Rabies

Rabies is a viral infection that can be spread to people from infected animals. The infection affects the brain and central nervous system. Once the disease develops, it almost always causes death. Because of this, when a person is bitten by an animal that may have rabies, treatment to prevent rabies often needs to be started whether or not the animal is known to be infected. Prompt treatment with the rabies vaccine and rabies immune globulin is very effective at preventing the infection from developing in people who have been exposed to the rabies virus.

CAUSES

Rabies is caused by a virus that lives inside some animals. When a person is bitten by an infected animal, the rabies virus is spread to the person through the infected spit (saliva) of the animal. This virus can be carried by animals such as dogs, cats, skunks, bats, woodchucks, raccoons, coyotes, and foxes.

SYMPTOMS

By the time symptoms appear, rabies is usually fatal for the person. Common symptoms include:

  • Headache.

  • Fever.

  • Fatigue and weakness.

  • Agitation.

  • Anxiety.

  • Confusion.

  • Unusual behavior, such as hyperactivity, fear of water (hydrophobia), or fear of air (aerophobia).

  • Hallucinations.

  • Insomnia.

  • Weakness in the arms or legs.

  • Difficulty swallowing.

Most people get sick in 1–3 months after being bitten. This often varies and may depend on the location of the bite. The infection will take less time to develop if the bite occurred closer to the head.

DIAGNOSIS

To determine if a person is infected, several tests must be performed, such as:

  • A skin biopsy.

  • A saliva test.

  • A lumbar puncture to remove spinal fluid so it can be examined.

  • Blood tests.

TREATMENT

Treatment to prevent the infection from developing (post-exposure prophylaxis, PEP) is often started before knowing for sure if the person has been exposed to the rabies virus. PEP involves cleaning the wound, giving an antibody injection (rabies immune globulin), and giving a series of rabies vaccine injections. The series of injections are usually given over a two-week period. If possible, the animal that bit the person will be observed to see if it remains healthy. If the animal has been killed, it can be sent to a state laboratory and examined to see if the animal had rabies.

If a person is bitten by a domestic animal (dog, cat, or ferret) that appears healthy and can be observed to see if it remains healthy, often no further treatment is necessary other than care of the wounds caused by the animal.

Rabies is often a fatal illness once the infection develops in a person. Although a few people who developed rabies have survived after experimental treatment with certain drugs, all these survivors still had severe nervous system problems after the treatment. This is why caregivers use extra caution and begin PEP treatment for people who have been bitten by animals that are possibly infected with rabies.

HOME CARE INSTRUCTIONS

If you were bitten by an unknown animal, make sure you know your caregiver's instructions for follow-up. If the animal was sent to a laboratory for examination, ask when the test results will be ready. Make sure you get the test results.

Take these steps to care for your wound:

  • Keep the wound clean, dry, and dressed as directed by your caregiver.

  • Keep the injured part elevated as much as possible.

  • Do not resume use of the affected area until directed.

  • Only take over-the-counter or prescription medicines as directed by your caregiver.

  • Keep all follow-up appointments as directed by your caregiver.

PREVENTION

To prevent rabies, people need to reduce their risk of having contact with infected animals.

  • Make sure your pets (dogs, cats, ferrets) are vaccinated against rabies. Keep these vaccinations up-to-date as directed by your veterinarian.

  • Supervise your pets when they are outside. Keep them away from wild animals.

  • Call your local animal control services to report any stray animals. These animals may not be vaccinated.

  • Stay away from stray or wild animals.

  • Consider getting the rabies vaccine (preexposure) if you are traveling to an area where rabies is common or if your job or activities involve possible contact with wild or stray animals. Discuss this with your caregiver.