Rabies

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KEY POINTS

• Rabies infection is caused by a virus in the saliva of an infected animal. It is usually spread to humans by an animal bite.
• If you may have been exposed to rabies by being licked or bitten by a possibly infected animal, carefully wash the wound or licked area and get medical help right away. There is no cure for rabies after the virus moves to the nervous system and brain. However, if you get treatment right away, the virus can be killed before it infects your brain.
• Make sure your pets get rabies shots on a regular schedule. Avoid stray and wild animals.
• If your work puts you at risk for rabies, you should have the rabies vaccine and be checked yearly.

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What is rabies?

Rabies is an infection caused by a virus. If you don’t get treatment immediately after you have been exposed to the virus, rabies is almost always fatal.

What is the cause?

Rabies is caused by a virus in the saliva of an infected animal. It is usually spread to humans by an animal bite. Less often the virus is spread when the saliva of an infected animal gets into your mouth, nose, eyes, or an open skin wound, such as when an animal licks you.

In the US, the animals most likely to be infected with rabies are dogs, cats, and certain wild animals, such as bats, skunks, raccoons, foxes, and coyotes. Dogs and cats can get infected from wild animals, or from other dogs and cats that have not been immunized against rabies. A bite from a wild animal does not always mean you’ve been exposed to rabies.

What are the symptoms?

If you have been bitten, you may have some redness or an infected area around the bite, as with any bite. Otherwise, you may have no symptoms for 1 to 3 months.

When you start having symptoms, at first they are like the symptoms of a minor infection, such as:

• Fever
• Headache
• Muscle aches
• Nausea and vomiting

The symptoms worsen quickly over a few days. The virus affects the brain and nervous system and can cause:

• Loss of control of muscles and bodily functions
• Loss of the ability to think and act rationally
• Muscle spasms or inability to move your body (paralysis)
• Hallucinations (hearing or seeing things that are not there)
• Irritability and restlessness

The muscle spasms can affect the muscles of the throat and cause trouble swallowing.

Once the symptoms of severe illness have begun, coma and death usually follow in 3 days to 3 weeks.

How is it diagnosed?

There is no lab test to detect the virus before it has infected the brain. Your provider may suspect that you have been infected with rabies if the animal that bit you was aggressive for no reason or looked sick. If you know the animal has not had rabies shots, is sick, or is a type of wild animal that can carry rabies, you are at greater risk.

The only way to diagnose rabies in the animal is by testing a piece of the animal's brain for the virus after the animal is killed.

How is it treated?

If you may have been exposed to rabies by being licked or bitten by a possibly infected animal, carefully wash the wound or licked area and get medical help right away.

There is no cure for rabies after the virus moves to the nervous system and brain. However, if you get treatment right away, the virus can be killed before it infects your brain.

When possible, the animal that bit you is observed for rabies.

• If a pet bit you, it will be caged and watched for possible illness for 10 days.
• If a wild animal bit you, it should be captured, if possible, or killed so it can be examined. It is best if someone trained in capturing animals does this.

An animal that shows signs of rabies will most likely be killed and tested for rabies.

If the animal is suspected or known to have rabies, you may be given shots to help your body kill the virus. You may also get the shots if the animal was never caught or identified. The treatment begins with 2 shots of rabies immune globulin. The treatment is continued with a series of 5 shots of rabies vaccine given over a period of 28 days. This series of shots must be started as soon as it is determined that you are at risk for rabies. If the animal is found to be free of rabies after you have started the shots, then you can stop getting the shots.

How can I help prevent rabies?

• Make sure your pets get rabies shots on a regular schedule. Some shots are good for 1 year, others for 3 or more years.
• Carefully wash all wounds promptly and thoroughly. If you have questions about any animal bite you have gotten, get medical advice right away.
• Avoid stray and wild animals.
  • Call a professional to handle dead or injured animals.
  • Keep pets indoors or fenced in at night.
  • Keep locking lids on outdoor trashcans.
• If your work involves activities that put you at risk for rabies infection, you should be given 3 shots of rabies vaccine in a 28-day period to help prevent rabies. After the first series of shots, your healthcare provider should check your immunity regularly, usually every year, to see if you need a booster shot to keep you protected.