Rabies is one of the most lethal infections in medicine.

Symptoms, severe stages, and why PEP is essential

Early symptoms (non-specific)

  • Fever, headache, malaise
  • Pain or abnormal sensation at the bite site (in some cases)

Severe neurological disease

  • Agitation, confusion, hallucinations
  • Hydrophobia (fear/pain with swallowing water) and aerophobia
  • Paralysis, seizures, coma
Once clinical rabies starts, survival is extraordinarily rare; prevention is the critical strategy.

Key takeaway

If there is a credible exposure risk, starting PEP promptly is rational and typically far safer than “watchful waiting.”

Go to: What to do now and Vaccine schedules.


When to seek urgent care immediately

  • Any bite to face/neck/hands
  • Deep bites, bleeding wounds
  • Unknown animal status or animal unavailable
  • Bat contact, mucosal exposures