4 ms·

> While cases of human rabies in the United States are rare with only 1 to 3 cases reported each year I'm rather amazed that case numbers are so low in such a

> While cases of human rabies in the United States are rare with only 1 to 3 cases reported each year I'm rather amazed that case numbers are so low in such a large population as the US. I would have expected rabies deaths to be 1-3 per year, with cases being in the low hundreds. Clearly I've overestimated how often people come into physical contact with wild animals and or pets with rabies. Back when I was a child parents always instructed children on avoiding animals in regards to rabies, what to watch out for as signs. Wildlife instructors would come into school for a fun day, and rabies would inevitably be one of the topics of safety. Given the warnings I fully expected to encounter rabid animals far more often than I have in my lifetime (which is zero times so far).

mach1ne 5y ago
I might be wrong, but I don't think they report cases prevented with post-exposure treatment as cases. This would mean that the 1-3 cases are equal to 1-3 deaths.
foxyv 5y ago
It used to be, treatment for rabies was subsidized by state governments in the US. Lately these programs have been discontinued because they were getting really expensive. Costs for rabies treatment has gone up 400% in the last 10 years or so. Someone posted this article recently. https://www.webmd.com/a-to-z-guides/news/20180220/the-high-cost-of-surviving-rabies https://www.webmd.com/a-to-z-guides/news/20180220/the-high-c...
- alistairSH 5y ago
  Ugh. 380% increase in the immunoglobulin cost in a decade. Large increases in the vaccine cost. 2-3x markup at the ER. Plus, the ER charges thousands for administering the shot. $20k for the first round alone in one case (most of which would have been hospital fees - the drugs don't come anywhere near that despite the massive markups). Absolutely disgusting.
xen0 5y ago
A case of rabies is, 99% of the time, a case of death.
- User23 5y ago
  There’s only one known survivor ever[1] and it’s a hell of a way to die. [1] https://www.scientificamerican.com/article/jeanna-giese-rabies-survivor/ https://www.scientificamerican.com/article/jeanna-giese-rabi...
  - dangerbird2 5y ago
    According to this study[1], there have been about 20 reported survivors worldwide. Because it's so rare in countries with the medical infrastructure to report these things, it's probably pretty hard to infer the actual survival rate. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670764/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670764/
    - cge 5y ago
      >Because it's so rare in countries with the medical infrastructure to report these things, it's probably pretty hard to infer the actual survival rate. I'm reasonably certain that rabies without intensive treatment (Milwaukee or Recife or similar, the topics of that study) has had no recorded survivors after exhibiting symptoms, ever, in all the thousands of years it has been known. Given how technically intensive the treatment is, anyone performing it likely has the infrastructure to report on the treatment as well, and so I expect that study likely does include most treatment attempts. With that said, cases slipping through pre-symptomatic discovery and treatment are so rare in countries with the infrastructure to even attempt post-symptomatic treatment that we likely don't have a good idea of what we could get the survival rate to be.
  - cge 5y ago
    That article is from a few years after the first successful attempt at treatment. While enormously involved and expensive, with a low probability of success and a near certainty of moderate to severe neurological damage, it appears that the general treatment approach used for Giese has since resulted in further survivors, such that there have now been around a dozen survivors out of a few dozen post-symptomatic treatment attempts. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670764/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670764/
tzs 5y ago
Plenty of people come into such contact in the US, but they get treated before they develop rabies [1]: > Yet each year, hundreds of thousands of animals need to be placed under observation or be tested for rabies, and between 30,000 to 60,000 people need to receive rabies postexposure prophylaxis. [1] https://www.cdc.gov/rabies/location/usa/surveillance/human_rabies.html https://www.cdc.gov/rabies/location/usa/surveillance/human_r...
- wombatpm 5y ago
  Any dog or cat bite where the animal is retained typically requires a 10 day rabies observation. I worked for a vet and was trained in the process. If the animal is alive after 10 days and not showing symptoms, no rabies. If the animal dies for any reason, remove head and ship to lab for testing. When you don’t have the animal it is a problem. Had a friend but by a stray cat that subsequently ran away -— he had to get the treatment. Same friend was subsequently bit by a beaver and had the treatment a second time. I’m sure this guy’s response at 80 was something like “ we all gotta die of something “
kevinmchugh 5y ago
I'm sure I got told to "stop, drop, and roll" dozens of times before I turned 10. I haven't caught on fire yet (mostly because of other fire safety techniques they taught). Teaching before the knowledge is needed is important
acheron 5y ago
Depends where you live I suppose. My daughter and two of her friends were in the woods with one of the moms a month or so ago, and one of the girls was bit by a presumably rabid raccoon. She went to the hospital, got treated, was released the next day and has been fine. We don't live in a particularly dangerous area as far as rabies goes, and the county animal control guy was apparently surprised, but it just happens sometimes I guess. Fortunately it seems like the course of rabies treatment is not as difficult as it used to be assuming you get to the hospital in time.

