5.5.8 End of life care for rabies patients

An increasing number or patients surviving clinical rabies are being reported. However, these remain a tiny fraction of rabies patients and the disease is still regarded as almost 100% fatal. In low resource settings reducing suffering in the terminal stages of rabies is important, even if patients leave medical facilities to die at home.

WHO recommendations say that patients should receive adequate sedation and care in an appropriate medical facility, preferably in a quiet private room, free of drafts and with suitable emotional and physical support. Once furious rabies has been diagnosed, invasive procedures should be avoided, and the focus should be on comfort, with heavy sedation and the avoidance of intubation or life-support measures once the diagnosis is certain. Patients with hydrophobia should have their often intense thirst alleviated by intravenous rehydration.

Guidance on how to best care for patients in less well equipped health settings and how to reduce suffering in patients who leave the hospital to die are also available. See here for more information.

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Version 4 - last updated May 2017