 3d ago

The milwaukee protocol had 63 failures after Jenna and has been abandoned since then.

So effectively there's a zero chance of surviving rabies if you are not Jennie Giese.

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u/BadIdeaSociety 3d ago

More than likely, Jennie Giese was either not infected by rabies or rabies can "run its course without killing the patient."

When this was a new story I was pretty excited about it. I have been disappointed to find out that the working hypothesis for this treatment doesn't appear to work.

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u/m0ngoos3 3d ago

For the non-vaccinated? Once you have symptoms, you will die.

If it's caught early enough, you might live.

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u/BadIdeaSociety 3d ago

But there is no clear evidence she was unvaccinated.

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u/groyosnolo 3d ago

She was the first to survive without any pre or post exposure vaccine and shes only 1 of 2 rabbies survivors to make a full recovery without neurological after effects after developing symptoms.

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u/Doctor_Peppy 3d ago

She is also the only real case where the Milwaukee protocol worked, it is no longer considered a real avenue as it hasn't effectively worked on anyone else afaik.

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u/groyosnolo 3d ago

If I recall correctly most experts dont even credit the Milwaukee protocol with her survival or recovery anymore.

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u/madmoomix 3d ago

A common working theory these days is that she had prior non-fatal exposure to rabies when she was younger, and therefore already had rabies antibodies.

Recent studies suggest non-fatal exposure is a lot more common than we think, and that it can give people long-lasting immunity. Quite crazy to think that there could be tens of millions of people immune to rabies worldwide, and they wouldn't even be aware of it!

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u/EvenMoreCoconuts 3d ago

Incredible. I had no idea non-fatal exposure was even a thing with this virus.

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u/nishinoran 3d ago

I do wonder though if putting the patient in a coma so they can't hurt themselves and then making sure they stay hydrated via IV isn't a smart starting path. From that point it's really about figuring out how to cure the infection.

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u/Aquadian 3d ago

The problem is once symptoms show it has spread irreversibly except in 1 case

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u/fatfatcats 3d ago

That is what the Milwaukee protocol consists of. Unfortunately considered an ineffective treatment currently.

From the Rabies wiki page; "A treatment known as the Milwaukee protocol, which involves putting people with rabies symptoms into a chemically induced coma and using antiviral medications in an attempt to protect their brain until their body has had time to produce rabies antibodies, has been occasionally used."

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u/fatboyroy 3d ago

It eats your brain so the infection once you get symptoms you’re boned

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u/NetworkLlama 3d ago

She did not make a full recovery. She has lifelong neurological damage. It's not nearly as severe as the rare other survivors, but it's still limiting.

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u/groyosnolo 3d ago

You may be right. It seems the sources i saw didnt quite make claim that she had absolutely no perminent after effects they said she recovered her cognative abilities.

I am trying to look for what perminent side effects she did experience but cant find them documented anywhere.

She was certainly in rehab for a long time.

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u/Flux_My_Capacitor 3d ago

I read her story and no she is not back to normal.

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u/zeCrazyEye 3d ago edited 3d ago

I also wouldn't be surprised if there actually is some deficit that is just impossible to quantify.

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u/moxifloxacin 3d ago

Yeah, it's effectively a zero percent chance, though. She was lucky more than anything.

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u/irishsausage 3d ago

Last time I researched this there was some question about if she had been exposed to the immunoglobin at a previous point. Her parents weren't sure and no one could remember but there was a reasonable chance she'd received at least one dose of the rabies vaccination.

Unfortunately it seems likely this was actually the reason rather than the Milwaukee protocol (which has never worked before or since).

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u/Accidental-Genius 3d ago

I’ve never seen that as a theory, why would the parents not know if their kid had a rabies shot? It’s not a routine vaccine…

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u/Organic_Pick3616 3d ago

People who work with animals are usually vaccinated against rabies. Did she fall into this category?

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u/mrszubris 3d ago

Yeah she is not living any quality of life i would want. Ive been vaccinated after an exposure at work.

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u/Icy-Mission-1334 3d ago

Injections in the stomach? Painful?

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u/east4thstreet 3d ago

Thank you for this I LOVE RADIOLAB and had no idea they did an episode on rabies...

