Frequently Asked Questions

Has anyone in the US died from rabies in the last decade?

Yes. The CDC reports that 5 human deaths were attributed to rabies in the US in 2021. From 2009 to 2018, there were 23 deaths due to human rabies.1,2 

Is rabies found throughout the US?

Yes. Cases of rabies have been documented in every state except Hawaii.3 Find out about rabies in your area.

Are dogs responsible for the transmission of rabies?

Globally, dogs account for most human rabies deaths, contributing up to 99% of all rabies transmissions to humans. However, thanks to successful pet vaccination programs and other measures, rabies among dogs has been almost eradicated in the US. The bigger threat of rabies exposure in the US comes from wildlife: bats, skunks, foxes, and raccoons.3,4,5 

What are the signs and symptoms of rabies in animals?

At the onset, an animal may exhibit behavioral changes—appearing anxious, aggressive, or more friendly than normal. As rabies progresses, the animal may develop hypersensitivity to light and sound, experience seizures, and/or become vicious. In the final stages, as the disease paralyzes the nerves that control the head and throat, the animal will hypersalivate and lose the ability to swallow. Eventually, the animal experiences respiratory failure and dies.3

Is standard wound care and a vaccine enough to prevent rabies?

Although standard care is important and vaccines are critical, evidence suggests this alone may not be enough. For previously unvaccinated persons, the CDC and World Health Organization (WHO) recommend that a human rabies immune globulin (HRIG) such as HyperRAB® (rabies immune globulin [human]) be administered at the same time as the rabies vaccine. The most common causes of postexposure prophylaxis failures include when rabies immune globulin (RIG) is not used or is administered incorrectly.4,6,7 

How prevalent is human-to-human transmission of rabies?

Humans are an end host for rabies. Other than through transplantation, there are no confirmed cases of human-to-human transmission of the virus. This includes transmission from patients to healthcare workers.8,10

Do rabies vaccines provide immediate protection?

Although vaccines can protect for years, they may take weeks to build protective titers in previously unvaccinated people. An HRIG like HyperRAB provides critical protection immediately, allowing the vaccine time to establish active immunity.9

Can postexposure prophylaxis measures be stopped once they have begun?

If appropriate diagnostic tests indicate the animal that caused the exposure was not rabid, any initiated postexposure prophylaxis measures may be discontinued.7

Learn More About Postexposure Prophylaxis (PEP) for Rabies Exposure

PEP Guidelines

Important Safety Information for HyperRAB® (rabies immune globulin [human])

Indication and Usage
HYPERRAB® (rabies immune globulin [human]) is indicated for postexposure prophylaxis, along with rabies vaccine, for all persons suspected of exposure to rabies.

Limitations of Use
Persons who have been previously immunized with rabies vaccine and have a confirmed adequate rabies antibody titer should receive only vaccine. For unvaccinated persons, the combination of HYPERRAB and vaccine is recommended for both bite and nonbite exposures regardless of the time interval between exposure and initiation of postexposure prophylaxis. Beyond 7 days (after the first vaccine dose), HYPERRAB is not indicated since an antibody response to vaccine is presumed to have occurred.

Important Safety Information

For infiltration and intramuscular use only.

Severe hypersensitivity reactions may occur with HYPERRAB. Patients with a history of prior systemic allergic reactions to human immunoglobulin preparations are at a greater risk of developing severe hypersensitivity and anaphylactic reactions. Have epinephrine available for treatment of acute allergic symptoms, should they occur.

HYPERRAB is made from human blood and may carry a risk of transmitting infectious agents, eg, viruses, the variant Creutzfeldt-Jakob disease (vCJD) agent, and, theoretically, the Creutzfeldt-Jakob disease (CJD) agent.

The most common adverse reactions in >5% of subjects during clinical trials were injection-site pain, headache, injection-site nodule, abdominal pain, diarrhea, flatulence, nasal congestion, and oropharyngeal pain.

Do not administer repeated doses of HYPERRAB once vaccine treatment has been initiated as this could prevent the full expression of active immunity expected from the rabies vaccine.

Other antibodies in the HYPERRAB preparation may interfere with the response to live vaccines such as measles, mumps, polio, or rubella. Defer immunization with live vaccines for 4 months after HYPERRAB administration.

Please see full Prescribing Information for HYPERRAB.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088

Important Safety Information for HyperTET® (tetanus immune globulin [human])

HyperTET® (tetanus immune globulin [human]) is indicated for prophylaxis against tetanus following injury in patients whose immunization is incomplete or uncertain.

HyperTET should be given with caution to patients with a history of prior systemic allergic reactions following the administration of human immunoglobulin preparations.

In patients who have severe thrombocytopenia or any coagulation disorder that would contraindicate intramuscular injections, HyperTET should be given only if the expected benefits outweigh the risks.

Slight soreness at the site of injection and slight temperature elevation may be noted at times. Sensitization to repeated injections of human immunoglobulin is extremely rare. In the course of routine injections of large numbers of persons with immunoglobulin, there have been a few isolated occurrences of angioneurotic edema, nephrotic syndrome, and anaphylactic shock after injection. Administration of live virus vaccines (eg, MMR) should be deferred for approximately 3 months after tetanus immune globulin (human) administration.

HyperTET is made from human plasma. Products made from human plasma may contain infectious agents, such as viruses and theoretically, the Creutzfeldt-Jakob disease (CJD) agent that can cause disease. There is also the possibility that unknown infectious agents may be present in such products.

Please see HyperTET full Prescribing Information for complete prescribing details.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

References

  1. Centers for Disease Control and Prevention (CDC). Human rabies. Updated September 22, 2021. Accessed July 16, 2024. https://www.cdc.gov/rabies/location/usa/surveillance/human_rabies.html.
  2. Gross J. U.S. records 5 rabies deaths in 2021, highest number in a decade. The New York Times. January 7, 2022. Accessed July 16, 2024. https://www.nytimes.com/2022/01/07/health/rabies-deaths.html.
  3. American Humane. Rabies facts & prevention tips. Updated August 25, 2016. Accessed July 16, 2024. https://www.americanhumane.org/fact-sheet/rabies-facts-prevention-tips.
  4. World Health Organization (WHO). Rabies. Updated June 5, 2024. Accessed July 15, 2024. https://www.who.int/news-room/fact-sheets/detail/rabies.
  5. Ma X, Bonaparte S, Corbett P, et al. Rabies surveillance in the United States during 2021. J Am Vet Med Assoc. 2023;261(7):1045-1053.
  6. Wilde H. Failure of rabies post-exposure prophylaxis. Vaccine. 2007;25(44):7605-7609.
  7. Manning SE, Rupprecht CE, Fishbein D, et al. Human rabies prevention—United States, 2008: recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. 2008;57(RR-3):1-28.
  8. Crowcroft NS, Thampi N. The prevention and management of rabies. BMJ. 2015;350:g7827.
  9. Rupprecht CE, Briggs D, Brown CM, et al; Centers for Disease Control and Prevention (CDC). Use of a reduced (4-dose) vaccine schedule for postexposure prophylaxis to prevent human rabies: recommendations of the Advisory Committee on Immunization Practices. MMWR Recomm Rep. 2010;59(RR-2):1-9. 
  10. Centers for Disease Control and Prevention (CDC). Clinical overview of rabies. Updated June 20, 2024. Accessed July 16, 2024. https://www.cdc.gov/rabies/hcp/clinical-overview.