Treatment discussed here focuses on animal exposures where rabies transmission is a possibility. This is the primary concern of the emergency physician. Treatment of human rabies is supportive and often involves therapy for other possible etiologies before specific diagnosis is made, usually postmortem or well into an intensive care unit (ICU) hospitalization.
Eliciting a history of recent animal or bite exposures is of utmost importance, as many patients described in the literature were initially sent home by the emergency department.
Postexposure prophylaxis (PEP) consists of wound cleaning, vaccination, and administration of rabies immunoglobulin.