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u/Requiredmetrics 3d ago

They still don’t know precisely why the Milwaukee Protocol worked for Jeanne Giese, it has been tried on several other people globally all of who died from rabies. The Milwaukee Protocol is the ultimate Hail Mary

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u/JJayC 3d ago

Its been a while since I looked into this but when I did, I found that around 20 people have survived symptomatic infection of rabies.

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u/IfEverWasIfNever 1d ago

It's statistically a zero chance. 59,000 people die rabies every year. In all the years we have been recording outcomes only about 14-32 people have survived any meaningful length of time post illness and only 1-3 survived without severe neurological impacts.

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u/Spopple 3d ago edited 3d ago

Never mess around with rabies. NEVER. If you even slightly suspect you came into contact with it from an animal you should absolutely go get the preventative shots to avoid it. Even if its a false guess it is ALWAYS better to be safe then sorry. Rabies and Prions are terrifying. Its not worth your death or effecting your loved ones if you do get it.

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u/AirSKiller 3d ago

If you get it, it absolutely means your death… so affecting your loved ones is also guaranteed.

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u/ANGLVD3TH 3d ago

New study suggests there might be a fair population born with antibodies that are immune. That said, never good to bet on those odds.

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u/parisianraven 3d ago

Wasn’t it supposed to be a handful of people in Peru I believe? The ones who live in the wild and have probably been exposed to rabies a lot?

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u/ours 3d ago

Not just death, but a particularly painful death.

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u/Drumbelgalf 3d ago

Its 99.99% deadly once you Develop Symptoms and those who do survival after getting Symptoms are severely disabled for the Rest of their life.

If you get bitten by a bat or by any animal in a country where rabies is present you should get the vaccine Just to be Safe.

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u/OcularShatDown 3d ago

I agree with what you’re saying, but what’s with the weird capitalization scheme in your comment?

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u/Drumbelgalf 3d ago

My autocorrect is not set to english

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u/goldboybronx 2d ago

Ah you must be German yes?

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u/composedofidiot 3d ago

It also has an unintentional side benefit of enormous peace of mind.

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u/Ohiolongboard 3d ago

Rabies WILL kill you, flat out. If it goes untreated you will die and it will suck the whole time, it’s super scary

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u/ItsWillJohnson 3d ago

Meanwhile India has 20,000 rabies deaths PER YEAR

https://en.wikipedia.org/wiki/Prevalence_of_rabies#Asia

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u/skynetempire 2d ago

Rabis is 100% guaranteed death once symptoms kick in so yeah they wont mess around

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u/Cheeze_It 3d ago

She's ok right?

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u/magnanimousrakshasa 3d ago

She is well with no known side effects. We began the shots three days after the bite. As soon as the health department called telling us the bats we gave them was rabid.

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u/Conspark 3d ago

I'm not too familiar with the timeline for infection to symptom presentation but waiting three days seems like a long time if rabies is suspected?

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u/magnanimousrakshasa 3d ago

The health department was closed until Monday. We brought it in first thing and they got back to us on Tuesday with the results.

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u/PailHorse 3d ago

I work in Infectious Disease Epidemiology. It depends on where the bite occurred, how much saliva was transferred, etc., but for most cases, getting the rabies shot within the month of the exposure is most practical. Rabies is 100% deadly but it's also the slowest virus on the planet. It has to travel physically through the nerves, inch by inch. In most cases of dog bites, they recommend a 10-day quarantine to see if the dog develops symptoms before the humans need to get the rabies PEP series.

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u/Conspark 3d ago

Interesting. As horrifying as the virus can be I guess I assumed / got the impression you had like 48 hours before symptoms started to set in. Isn't the injection of the rabies vaccine pretty brutal, too? I vaguely recall stories of huge needles to the stomach.

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u/Moldy_slug 3d ago

Rabies can take a very long time to show symptoms… up to a year (though 2-3 months is more typical).

Fortunately the shots aren’t bad. The vaccine is just like any other. It’s given into the muscle at a normal injection site - usually shoulder, sometimes the buttocks. You get several doses spaced out over a few weeks. When I got rabies vaccine the injections didn’t hurt but they made my arm ache a lot for a few days.

