Management of rabies in humans.
Rabies is a fatal disease in humans, and, to date, the only survivors of the disease have received rabies vaccine before the onset of illness. The approach to management of the rabies normally should be palliative. In unusual circumstances, a decision may be made to use an aggressive approach to therapy for patients who present at an early stage of clinical disease. No single therapeutic agent is likely to be effective, but a combination of specific therapies could be considered, including rabies vaccine, rabies immunoglobulin, monoclonal antibodies, ribavirin, interferon-alpha, and ketamine. Corticosteroids should not be used. As research advances, new agents may become available in the future for the treatment of human rabies.
Jackson
Alan C
AC
Department of Medicine, Queen's University, Kingston, Ontario, Canada K7L 2V7. jacksona@post.queensu.ca
Warrell
Mary J
MJ
Rupprecht
Charles E
CE
Ertl
Hildegund C J
HC
Dietzschold
Bernhard
B
O'Reilly
Michael
M
Leach
Richard P
RP
Fu
Zhen F
ZF
Wunner
William H
WH
Bleck
Thomas P
TP
Wilde
Henry
H
D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000818:Animals; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D000914:Antibodies, Viral / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004195:Disease Models, Animal; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D007649:Ketamine / Q000627:therapeutic use; D051379:Mice; D010166:Palliative Care; D011818:Rabies / Q000401:mortality / Q000517:prevention & control / Q000628:therapy*; D011819:Rabies Vaccines / Q000008:administration & dosage*; D012254:Ribavirin / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D000914:Antibodies, Viral; D016898:Interferon-alpha; D011819:Rabies Vaccines; D012254:Ribavirin; D007649:Ketamine