How does one determine the first date of onset of clinical signs in a patient with rabies?
The clinical presentation of rabies varies, and not all persons will develop the same clinical signs. The infection typically manifests as a viral prodrome, with any or all of the following symptoms: fever, myalgias, paresthesias, or other, flu-like symptoms. However, rabies patients usually progress to have defined CNS disturbances within 1 week of illness onset. Therefore, the patient’s medical history should be carefully reviewed, and the earliest report/awareness of illness within 1 week of recognition of full CNS dysfunction should be considered the date of illness onset.
