Treatment of rabies - can it be treated?

Unfortunately, no approved pharmacological treatment is currently available. The only way to save the patient pharmacologically is so-called post-exposure prophylaxis.

If the first signs of rabies have already appeared, palliative care is appropriate.

In the USA, the 'Milwaukee Protocol' was once successful in treating rabies, involving medically induced coma and administration of antiviral drugs. However, over time it has become clear that it is not appropriate for rabies patients to be anaesthetised. This protocol is now used as a last resort treatment.

Once a bite from an infected animal is suspected, the wound should be properly cleaned and disinfected.

Immediate cleaning with soap and water, disinfectant, povidone-iodine for a minimum of 15 minutes greatly reduces the risk of rabies.

When cleaning, contamination of the site of the wound or enlargement of the wound should be avoided. This will prevent faster centrifugal spread of the virus.

At the end of the treatment, anti-rabies immunoglobulin is injected directly into the wound.

The administration of antibiotics is also recommended as prevention of bacterial superinfection and specific prophylaxis for tetanus.

Palliative care

If a patient is admitted to hospital with suspected or confirmed rabies, he or she should be placed in a separate quiet room with blacked-out windows.

Symptomatic treatment should be given, especially antipyretics for fever, analgesics for severe pain, sedatives to calm the confused patient and adequate intravenous hydration.

Physical and emotional support is also an important component.

Hospital staff who have been in contact with a rabid patient do not need to undergo post-exposure prophylaxis. This is only necessary if there has been a bite, mucous membrane contact or open wounds to staff that may have been contaminated by either saliva, fluid or brain tissue of the affected patient.