Prognosis
Rabies is a fatal illness. Typically, patients with rabies do not survive more than 18 days from the onset of symptoms even with modern critical care.[53] Approximately 15 survivors have been reported worldwide, all with moderate-to-severe neurological sequelae.[59]
Fatal breakthrough infections can very rarely occur in people who have started post-exposure prophylaxis (PEP) after a zoonotic exposure. The median time from exposure to symptom onset in patients with breakthrough infections was 20 days. Most patients received PEP within 2 days of an exposure, and severe wounds were common. Adherence to core practices (i.e., wound cleaning and vaccine administration) is important, as deviations from core practices were reported in 56% of patients with breakthrough infections.[60]
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