Rabies virus exposure typically occurs following a bite from an infected animal. Depending on the anatomic site of exposure, an incubation period of variable duration follows as the virus evades the immune response by hiding in the central nervous system. Virus amplification occurs in the dorsal root ganglion (a cluster of neurons in a dorsal root of a spinal nerve) after which it travels towards the brain via the spinal cord. At this point, clinical signs of rabies become manifest and therapy is almost invariably futile. Without early treatment, rabies is nearly 100% fatal.

Rabies is a zoonotic (capable of being transmitted from animals to humans) disease that is distributed nearly worldwide. Attention to the disease is primarily focused on preventive and control strategies. Many countries are considered rabies-free for the purposes of importing dogs into the United States; learn more at cdc.gov/importation/rabies-free-countries.html.

Rabies can be prevented by pre-exposure vaccination in both humans and animals. A human diploid cell vaccine and a purified chick embryo vaccine are available for humans (the latter is mainly used outside of the U.S.) for pre- and post-exposure to rabies, with rabies immune globulin available only for post-exposure treatment in exposed humans.

Pre-exposure vaccination involves administration of three doses of vaccine given over a one-month period. In unvaccinated humans, post-exposure treatment consists of the administration of five doses of vaccine. Vaccines for multiple species of domestic animals, including horses, are available to licensed veterinarians. Wildlife vaccines might be available from veterinarians but are typically used in targeted locations by the Kentucky Department of Fish and Wildlife and the USDA.

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