The Latest Information on One of the World’s Oldest Diseases

Rabies Watch: Your comprehensive source for information on rabies and rabies exposure in the US. Rabies Watch provides healthcare professionals an overview of rabies, the CDC recommended rabies treatment protocol for possible rabies exposure, and other resources.

A medical professional discussing treatment for rabies exposure.

The Latest Information on One of the World’s Oldest Diseases

Rabies Watch: Your comprehensive source for information on rabies and rabies exposure in the US. Rabies Watch provides healthcare professionals an overview of rabies, the CDC recommended rabies treatment protocol for possible rabies exposure, and other resources.

A medical professional discussing treatment for rabies exposure.

What Is Rabies?

Rabies is a zoonotic disease caused by a highly neurotropic RNA virus typically present in the saliva of a rabid animal. Transmission is commonly through a bite wound. Once saliva enters the body, virions infect peripheral nerves and travel to the spinal cord and brain, resulting in acute, progressive encephalitis. Rabies is almost invariably fatal after the onset of clinical symptoms.1-3

A medical professional treating a bandaged child who may have been wounded by a rabid animal.

Preventing Deadly Human Rabies Requires Medical Vigilance and Rapid Response

Commonly transmitted through the bite of a rabid mammal, rabies has the highest case fatality rate of any infectious disease. Animal bites are reported every year in the US.4,5

Bats are a leading cause of rabies exposure in the US. However, their bites do not always leave a visible mark—which may make them harder to detect. Any contact with a bat warrants immediate medical assessment.4,6,7

Map of the Upper Midwest of the United States.

Rabies in Your State

An estimated 55,000 people receive rabies postexposure prophylaxis in the US every year. Most rabies exposures are due to animal bites. See state-by-state data on documented cases of animal rabies.4,8

Two female medical professionals discussing the medical chart of a patient who may have been exposed to rabies.

Rabies Postexposure Prophylaxis (PEP) Guidelines

Review the CDC/ACIP-recommended protocol for PEP, including the administration of human rabies immune globulin for the prevention of rabies.

Important Safety Information for HyperRAB® (rabies immune globulin [human])

Indication and Usage
HYPERRAB® (rabies immune globulin [human]) is indicated for postexposure prophylaxis, along with rabies vaccine, for all persons suspected of exposure to rabies.

Limitations of Use
Persons who have been previously immunized with rabies vaccine and have a confirmed adequate rabies antibody titer should receive only vaccine. For unvaccinated persons, the combination of HYPERRAB and vaccine is recommended for both bite and nonbite exposures regardless of the time interval between exposure and initiation of postexposure prophylaxis. Beyond 7 days (after the first vaccine dose), HYPERRAB is not indicated since an antibody response to vaccine is presumed to have occurred.

Important Safety Information

For infiltration and intramuscular use only.

Severe hypersensitivity reactions may occur with HYPERRAB. Patients with a history of prior systemic allergic reactions to human immunoglobulin preparations are at a greater risk of developing severe hypersensitivity and anaphylactic reactions. Have epinephrine available for treatment of acute allergic symptoms, should they occur.

HYPERRAB is made from human blood and may carry a risk of transmitting infectious agents, eg, viruses, the variant Creutzfeldt-Jakob disease (vCJD) agent, and, theoretically, the Creutzfeldt-Jakob disease (CJD) agent.

The most common adverse reactions in >5% of subjects during clinical trials were injection-site pain, headache, injection-site nodule, abdominal pain, diarrhea, flatulence, nasal congestion, and oropharyngeal pain.

Do not administer repeated doses of HYPERRAB once vaccine treatment has been initiated as this could prevent the full expression of active immunity expected from the rabies vaccine.

Other antibodies in the HYPERRAB preparation may interfere with the response to live vaccines such as measles, mumps, polio, or rubella. Defer immunization with live vaccines for 4 months after HYPERRAB administration.

Please see full Prescribing Information for HYPERRAB.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088

References

  1. Rupprecht CE, Briggs D, Brown CM, et al; Centers for Disease Control and Prevention (CDC). Use of a reduced (4-dose) vaccine schedule for postexposure prophylaxis to prevent human rabies: recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. 2010;59(RR-2):1-9.
  2. Feder H, Petersen B, Robertson K, et al. Rabies: still a uniformly fatal disease? Historical occurrence, epidemiological trends, and paradigm shifts. Curr Infect Dis Rep. 2012;14:408–422.
  3. Kaur M, Garg R, Singh S, Bhatnagar R. Rabies vaccines: where do we stand, where are we heading? Expert Rev Vaccines. 2015;14(3):369-381.
  4. Manning SE, Rupprecht CE, Fishbein D, et al. Human rabies prevention—United States, 2008: recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. 2008;57(RR-3):1-28.
  5. Encyclopedia of Children’s Health. Animal bite infections. Accessed April 15, 2022. http://www.healthofchildren.com/A/Animal-Bite-Infections.html.
  6. Centers for Disease Control and Prevention (CDC). CDC reports increase in human rabies cases linked to bats in the U.S. Accessed January 24, 2022. https://www.cdc.gov/media/releases/2022/p0106-human-rabies.html.
  7. Crowcroft NS, Thampi N. The prevention and management of rabies. BMJ. 2015;350:g7827.
  8. Ma X, Monroe B, Wallace R, et al. Rabies surveillance in the United States during 2019. J Am Vet Med Assoc. 2021;258(11):1205-1220.