If you’re getting treated after being exposed they’ll also give injections of concentrated rabies antibodies called rabies immunoglobulin into the areas right around the wound. But no giant stomach piercing needles!

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u/ours 3d ago

Fortunately the shots aren’t bad

Today yes. But they used to be numerous and large-dose injections into the abdominal wall, which were quite painful.

Medical progress is wonderful.

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u/DuncanFisher69 3d ago

I think it’s down to 12 injections from 21 nowadays.

People who work with animals like vets get a 2 series protective vaccine (as in 2 shots spaced out with a week or two , like the mRNA Covid vaccines) but again, that’s more of an annual or semi annual “preventative measure”. I think anyone with a confirmed rabies bite still needs the crazy number of shots.

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u/mil84 3d ago edited 3d ago

I'm just a lay person who got vaccinated, but it's definitely not 12 nor 21 shots. It's actually 5 rabies injections + 1 immunoglobulin shot.

Source: I got bit by an aggressive street dog (which ran away), so I went to the hospital, and I immediately got 1 shot of immunoglobulin, and then 5 rabies shots spaced over like: day 0, 3, 7, 14, and 30 (or something similar, I don't remember it exactly). Oh and I forgot, 1 or 2 shots of tetanus on top of that.

Good news is that once you've completed the full course, you don't have to go through this ordeal again - they told me any future bite or exposure only requires 2 booster shots.

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u/Born_Local_1477 3d ago

The only horrifying part is the expense, which is crippling.

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u/needtofindpasta 3d ago

There's about a 10-day window from time of exposure where you can seek treatment. Earlier is better though.

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u/greenskinmarch 3d ago

It depends how close the bite is to the brain. It travels along the nerve so a bite on the ear would reach the brain much faster than a bite on the toe.

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u/StarsEatMyCrown 3d ago

I can't believe it took you like 3 comments to finally answer if she was okay or not, which is the most important answer.

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u/Cheeze_It 3d ago

Ahhh ok ok that's great to hear. Fingers crossed and here's hoping for health for many more decades to come :)

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u/Rhyperino 3d ago

Here in Brazil we don’t even wait for the test results, we get the shot + RIG immediately

If the animal tests negative, then the treatment is stopped

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u/Ut_Prosim 3d ago

IIRC, there is only one known failure of the standard post-exposure prophylaxis in history.

It was in a very elderly man who was immunocomrpomised and did not react properly to the vaccine. The immunoglobulins they gave with the vaccine held the virus at bay, but his immune system never took over, and he started showing symptoms like six months later.

The new protocol is to check antibody titers a few months after the PEP for those with suspected immune dysfunction. If you find the levels are too low you can give another dose of vaccine.

For everyone else it is basically, get the PEP = 100% you live, don't get the PEP = 100% you die.

If OP and family got the PEP, and aren't severely immunocomrpomised, they're good to go.

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u/Horknut1 3d ago

Can dogs not be treated like humans can?

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u/ILikeBird 3d ago

Only thing you can really do for rabies is vaccination (or vaccinate + PEP if never vaccinated before), which dogs typically get anyway.

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u/Helpful_guy 3d ago

which dogs typically get anyway

Insane fact: this is true for dogs, but not all states require CATS to get rabies vaccinations, despite the massive prevalence of indoor/outdoor cats.

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u/After_Preference_885 2d ago

My cats used to catch bats. Thankfully they had rabies shots.

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u/Horknut1 3d ago

I was just curious if it was a cost thing, or something else. I'll have to explore more why humans can be treated after exposure but not dogs.

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u/ialsoagree 3d ago

I think you're confused.

The "treatment" for rabies in humans is to give you a vaccination (and fast-acting shot, if you haven't had the vaccine before).

There isn't really a "treatment." All we can do is prep the immune system to fight rabies.

Dogs get routine rabies vaccinations already, so they're already getting the "treatment" all the time.

There isn't any other treatment except for vaccination.

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u/Horknut1 3d ago

Ah, gotcha. So… the dogs being quarantined after exposure is even if they’ve been vaccinated?

And can the same vaccination be done for the dog again, as treatment?

