The case de scribed in this report underscores two important aspects of human rabies prevention: (1) the importance of awareness about rabies risks when traveling abroad and (2) the need to seek prompt medical evaluation after an animal exposure. Since 2000, seven of the 31 human rabies cases reported in the United States were acquired from exposure abroad; two were acquired in the Philippines (California, 2001 and 2006), and one each were acquired in Ghana (New York, 2000), El Salvador (California, 2004), Haiti (Florida, 2004), Mexico (California, 2008), and India (the 2009 case described in this report) . An attempt to treat the patient after the onset of clinical symptoms of rabies using an experimental treatment (the Milwaukee protocol) failed. Prompt administration of rabies PEP after an exposure remains the only documented method for preventing death after an exposure to rabies.
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