The Critical Need for a Comprehensive Post-Exposure Care Bundle following Rabies Exposure: A Report of Two Cases

Rabies is a zoonotic disease that is almost always fatal but can be prevented; it disproportionately affects areas of Asia and Africa with limited resources. Post-exposure prophylaxis (PEP) failures continue to cause avoidable deaths despite advancements in vaccination techniques. Two rabies deaths in which vaccination was not enough to prevent death are reported in the current study: one in an adult bitten by a wolf and another in a child bitten on the face by a stray dog. Critical shortcomings in comprehensive care, such as improper wound suturing, poor wound management, and a failure to administer rabies immunoglobulin (RIG), are highlighted in both cases. Both patients' rabies infections were verified using histopathological and molecular analyses. These incidents underscore the crucial importance of a comprehensive "rabies care bundle" that encompasses active vaccination, passive immunization with RIG, and thorough wound care. To avoid similar results and preserve public trust in rabies vaccination programs, it is crucial to increase clinician awareness, ensure that all PEP components are accessible, and adhere to WHO guidelines.