Intensive care in rabies therapy. Clinical observations

Area of Science:

• Neurology
• Infectious Diseases
• Critical Care Medicine

Background:

• Rabies is a fatal viral zoonotic disease with nearly 100% mortality once clinical symptoms appear.
• Dog bites are the primary source of human rabies transmission globally, particularly in Asia and Africa.
• Limited treatment options exist for rabies, with supportive care being the mainstay.

Purpose of the Study:

• To evaluate the efficacy of intensive care management in patients with severe rabies following dog bites.
• To document the clinical course and physiological effects of rabies during intensive therapy.
• To explore potential advancements in rabies treatment through aggressive supportive measures.

Main Methods:

• Seven patients with confirmed dog-bite rabies received intensive care, including mechanical ventilation, sedation, nutritional support, and fluid/electrolyte management.
• Antiviral agents and immunological stimulation were administered.
• Continuous monitoring of vital signs, temperature, blood pressure, and metabolic parameters was performed.
• Intensive nursing care was provided by immunized volunteer staff.

Main Results:

• Patients survived for 1 to 17 days after the onset of clinical rabies.
• Prolonged survival (over 2-4 days) revealed diverse and severe systemic effects, including temperature and blood pressure fluctuations, cardiac arrhythmias, and diabetes insipidus.
• Despite intensive interventions, all seven patients ultimately succumbed to the disease.

Conclusions:

• Intensive care can prolong survival in rabies patients, offering a window to observe disease manifestations.
• The study highlights the complex and severe systemic impact of rabies, even with aggressive management.
• While current intensive therapy did not achieve survival, it provides valuable data and raises hope for future therapeutic strategies in rabies management.