Case Reports: Survival from Rabies: Case Series from India

Abstract

Rabies, a zoonotic viral encephalitis, continues to be a serious public health problem in India and several other countries in Asia and Africa. Survival is rarely reported in rabies, which is considered to be almost universally fatal. We report the clinical and radiological findings of eight patients with laboratory-confirmed rabies who survived the illness. With the exception of one patient who recovered with mild sequelae, all survivors had poor functional outcomes. The reported survival from rabies in recent years may reflect an increased awareness of the disease and greater access to better critical care facilities in rabies-endemic countries. Nonetheless, there is an urgent need to focus on preventive strategies to reduce the burden of this dreadful disease in rabies-endemic countries.

Utility of rabies neutralizing antibody detection in cerebrospinal fluid and serum for ante-mortem diagnosis of human rabies

“…Though the number of current survivors is small, an increasing number of survivors are being reported from India in recent years and probabilistically, better outcomes will follow. In fact, 10 patients in this study (7 cases published [33]) have survived beyond 6 months, two of them with good functional outcomes (Table 3).…”

Unusual Chief Complaint of Patient with History of Vaccination Leading to Unrecognized Human Rabies with Extreme Risk of Saliva Exposure for Medical Personnel-A Case Report and Literature Review

“…Especially in the case presented here, the chief complaint of chest pain deviated the medical team's attention/focus away from a diagnosis of rabies to heart disease. Though uncommon, such cases have been reported ( Table 2) [4][5][6][7][8] , since rabies can caused focal interstitial myocarditis as discussed by Park et al 9 In the case series reported by Mani et al 10 , all cases presented without evidence of chest pain, so the clinical presentations of rabies vary. Furthermore, concerning the classical sign of fear of water, in our case, the patient 11 In terms of the forensics aspect, since a rabies investigation is not performed on every case with an unknown cause of death examined by only external examination, the forensic physician thought of rabies infection as the cause of death based on the review of the history recorded on the first emergency room visit and the numerous dogs observed by the forensic physician at the crime scene during the post-mortem visit at the patients residence.…”

Clinical features of rabies patients with abnormal sexual behaviors as the presenting manifestations: a case report and literature review

“…The primary reason for these miserable deaths is that a large number of victims do not receive rabies vaccination at all, and some of those who do do not complete the full course. Noticeably, while rabies used to be considered certainly fatal, several rabies survivors have been increasingly reported over the past two decades worldwide, particularly in recent years [53–61]. Excellent intensive care facilities and aggressive management approaches with appropriate supportive care are believed to contribute to the increase of human rabies survivors [53].…”

“…For example, in India, although public health facilities may be lacking (especially in rural areas), several private and some public medical institutes provide world-class medical care, thus likely playing an important role in the prolonged survival of human rabies patients [53]. Most recently, Mani et al [61] reported two cases whose lives were saved after receiving both rabies vaccine and immunoglobulin and intensive care. However, the patients progressed to clinical disease with typical symptoms of rabies, probably due to multiple exposures or bites on highly innervated areas [61].…”