Recurrent temporary paralysis reported after human rabies post-exposure prophylaxis

Area of Science:

• Neurology
• Immunology
• Infectious Diseases

Background:

• Adverse events following rabies post-exposure prophylaxis (PEP) are known but causality can be challenging to establish.
• Rabies PEP is crucial for preventing rabies virus infection after potential exposure.

Observation:

• A patient developed recurrent temporary paralysis immediately after initiating rabies PEP post-bat exposure.
• Paralysis episodes recurred after the initial dose and on day 3 of the PEP regimen.

Findings:

• The patient experienced multiple distinct episodes of temporary paralysis lasting over two years.
• Rabies PEP was discontinued before a serologic response was achieved.

Implications:

• This case highlights a potential, albeit rare, adverse neurological event associated with rabies PEP.
• Further investigation is needed to understand the mechanism and frequency of such paralysis in relation to rabies vaccination.