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Updated: Jun 27, 2026

Rabies Necropsy Techniques in Large and Small Animals

Rabies Necropsy Techniques in Large and Small Animals

Published on: July 30, 2019

Rabies in humans: A treatment approach.

Cornelis A De Pijper¹, Pieter P A M van Thiel¹, Diederik van de Beek²

¹Centre for Tropical Medicine and Travel Medicine, Department of Infectious Diseases, Amsterdam Infection & Immunity, Amsterdam Public Health, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, the Netherlands.

Travel Medicine and Infectious Disease

|February 8, 2025

Summary

Few rabies survivors exist, often with severe neurological issues. Experimental treatments, including monoclonal antibodies, were unsuccessful in two patients lacking key survival factors like high antibody titers, suggesting palliative care may be most rational.

Keywords:

Lyssavirus Milwaukee protocol Rabies Rabies virus Treatment

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Area of Science:

Neurology
Infectious Diseases
Immunology

Background:

Rabies survivors are rare, frequently experiencing severe neurological deficits.
Established treatment protocols for rabies have limited success.
Experimental therapies may offer benefits if prognostic survival factors are present.

Purpose of the Study:

To describe the clinical course and treatment decisions for two rabies patients.
To compare the observed outcomes with published data on rabies treatment and survival factors.
To evaluate the efficacy of experimental treatments in the context of clinical practice.

Main Methods:

Detailed case reports of two patients with clinical rabies.
Comparison of clinical data with existing literature on rabies treatment and prognostic factors.
Analysis of treatment strategies, including supportive care and novel antibody-based therapies.

Main Results:

Neither patient presented with high serum or cerebrospinal fluid (CSF) antibody titers, a key survival factor.
Experimental treatment with intrathecal and intravenous monoclonal rabies antibodies was unsuccessful.
The antibody treatments minimally increased serum and CSF antibody levels.

Conclusions:

Higher-dose monoclonal antibody treatments administered systemically might be necessary for efficacy.
Experimental treatments are most promising in patients with favorable prognostic factors.
In the absence of survival factors, palliative care remains the most rational approach.