Table 3: Human rabies survivors reported worldwide

From: Rabies

Country and year of disease onset Sex and age (years) of the patient and disease outcome Mode and site of exposure PEP type and doses; type of RIG Incubation period Antibodies in CSF and serum (highest titres or concentrations recorded) Type of antibody and method of testing Viral material detected (sample tested) Refs
India, 2014 Male, 6, severe sequelae* Dog bite; neck and back PCECV, 4; ERIG 22 days CSF (8,192); serum (>200,000) RVNA; RFFIT None (saliva, nuchal skin and CSF) 195
India, 2014 Male, 13, severe sequelae Dog bite; right hand PCECV, 3; none 2 weeks CSF (>64,000); serum (>64,000) RVNA; RFFIT Antigen (nuchal skin) 196,197
South Africa, 2012 Male, 4, severe sequelae Dog bite on left ankle and scratch on forehead Type NA, 3; none 3–7 weeks (multiple exposures to dogs) CSF (>13,975 IU/ml); serum (>13,975 IU/ml) RVNA; RFFIT None (saliva, nuchal skin and CSF) 198
USA, 2011 Female, 8, complete recovery§ Scratches from free-roaming, unvaccinated cats (probable source); site NA None; none Unknown CSF (8); serum (160) IgM antibody; IFA None (saliva and nuchal skin) 199
India, 2011 Male, 17, severe sequelae Dog bite; left calf PCECV, 4; HRIG 2 weeks CSF (>8,000); serum (>16,000) RVNA; RFFIT None (corneal smear and nuchal skin) 146
India, 2010 Male, 4, severe sequelae Dog bite; face PCECV, 4; HRIG 25 days CSF (512); serum (16,384) RVNA; RFFIT Antigen (nuchal skin) and RNA (nuchal skin and CSF) 200
Turkey, 2008 Male, 17, complete recovery# Dog bites; left forearm and right shoulder VCV, 1; none 3 weeks CSF (NA); serum (3,788) RVNA; RFFIT Antigen (corneal smear) and RNA (CSF and saliva) 201
Brazil, 2008 Male, 15, moderate sequelae Vampire bat bite; site NA Type NA, 4; none 29 days CSF (>100 IU/ml); serum (>100 IU/ml) RVNA; RFFIT RNA (nuchal skin hair follicles) 202
USA, 2004 Female, 15, mild sequelae**‡‡ Bat bite; left index finger None; none 1 month CSF (1,300); serum (1,604) RVNA; RFFIT None (saliva and nuchal skin) 148
India, 2000 Female, 6, severe sequelae Dog bites; face and hands PCECV, 3; none 20 days CSF (312,000); serum (182,000) RVNA; MNT None (CSF, nuchal skin and corneal smear) 203
Mexico, 1992 Male, 9, severe sequelae Dog bite; face VCV, 3 and HDCV, 1; none 18 days CSF (78,125); serum (134,800) RVNA; RFFIT None (saliva, nuchal skin and corneal smear) 204
USA, 1977 Male, 32, severe sequelae§§ Laboratory exposure to virus (aerosol) None¶¶; none 2 weeks (probable) CSF (16,225); serum (175,000) RVNA; RFFIT None (nuchal skin and corneal smear) 205,206
Argentina, 1972 Female, 45, nearly complete recovery Dog bite; left arm SMBV, 14 and 2 boosters; none 21 days CSF (160,000); serum (640,000) RVNA; MNT None (saliva, nuchal skin and corneal smear) 207
USA, 1970 Male, 6, complete recovery Bat bite; left thumb DEV, 14; none 20 days CSF (3,200); serum (63,000) RVNA; MNT None (saliva, CSF, brain biopsy, corneal smear) 208

    Only published and adequately documented cases are included. CSF, cerebral spinal fluid; DEV, duck embryo vaccine; ERIG, equine rabies immunoglobulin; HDCV, human diploid cell vaccine; HRIG, human rabies immunoglobulin; IFA, indirect immunofluorescence assay; IgM, immunoglobulin M; MNT, mouse neutralization test; NA, not available; PCECV, purified chick embryo cell vaccine; PEP, post-exposure prophylaxis; RFFIT, rapid fluorescent focus inhibition test; RIG, rabies immunoglobulin; RVNA, rabies virus-neutralizing antibodies; SMBV, suckling mouse brain vaccine; VCV, purified vero cell vaccine.

  1. *Sequelae generally include neurological problems and can vary depending on cases. Examples include convulsions, poor swallowing reflex and paralysis.
  2. Deviations in PEP protocol used.
  3. §Rabies-neutralizing antibodies not detected in CSF or serum. Diagnosis based on virus-specific antibodies in CSF and serum detected by IFA.
  4. Delay in initiating PEP.
  5. Nuchal skin biopsy sample positive for viral RNA even 4 years after onset of illness.
  6. #ERIG administered after onset of symptoms.
  7. **The US case definition for human rabies is “a clinically compatible case that is laboratory confirmed by testing at a state or federal public health laboratory” (https://wwwn.cdc.gov/nndss/conditions/rabies-human/case-definition/2011/). The patient met these criteria, and at the time of publication, the state of California has not withdrawn this case notification.
  8. ‡‡The first reported rabies survivor who had never received prior vaccination.
  9. §§The first reported case of rabies in a pre-immunized individual.
  10. Virus isolated from bat.
  11. ¶¶Pre-exposure immunization with DEV.