Rabies

Written by Shannon Johnson | Published on August 7, 2012
Medically Reviewed by Brenda B. Spriggs, MD, MPH, FACP

Understanding Rabies

Rabies—the word probably brings to mind an enraged animal frothing at the mouth. Unfortunately, an encounter with an infected animal can result in a painful, life-threatening condition and even death. According to the World Health Organization, more than 55,000 people die from rabies every year worldwide (WHO). Most of them—a staggering 99 percent—have been bitten by a rabid dog.

Rabies is caused by a virus that affects the central nervous system. Domestic dogs, cats and rabbits and wild animals, such as skunks, raccoons, and bats, are able to transfer the virus to humans via bites and/or scratches. The key to fighting the virus is quick response. Once you start showing symptoms, if you do not receive the rabies vaccine promptly, death is not far behind.

Types of Rabies

Furious Rabies

Infected individuals will be hyperactive and excitable, display erratic behavior, have hallucinations, fear of water and have hypersalivation (increase production of saliva).

Paralytic Rabies

This form of rabies takes longer to set in, but the effects are just as severe. Infected patients slowly become paralyzed, will eventually slip into a coma, and die. According to the World Health Organization, 30 percent of rabies cases are paralytic (WHO).

Recognizing the Symptoms of Rabies

The initial onset of rabies begins with:

  • fever
  • muscle weakness
  • tingling
  • burning at the bite site

As the virus continues to attack your central nervous system, the following symptoms occur:

  • insomnia
  • anxiety
  • confusion
  • partial paralysis
  • agitation
  • hallucinations
  • excess salivation
  • problems swallowing
  • fear of water

How Do People Catch Rabies?

Animals with rabies transfer the virus to other animals and to people via saliva following a bite or via a scratch. However, any contact with the mucous membranes or an open wound can also spread the virus. The transmission of this virus is considered to be exclusively from animal to human. While human-to-human transmission of the virus is extremely rare, there have been a handful of cases reported following transplantation of corneas.

Once a person has been bitten, the virus spreads through their nerves to the brain. It is important to note that bites or scratches on the head and neck are thought to speed up the brain and spinal cord involvement because of the location of the initial trauma. If you are bitten on the neck, seek help as soon as possible. The period between the bite and the onset of symptoms is called the incubation period. Incubation periods can range from a few days to several years. Following a bite, the rabies virus spreads by way of the nerve cells to the brain. Once in the brain, the virus multiplies rapidly. This activity causes severe inflammation of the brain and spinal cord after which the person deteriorates rapidly and dies.

Animals that Can Spread Rabies

Both wild and domesticated animals can spread the rabies virus. The following animals are the main sources of rabies infection in humans:

  • cats
  • cows
  • dogs
  • ferrets
  • goats
  • horses
  • rabbits
  • bats
  • beavers
  • coyotes
  • foxes
  • monkeys
  • raccoons
  • skunks
  • woodchucks

Risk of Contracting Rabies

For most individuals, the risk of contracting rabies is relatively low. However, there are certain situations that may put you at a higher risk and these include:

  • Living in an area that is populated by bats
  • Traveling to developing countries
  • Living in a rural area where there is greater exposure to wild animals and little or no access to vaccines and immunoglobulin preventive therapy
  • Frequent camping and exposure to wild animals
  • Being under the age of 15 (rabies is most common in this age group)

Although dogs are responsible for most rabies cases worldwide, bats are the cause of most rabies deaths in the U.S. and Canada.

How Do Doctors Diagnose Rabies?

There is no test to detect the early stages of rabies infection. After the onset of symptoms, a blood or tissue test will help a doctor determine whether you have the disease. If you have been bitten by a wild animal, doctors will typically administer a preventative shot of rabies vaccine to stop the infection before symptoms set in.

Can Rabies Be Cured?

After being exposed to the rabies virus, you can have a series of injections to prevent an infection from setting in. Rabies immunoglobulin, which gives you an immediate dose of rabies antibodies to fight the infection, helps to prevent the virus from getting a foothold. Then, getting the rabies vaccine is the key to avoiding the disease. The rabies vaccine is given in a series of five shots over 14 days.

Animal control will probably try to find the animal that bit you so that it can be tested for rabies. If the animal is not rabid, you can avoid the large round of rabies shots. However, if the animal cannot be found, the most prudent course of action is to take the preventive shots.

Getting a rabies vaccination as soon as possible after an animal bite is the best way to prevent the infection. Doctors will treat your wound by washing it for at least 15 minutes with soap and water, detergent, or iodine. Next, you will be given the rabies vaccine. The following is the World Health Organization’s recommended treatment for a possible rabies infection (WHO):

Type of Exposure

Post Exposure Actions

Touching or feeding infected animals, a lick on unbroken skin

None

Nibbling of bare skin, minor scratches/abrasions, no bleeding

Immediate vaccination, local treatment of the wound

Superficial bites or licks on broken skin, exposure to bats

Immediate vaccination, rabies immunoglobulin, and local treatment

Side Effects of Rabies Treatment

The rabies vaccine and/or immunoglobulin may cause some rare side effects, including:

  • pain, swelling, or itching at the injection site
  • headache
  • nausea
  • stomach pain
  • muscle aches
  • dizziness

How to Prevent Rabies

There are some simple measures you can take to help keep you from catching rabies:

  • Vaccinate your pets.
  • Keep your pets from roaming outside.
  • Report stray animals to animal control.
  • Avoid contact with wild animals.
  • Prevent bats from entering living spaces or other structures near your home
  • Get a rabies vaccination before traveling to developing countries, working closely with animals, or working in a lab handling the rabies virus.
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