Rabies

What Is Rabies?

Rabies is a rare but serious disease caused by a virus. It affects the nerves and brain.

The virus is usually transmitted by a bite from an infected animal. Rabies can be prevented if the bitten person gets treatment quickly. If a person isn't treated and develops rabies, it is almost always fatal.

What Are the Signs & Symptoms of Rabies?

The first symptoms of rabies can appear from a few days to more than a year after the bite happens.

At first, there's a tingling, prickling, or itching feeling around the bite area. A person also might have flu-like symptoms such as a fever, headache, muscle aches, loss of appetite, nausea, and tiredness.

After a few days, neurological symptoms develop, including:

• irritability or aggressiveness
• excessive movements or agitation
• confusion, bizarre or strange thoughts, or hallucinations
• muscle spasms and unusual postures
• seizures (convulsions)
• weakness or paralysis (when a person cannot move some part of the body)
• extreme sensitivity to bright lights, sounds, or touch

Someone with rabies can produce a lot of saliva (spit), and muscle spasms in their throat might make it hard to swallow. This causes the "foaming at the mouth" effect that has long been associated with rabies infection. It also leads to a fear of choking or what seems like a "fear of water," another well-known rabies sign.

What Causes Rabies?

Rabies is caused by the rabies virus. Infected animals have the virus in their saliva. The virus enters the body through broken skin or the eyes, nose, or mouth, and travels through nerves to the brain. There it multiplies and causes inflammation and damage.

Bites from a wild infected animal cause most U.S. rabies cases. Raccoons are the most common carriers, but bats are most likely to infect people. Skunks and foxes also can be infected, and a few cases have been reported in wolves, coyotes, bobcats, and ferrets. Small rodents such as hamsters, squirrels, chipmunks, mice, and rabbits are rarely infected. Widespread animal vaccination has made transmission from dogs to people rare in the U.S. In the rest of the world, exposure to rabid dogs is the most common cause of transmission to humans.

Is Rabies Contagious?

Rabies is not contagious from person to person. The virus most often spreads through bites from an infected animal. But it can also spread if the animal's saliva (spit) gets directly into a person's eyes, nose, mouth, or an open wound (such as a scratch or a scrape).

How Is Rabies Diagnosed?

There's no way to know right away if a wild animal has rabies. When a person is bitten by or exposed to an animal that might be sick, doctors don't wait for a diagnosis — they treat right away. Lab tests can check for infection, but the results come later in the disease, when it would be too late to treat.

A biting animal that's caught can be tested to see if the virus is in its brain, but it must be euthanized (put to sleep) first. If it's a healthy pet, such as a dog, cat, or ferret, experts recommend watching the animal for 10 days to see if it gets sick. If it's a rabbit, rodent, or other small animal that doesn't usually spread rabies, a doctor can check with the local health department to decide what to do.

How Is Rabies Treated?

If rabies symptoms start, there is no effective treatment. This is why doctors focus on prevention and try to stop the disease right after a person is exposed.

Anyone who thinks they may have been exposed to the rabies virus must get medical care right away.

Doctors give two shots as soon possible:

1. rabies immune globulin: This provides protection right away while the vaccine starts working.
2. rabies vaccine: This is given as a series of four doses, on days 0, 3, 7, and 14 (day 0 is the day of the first dose). People with a weakened immune system get an extra dose on day 28.

How Is Exposure to Rabies Prevented?

To reduce the chances of rabies exposure:

• Vaccinate your pets.
• Report stray animals to your local health authorities or animal-control officer.
• Remind kids not to touch or feed stray cats or dogs wandering in the neighborhood or elsewhere.
• Teach kids to stay away from wild animals such as bats, raccoons, skunks, and foxes.

What Else Should I Know?

If your child has been bitten by an animal, especially if it was an unknown dog or wild animal:

• Wash the bite area well with soap and water and cover the bite with a clean bandage.
• Call your doctor right away and go to the nearest emergency department. Anyone with a possible rabies infection must be treated in a hospital.
• Call local animal-control authorities to help find the animal. It may need to be caught and watched for signs of rabies.
• If you know the owner of the animal that bit your child, get all the information you can, including its vaccination status and the owner's name and address. Notify your local health department, especially if the animal wasn't vaccinated.

Also call your doctor if:

• Your child was exposed to an animal that might have rabies, but is too young to describe the contact with the animal.
• Your child was exposed to bats, even if there is no bite.
• You plan to travel abroad and may come into contact with wild animals. This is even more important if you're going to an area with limited access to health care.