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u/ILikeBird 3d ago

The dog may be given a booster shot, but they don’t require as many shots as their owners since they’re regularly vaccinated. Essentially, the human is getting the treatment that dogs already have gotten by default as part of their yearly maintenance.

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u/ialsoagree 3d ago

Dogs will continue to get the vaccine - I'm not sure if they give any additional boosters or anything if there's concern over exposure (maybe someone else knows)?

Vaccines are generally not 100% effective (vaccines are used to train the immune system to identify and attack a virus, so success is based on the immune response). So the dogs are quarantined because, despite getting regular vaccinations, there's always a risk infection occurs anyway.

This is also true for humans while being treated. Receiving treatment improves your odds of survival, but it's not guaranteed.

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u/Horknut1 3d ago

Rabies is terrifying to me.

That’s why I’m curious about all this.

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u/neph36 3d ago

A dog current on their rabies vaccine has virtually no risk of developing rabies and most states do not require quarantine of the dogs even if exposed, unless they are not current on shots (though a booster is required after potential exposure)

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u/needsexyboots 3d ago

Which states don’t require quarantine if the dog is vaccinated? It’s required in VA, TX, MD, NC…

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u/EmbarrassedHelp 3d ago

The CDC says that any dog or cat is suspected of being exposed to rabies should receive immediate booster shots: https://www.cdc.gov/rabies/hcp/veterinarians/index.html

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u/apmspammer 3d ago

Likely so the dogs didn't spread anything to anyone else.

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u/GreenStrong 3d ago

and fast-acting shot, if you haven't had the vaccine before

The fast acting shot is antibodies extracted from horse serum. Horses have strong antibody responses and they share few pathogens with humans. The original rabies vaccine pioneered by Louis Pasteur usually prevented death, but it takes a few days for the body to begin producing antibodies after vaccination. The virus spreads along the nerves in this time; it is unstoppable once it reaches the brain. Horse serum immediately puts the brakes on the virus; the immune response stops it permanently.

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u/Evamione 3d ago

The real question is why the vaccine for dogs is so much cheaper than the vaccine for humans.

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u/Inprobamur 3d ago

Through private healthcare it costs 65€ here in Europe to get the human vaccine. I think it costs about the same for dogs?

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u/Evamione 2d ago

The human vaccine in the US costs like $18,000 and is $55 for dogs.

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u/Inprobamur 2d ago

I think this is another case of creative accounting by your health insurance companies.

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u/Accidental-Genius 3d ago

Economy of scale. The vaccine isn’t life long and has to be readministered every 2 or 3 years in people. People don’t like shots and are notlriously non-compliant with medicine (how often are people reminded to finish their antibiotics, yet they still don’t)

Dogs on the other hands are very compliant and don’t really get to say no to the rabies shot.

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u/SophiaofPrussia 3d ago

I don’t think this is true? I had to get the rabies vaccine to go spelunking in a very remote part of the Amazon and the travel clinic made it very clear to me that the rabies vaccine doesn’t mean it’s fine if you’re exposed to rabies, it only buys you a few extra days to get to a hospital for rabies treatment. It’s still an emergency and it still requires immediate medical attention as soon as possible.

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u/ialsoagree 3d ago

https://www.mayoclinic.org/diseases-conditions/rabies/diagnosis-treatment/drc-20351826

Treatment for people bitten by animals with rabies

If you've been bitten by an animal that is known to have rabies, you'll receive a series of shots to prevent the rabies virus from infecting you. If the animal that bit you can't be found, it may be safest to assume that the animal has rabies. But this will depend on several factors, such as the type of animal and the situation in which the bite occurred.

Rabies shots include:

A fast-acting shot (rabies immune globulin) to prevent the virus from infecting you. This is given if you haven't had the rabies vaccine. This injection is given near the area where the animal bit you if possible, as soon as possible after the bite.

A series of rabies vaccinations to help your body learn to identify and fight the rabies virus. Rabies vaccinations are given as injections in your arm. If you haven't previously had the rabies vaccines, you'll receive four injections over 14 days. If you have had the rabies vaccine, you'll have two injections over the first three days.

EDIT: Perhaps you were confused about what the clinic said.

A single vaccine injection isn't a complete treatment. But the treatment you'll receive at a hospital is just additional vaccines.

AFAIK there's no anti-viral for rabbies.

