Rabies

The initial symptoms of rabies resemble those of other systemic viral infections (Anderson, 1984). Two kinds of central nervous system (CNS) presentation can be seen: the furious form in 70% of all cases and the paralytic form in the remainder (WHO, 2013).

The furious form usually lasts around 12 days on average (range 9–17.8 days) (Udow, 2014). The paralytic form has a longer survival period of 22 days on average (range 18–28 days) and generally results in death.

Case fatality proportion

Once the symptomatic disease onset is confirmed the case fatality proportion is considered to be 100%.

Model input summary

Table 1. Transition probabilities used in the outcome tree

Health outcome
(Health state)

Distribution of health states in health outcome

Transition probability

Source/assumption

Symptomatic infection

(Furious form)

(Paralytic form)

 

70%

30%

 

 

 

WHO, 2013

Fatal cases

 

100%

WHO, 2013

Table 2. Disability weights and duration

Health outcome
(Health state)

Disability Weight (DW) (Haagsma, 2015)

Duration

DW

Label

In years

Source

Symptomatic infection

 

(Furious form)

 

(Paralytic form)

0.655 (0.579-0.727)

 

As above

 

As above

Intensive Care Unit admission

 

As above

 

As above

 

 

0.033 (0.025-0.049)

 

0.060 (0.049-0.077)

 

 

Udow, 2014

 

Udow, 2014

References

Anderson LJ, Nicholson KG, Tauxe RV, Winkler WG. Human rabies in the United States, 1960 to 1979: Epidemiology, diagnosis, and prevention. Ann Intern Med 1984;100:728-735.

Haagsma JA, Maertens de Noordhout C, Polinder S, Vos T, Havelaar AH, Cassini A, Devleesschauwer B, Kretzschmar ME, Speybroeck N, Salomon JA. Assessing disability weights based on the responses of 30,660 people from four European countries. Population Health Metrics 2015; 13: 10

Udow S, Marrie R, Jackson A. Clinical Features of Dog- and Bat-Acquired Rabies in Humans. Clinical Infectious Diseases Volume 57, Issue 5 Pp. 689-696.

WHO. Rabies. Fact Sheet N°99. Available at: http://www.who.int/mediacentre/factsheets/fs099/en/.