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One of my favourite information snippets to dish out to unsuspecting friends is that there are roughly only 10 recorded cases of rabies survival without vaccination, while it's estimated that around 160 people die from the virus every day. This also means more people die every couple of hours than there are known non-vaccination survivors (take that, anti-vacciners!). Coupled with it being a very nasty way to die, this factoid acts as a pretty effective conversation killer (yes, I sometimes can be that guy).

Anyway, I soon realised that the data I was dishing out (10 survivors, 160 deaths a day) had simply been heard from random sources, and I had no idea if they were actually founded or not.

So my question is: Does rabies in fact kill practically 100% of people who contract it, with around 100 deaths per day and only a single- or double-digit number of people having survived it after symptoms developed?

Claim: https://www.youtube.com/watch?v=gf2bObJGFkg

EDIT: It would also be interesting to learn what percentage of people who are vaccinated still die from rabies.

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    Look on wikipedia, the entry on rabies has all the information you are looking for, and probably enough references. Your numbers are basically confirmed there, although the death number is a little smaller. Interesting to note is that according to Wikipedia, the normal treatment would be to vaccinate short after the infection (survival rate seems to be good with that treatment if done shortly after the infection), and the only succesful treatment without vaccination has a survival rate of 8-12%. All this please with a grain of salt, this comment is just the digest of a quick read on Wikipedia – kutschkem May 15 '15 at 12:29
  • The survival rate of 8-12% doesn't seem to add up. On a list of disease fatality rates wiki says that Rabies has a untreated rate of "~100%" – Edward G-Jones May 15 '15 at 12:33
  • "the CFR is near 100%" en.wikipedia.org/wiki/List_of_human_disease_case_fatality_rates – Edward G-Jones May 15 '15 at 12:34
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    I cite Wikipedia: 5 of the first 43 patients (12%) treated with the Milwaukee protocol survived, and those receiving treatment survived longer than those not receiving the treatment. – kutschkem May 15 '15 at 12:36
  • Interesting, this would definitely suggest that there are many more survivors than just ten, if out of 43 there are already 5 survivors. I guess the majority of cases occur in LEDCs so most patients don't/can't receive proper care and so are substantially more likely to die. – Edward G-Jones May 15 '15 at 13:06
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According to the website of the journal Nature:

Jeanna Geise was only 15 years old when she became the world's first known survivor of Rabies without receiving any vaccination. Her miraculous survival has not only challenged a time-honored scientific fact, but has also brought about a new method of Rabies treatment, known as the Milwaukee Protocol. It had long been thought that Rabies is 100% fatal in humans who are not vaccinated. However, to the surprise of the medical world, Jeanna showed that fatal the virus can be beaten sans vaccination.

So prior to 2004, the disease was 100% fatal without receiving a vaccination.

However, "receiving a vaccination" includes receiving a vaccination after being bitten by the rabid animal.

For a recent (April 2015) update see Temporal evolution on MRI of successful treatment of rabies which explains 3 people have now survived, having received the Milwaukee protocol, while 26 have died despite such treatment. So still very fatal, but not 100% fatal.

As far as deaths, an NIH presentation states over 55,000 deaths per year world wide, specifically including:

India 19,200
China 2,217
Rest of Asia 9,328
Africa 23,979

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    I think you should perhaps stress that we're actually talking about treatment protocols, not "vaccination" (i.e. disease prevention). In other words, the OP's use of this factoid is misleading. – fredsbend May 15 '15 at 15:57
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    Agree with fredsbend. While technically the treatment is a vaccination, most people tend to think of a vaccination as something given before you are exposed to the disease. in this case it is usually given after exposure to the disease, and is therefore also a treatment. – DJClayworth May 15 '15 at 16:14
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    @DJClayworth technically its still a vaccine as its working to prevent the infection, a rabies bite takes about a week before you actually are "infected" and incurable. your body has a week with the vaccine to build up anti bodies it needs to fight the real infection that starts after a week. rabies essentially lies dormant for the first week after the bite. – Himarm May 15 '15 at 16:16
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    i think the OP's factoid is not misleading, because the vaccine is still a vaccine and anti-vacciners would still be against it(however if in anti-vacciners gets bitten who knows if they'll stand their ground or not), aka its not a treatment, its still a preventative measure so fredsbends statement is incorrect. – Himarm May 15 '15 at 16:21
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    @fredsbend The thing is, if an unvaccinated person is bit in head by a rabid dog, they have a 45% of getting the disease, and in the leg only a 5% chance. Even if the micro organism is present, they don't necessarily get the disease. ncbi.nlm.nih.gov/pmc/articles/PMC2626230 There is a distinction between being bit by a rabid animal and a person having rabies, and if the person actually has rabies the vaccine is not a successful treatment. – DavePhD May 15 '15 at 16:59
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This is one of a number of sites about rabies treatment. The page explains the perhaps surprising statistics.

  • If you have been exposed to rabies, for example bitten by a rabid animal, but have not developed rabies symptoms, the the usual treatment is a rabies vaccine course and/or rabies immunoglobin. Rabies treatments when you have not developed symptoms are very successful.
  • If you have symptoms of rabies, treatment usually focuses on making you as comfortable as possible. This is because rabies is almost always fatal when it reaches this stage. There is an experimental treatment called the Milwaulkee Protocol, but it has been effective in only three cases where symptoms have developed.

This explains the situation. Your 100% fatality quote is accurate, provided you are talking about only people who have symptoms. Rabies is indeed almost always fatal once it reaches the symptoms stage. Only 3 people are known to have survived after symptoms. With prompt treatment (i.e. vaccination) as soon as exposure is suspected it is highly curable.

People are sometimes confused because the rabies vaccine is most given as a treatment, i.e. after exposure, and not before exposure like most vaccines.

According to Scientific American:

Rabies is 100 percent preventable with vaccinations if patients receive them before the onset of symptoms

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  • No answer on the exact number of survivors though? The Milwaukee Protocol seems to be the thing saving people. – Edward G-Jones May 15 '15 at 14:24
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    @Noodlemanny No, the thing saving people is getting rabies vaccination treatment after exposure - i.e. after the animal bite - but before symptoms have developed. – DJClayworth May 15 '15 at 14:40
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    True but the Milwaukee Protocol seems to create tiny a possibility of survival after symptoms develop. However there seems to be some disagreement over whether it was the technique that saved patients or inherent immune resistance. – Edward G-Jones May 15 '15 at 14:42
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    The Milwaulkee Protocol has (maybe) moved the statistics from "100% fatal" to "almost 100% fatal", which is great for the people saved but not a big statistical impact. – DJClayworth May 15 '15 at 14:44
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    Agreed. bottom line is if you ever get bitten by anything ever at all; get vaccinated for rabies. Hell, if you bite yourself it probably wouldn't hurt to vaccinate :P – Edward G-Jones May 15 '15 at 14:47
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Googleing "Rabies kills 160 people daily" returns multiple results that seem to reference the same study. However good old BBC actually linked to it thankfully.

loss of human lives (approximately 59,000 annually)

(April 16 2015, Estimating the Global Burden of Endemic Canine Rabies, multiple authors) http://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0003709

Regarding the number of actual survivors Reading through the Milwaukee Protocol article on Wikipedia produced this result:

Some critics say those survivors (5 out of 36 survival rate)... despite no documented survivors before them

http://en.wikipedia.org/wiki/Milwaukee_protocol#Survival_hypotheses This seems to suggest that there are 5 known survivors but it's only implied and doesn't have proper citation.

Look at DavePhD's and DJClayworth's answers for information about fatality rates.

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