Why is rabies almost 100% fatal once symptoms appear?

Rabies is, without exaggeration, one of the deadliest diseases known to humankind. It’s not because it kills millions every year (thankfully, modern medicine and vaccination have kept numbers relatively low). It’s terrifying because once symptoms begin, survival is nearly impossible. Fewer than 20 people in recorded medical history have ever survived symptomatic rabies—and even those survivors required extreme, experimental treatment, often with permanent neurological damage. For all practical purposes, rabies is fatal once it declares itself.
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