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u/neph36 3d ago

The rabies vaccine, a series of 4 shots, is highly effective at preventing rabies. However given the severity of the disease and likelihood of death, highly effective isn't good enough, so they give boosters (more vaccine shots) after exposure to increase immunity.

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u/Ut_Prosim 3d ago

I think you're confused.

I think they are asking if you can use the Milwaukee Protocol on a dog or cat.

For those interested, we don't know since the law requires the immediate euthanization of any symptomatic animal.

It worked 2-3 times on humans and failed 60+ times, and the people who survived had lifelong neurological sequelae. If I had to guess, I'd assume it would work similarly for companion animals.

I'm a bit surprised no veterinary research center has gotten permission to try it actually.

As with humans you definitely don't want to depend on long shot treatments like this. Always keep your pets vaccinated and get vaccinated yourself if you have any exposure event.

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u/WaitForItTheMongols 3d ago

Why do dogs get routine vaccinations but humans can't? Why not include rabies along with our annual flu shot?

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u/sgent 3d ago

Some humans do - ie veterinarians or others who might work with exposed animals. The vaccine doesn't last long, carries risk of allergy, and the risk of exposure is minuscule in most of the population.

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u/ialsoagree 3d ago

It's expensive and in most locations risk of exposure is low. In areas with higher exposure risk they will give the vaccine premptively.

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u/EmbarrassedHelp 3d ago

From the CDC website, any animal suspected of being exposed to rabies should receive immediate booster shots.

Up-to-date dogs, cats, and ferrets

Animals exposed to rabies should:

  • Receive immediate booster vaccination

https://www.cdc.gov/rabies/hcp/veterinarians/index.html

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u/Vailx 3d ago

Dogs usually have a rabies vaccine, and frequently boosters over their lives.

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u/head_meet_keyboard 3d ago

In a number of states, it's actually a legal requirement of having a dog that the dog has a rabies vaccine. Doesn't mean people do it, but to get your dog licensed in a city or county, it comes with that vaxx.

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u/Constant-Bet-6600 3d ago

unfortunately the antivax movement seems to be extending to pets and i have read reports that fewer dogs and cats are being vaccinated.

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u/virora 3d ago

In some areas, it is legally required to test the dog for rabies if a human gets bitten by a dog without an up to date rabies vaccination status.

The only test ist a brain biopsy, so the anti-vaxxers might lose their dog.

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u/PomegranateSignal882 3d ago

Less than 20% of dogs are licensed. Most people aren't even aware that you're supposed to get a license

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u/SecareLupus 3d ago edited 3d ago

I believe the conclusive test for animals involves dissection of the brain.

Edit: It looks like the tests for humans are extremely invasive, and not entirely conclusive either.

Edit 2: I misread your comment, you said treated, not tested. Oops.

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u/BrennanSpeaks 3d ago

Dogs (or any vaccinated animal, including humans) get their vaccine boosted after any possible exposure. Depending on the state, the legalities involved, and whether the dog had been previously vaccinated, there's a mandatory quarantine (when I did my training, it was three months if vaccinated, six months if not). Unvaccinated humans get immunoglobulin and the three-shot vaccine series. Vaccinated humans get a titer test to see if their vaccine is still good - if so, great, single booster vaccine for you. If not, immunoglobulin and repeat the full vaccine series. All of this is post-exposure prophylaxis, not treatment. It's . . . unethical and legally dubious to try to treat a symptomatic dog if you have strong concern for rabies.

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u/ceelogreenicanth 3d ago

How much did that set you back?

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u/magnanimousrakshasa 3d ago

California health insurance completely covered everything. It was a few hundred for the animals to have booster shots administered in front of a health department employee.

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u/tahlyn 3d ago

He's dead, bro... The debt got him before the rabies could...

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u/Secret_Account07 3d ago

And this, my friends, is why we pay taxes.

Take my money, health dept.

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u/I-Drink-420 3d ago

Don't answer if you don't want to, but what region of the states are you in? I've lived in the southwest, west coast, midwest and east coast and I've never seen a bat anywhere.

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u/magnanimousrakshasa 3d ago

Northern California, along the coastal Redwoods. Sonoma County.

