Human rabies encephalomyelitis

Summary Seven weeks after he was bitten on the lip by a puppy in the Gambia a patient showed symptoms of rabies. Passive and active immunisation was begun three days after the onset of symptoms. The evidence indicated that death was a direct consequence of the central nervous system disease rather than any associated complication. Our inability to alter the course of the illness appreciably emphasises the importance of immediate postexposure immunisation in rabies and draws attention to the present lack of effective means of preventing virus replication within the central nervous system.