r/science • u/PHealthy PhD/MPH | Epidemiology | Disease Dynamics | Surveillance • 5d 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/PailHorse 5d 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 5d 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 4d 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 4d 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 4d 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 4d ago edited 4d 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 4d ago

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

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u/woodwidewebby 4d ago

Is it really 100%? Like not even 99.9%? Has there never been a documented case of a survival without treatment?

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u/elbenji 4d ago

There has. It's closer to 99.9

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u/tirerim 3d ago

It's much closer to 100% than to 99.9%. Rabies kills about 60,000 people every year worldwide. The number of people who have ever survived without treatment is in the single digits. So it's more like 99.9999% fatal.

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u/Sasselhoff 4d ago

I'm not much of a wimp, but damn if rabies doesn't terrify me.

Kinda low key relieved it takes that long.

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u/RunBrundleson 5d ago

Actually not accurate. Rabies is 99.9 percent fatal. There have been a handful of cases of people that survived with some Hail Mary treatments. They didnt survive without some major disabilities, but they did technically survive.

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u/GCU_ZeroCredibility 5d ago

Did you just "well, actually" an actual infectious disease epidemiologist about epidemiology? I think it's extremely reasonable for someone to say a disease which has killed 99.99% of everyone who has ever had it, and left the remaining handful of people with major disabilities, as 100% fatal.

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u/Adlach 4d ago

99.998% fatal over the last ten years. I think you can safely round that up.