Fatal Rabies Encephalitis despite Appropriate Post-Exposure Prophylaxis

RABIES encephalitis was one of the earliest diseases known.1 Because rabies is uniformly fatal, every attempt must be made to prevent invasion of the virus. Since the introduction of a rabies vaccine in 1885, post-exposure vaccination has formed the cornerstone of prophylaxis after the bite of a rabid animal. Occasional cases of failure of prophylaxis followed the use of the early duck-embryo vaccine and rabies immune globulin.1 In several of these cases, however, unacceptably long delays had preceded the institution of therapy.1 In one case, in which duck-embryo vaccine and rabies immune globulin were promptly administered, a suboptimal immune response… © 1987, Massachusetts Medical Society. All rights reserved.