Rabies

Rabies is an important disease in wildlife in the United States and Canada, and dog rabies is still a major public health problem in many developing c ountries of the world. Rabies virus is transmitted in saliva by animal bite s. Bats transmitted most recent cases of human rabies in the United States, often without known exposures. There have been recent developments in our understanding of rabies pathogenesis. Characteristic clinical features shou ld raise the possibility of a diagnosis of rabies and initiation of appropr iate diagnostic tests. Therapy of human rabies has been futile except in fo ur patients who were immunized with rabies vaccine prior to the onset of th eir disease. Rabies can be prevented after an exposure in unimmunized patie nts with local wound cleansing and administration of rabies vaccine and hum an rabies immune globulin.