Rabies: A Rare Disease but a Serious Pediatric Problem

Human rabies encephalitis is of particular interest to the pediatrician in the United States since the highest incidence occurs in the under 15 age group. When a child has been exposed to wild or domestic animals, specific antirabic treatment must be considered. Factors to consider in establishing treatment include the health status and changes in the behavior of the biting animal, the extent and location of the bite, and the relative risk of infection in the involved species. Recommendations for immunization following exposure have been made by the World Health Organization Expert Committee on Rabies. A case of human rabies encephalitis was imported to the United States from Egypt in 1967. The diagnosis was suspected but could not be confirmed antemortem. There are no readily available reliable tests for the diagnosis of rabies in the human prior to death. The risk of obtaining rabies from a human contact may be small, but death is the only outcome if the disease is contracted. Screening of hospital personnel involved in the care of a human rabies patient revealed that isolation procedures had not eliminated possibility of exposure. The value of rabies vaccines has been documented. Two forms of vaccine are presently available and others are in the experimental state. Antirabies serum is available for severely exposed individuals.