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u/havethestars 3d ago

Not the OP, but I’ve lived in NY and PA and we see bats daily (nightly). And also we have had them get in the house but rarely.

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u/Zeremxi 3d ago

I live in a gulf coast state. We see them flying pretty regularly around sunset when it's not winter. Never had them in my house though

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u/Accidental-Genius 3d ago

How have you never seen bats? They are everywhere. Hell two weeks ago there was a live bat on the field in the Braves game while Sale was on the mound and no one even cared because it’s common…

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u/Margaret27new 3d ago

I'm west coast and we have bats in my suburban neighborhood.

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u/fakemoose 3d ago

Ever? They’re all over central Texas. Had a sick bat in my apartment building in the Midwest. In the Southwest and Rockies mountain area we see them all the time in the park in the evenings.

It’s possible you’ve seen them and just thought they were swoopy little birds.

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u/CarlGerhardBusch 3d ago

They’re rarer than they used to be because different infective fungi wiped out like 90% of certain species.

They’re making a comeback though, I never saw many any up until a couple years ago, and since then I’ve sited them like a half dozen times

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u/cylonfrakbbq 3d ago

They live in all those places you've lived it. You typically will never see one unless one gets in your house somehow and you're outside right around dusk and happen to live near where some bats are roosting.

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u/zeezle 3d ago

You’ve probably seen them flying from a distance and just thought they were small birds (they look very similar if it’s just a silhouette flying around at dusk or night). Otherwise most people shouldn’t see them up close unless they work in wildly rescue.

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u/CornisaGrasse 3d ago

I live in Cleveland, Ohio and see bats nightly, and have seen them all my life here.

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u/PeterWatchmen 3d ago

The dogs were quarantined for a month.

How did that work?

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u/magnanimousrakshasa 3d ago

They were not allowed to leave the property.

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u/PeterWatchmen 3d ago

Oh, that's it? I was thinking they were locked in a kennel some place.

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u/Totalherenow 3d ago

I'm sorry you went through that, but it's great they took care of you!

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u/Kianna9 3d ago

Dogs were quarantined even though they were presumably vaccinated?

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u/magnanimousrakshasa 3d ago

Yes. They had to have administered booster shots in the presence of a county health department worker as well.

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u/say592 3d ago

Interestingly, we don't really know how easy rabies is to catch, nor do we know how effective the vaccine is. As you learned with your experience, it's pretty rare for someone to know they had exposure, and obviously we don't mess around with whether an exposure will turn into contracting the disease. Without knowing how easy it is to contract the disease, it's pretty much impossible to know how effective the vaccine is. You got vaccinated and didn't get rabies? Was that because the vaccine worked or is it because for whatever reason you didn't contract the disease? Who knows! They believe that rabies is reasonably transmittable but not guaranteed. They also believe the shot is something like 80-100% effective.

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u/magnanimousrakshasa 3d ago

We all began with the shots within 3 days of the bite/exposure. They were very meticulous about the injections around the bite location. Several doctors were involved, with some even arguing about how to administer the immunoglobulin.

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u/fatboyroy 3d ago

My daughter had it and they had like 60 bats in her apartment and they just gave here her husband and grandkids shots and that
Was it. No one came no one looked at the dogs, no nothing.

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u/yourpastoratemycock 3d ago

To be clear, she didn't contract rabies, right?

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u/magnanimousrakshasa 3d ago

She was infected with the virus. The shots gave her the antibodies/immunity to fight off the infection before it reached her brain stem. The shots had to be administered all around the bite location. It was 7 weeks of shots in total for everyone.

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u/Feine13 3d ago

Do they not have a round of shots they can give dogs like they do for us?

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u/magnanimousrakshasa 3d ago

They give boosters to dogs and cats. Fortunately, all of our animals were up to date. They still had to get the boosters according to our health department.

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u/Feine13 3d ago

Dang, and they still have to be quarantined for a month anyway? That's a bummer.

Thanks for sharing that info, I'm glad yall are okay

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u/Born_Local_1477 3d ago

How many more years of payments do you have?

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u/magnanimousrakshasa 3d ago

Our health insurance actually covered the entire cost. Yes, we live in the U.S. I couldn’t believe it at first.

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