mach1ne 5y ago

I might be wrong, but I don't think they report cases prevented with post-exposure treatment as cases. This would mean that the 1-3 cases are equal to 1-3 deaths.

foxyv 5y ago

It used to be, treatment for rabies was subsidized by state governments in the US. Lately these programs have been discontinued because they were getting really expensive. Costs for rabies treatment has gone up 400% in the last 10 years or so. Someone posted this article recently. https://www.webmd.com/a-to-z-guides/news/20180220/the-high-cost-of-surviving-rabies https://www.webmd.com/a-to-z-guides/news/20180220/the-high-c...

alistairSH 5y ago
Ugh. 380% increase in the immunoglobulin cost in a decade. Large increases in the vaccine cost. 2-3x markup at the ER. Plus, the ER charges thousands for administering the shot. $20k for the first round alone in one case (most of which would have been hospital fees - the drugs don't come anywhere near that despite the massive markups). Absolutely disgusting.

xen0 5y ago

A case of rabies is, 99% of the time, a case of death.

User23 5y ago
There’s only one known survivor ever[1] and it’s a hell of a way to die. [1] https://www.scientificamerican.com/article/jeanna-giese-rabies-survivor/ https://www.scientificamerican.com/article/jeanna-giese-rabi...
- dangerbird2 5y ago
  According to this study[1], there have been about 20 reported survivors worldwide. Because it's so rare in countries with the medical infrastructure to report these things, it's probably pretty hard to infer the actual survival rate. [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670764/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670764/
  - cge 5y ago
    >Because it's so rare in countries with the medical infrastructure to report these things, it's probably pretty hard to infer the actual survival rate. I'm reasonably certain that rabies without intensive treatment (Milwaukee or Recife or similar, the topics of that study) has had no recorded survivors after exhibiting symptoms, ever, in all the thousands of years it has been known. Given how technically intensive the treatment is, anyone performing it likely has the infrastructure to report on the treatment as well, and so I expect that study likely does include most treatment attempts. With that said, cases slipping through pre-symptomatic discovery and treatment are so rare in countries with the infrastructure to even attempt post-symptomatic treatment that we likely don't have a good idea of what we could get the survival rate to be.
- cge 5y ago
  That article is from a few years after the first successful attempt at treatment. While enormously involved and expensive, with a low probability of success and a near certainty of moderate to severe neurological damage, it appears that the general treatment approach used for Giese has since resulted in further survivors, such that there have now been around a dozen survivors out of a few dozen post-symptomatic treatment attempts. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670764/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7670764/

tzs 5y ago

Plenty of people come into such contact in the US, but they get treated before they develop rabies [1]: > Yet each year, hundreds of thousands of animals need to be placed under observation or be tested for rabies, and between 30,000 to 60,000 people need to receive rabies postexposure prophylaxis. [1] https://www.cdc.gov/rabies/location/usa/surveillance/human_rabies.html https://www.cdc.gov/rabies/location/usa/surveillance/human_r...

wombatpm 5y ago
Any dog or cat bite where the animal is retained typically requires a 10 day rabies observation. I worked for a vet and was trained in the process. If the animal is alive after 10 days and not showing symptoms, no rabies. If the animal dies for any reason, remove head and ship to lab for testing. When you don’t have the animal it is a problem. Had a friend but by a stray cat that subsequently ran away -— he had to get the treatment. Same friend was subsequently bit by a beaver and had the treatment a second time. I’m sure this guy’s response at 80 was something like “ we all gotta die of something “

kevinmchugh 5y ago

I'm sure I got told to "stop, drop, and roll" dozens of times before I turned 10. I haven't caught on fire yet (mostly because of other fire safety techniques they taught). Teaching before the knowledge is needed is important

acheron 5y ago

Depends where you live I suppose. My daughter and two of her friends were in the woods with one of the moms a month or so ago, and one of the girls was bit by a presumably rabid raccoon. She went to the hospital, got treated, was released the next day and has been fine. We don't live in a particularly dangerous area as far as rabies goes, and the county animal control guy was apparently surprised, but it just happens sometimes I guess. Fortunately it seems like the course of rabies treatment is not as difficult as it used to be assuming you get to the hospital in time.