Rabies is a preventable viral disease of mammals most often transmitted through the bite of a rabid animal. The vast majority of rabies cases reported to the Centers for Disease Control and Prevention (CDC) each year occur in wild animals like raccoons, skunks, bats, and foxes.
The rabies virus infects the central nervous system, ultimately causing disease in the brain and death. The early symptoms of rabies in people are similar to that of many other illnesses, including fever, headache, and general weakness or discomfort. As the disease progresses, more specific symptoms appear and may include insomnia, anxiety, confusion, slight or partial paralysis, excitation, hallucinations, agitation, hypersalivation (increase in saliva), difficulty swallowing, and hydrophobia (fear of water). Death usually occurs within days of the onset of these symptoms.
What are the signs and symptoms of rabies?
The first symptoms of rabies may be very similar to those of the flu including general weakness or discomfort, fever, or headache. These symptoms may last for days.
There may be also discomfort or a prickling or itching sensation at the site of bite, progressing within days to symptoms of cerebral dysfunction, anxiety, confusion, agitation. As the disease progresses, the person may experience delirium, abnormal behavior, hallucinations, and insomnia.
The acute period of disease typically ends after 2 to 10 days. Once clinical signs of rabies appear, the disease is nearly always fatal, and treatment is typically supportive.
Disease prevention includes administration of both passive antibody, through an injection of human immune globulin and a round of injections with rabies vaccine.
Once a person begins to exhibit signs of the disease, survival is rare. To date less than 10 documented cases of human survival from clinical rabies have been reported and only two have not had a history of pre- or postexposure prophylaxis.
Eliminating rabies in dogs
Rabies is a vaccine-preventable disease. Vaccinating dogs is the most cost-effective strategy for preventing rabies in people. Dog vaccination will drive down not only the deaths attributable to rabies but also the need for PEP as a part of dogbite patient care.
Preventive immunization in people
The same safe and effective vaccines can be used for pre-exposure immunization. This is recommended for travellers spending a lot of time outdoors, especially in rural areas, involved in activities such as bicycling, camping, or hiking as well as for long-term travellers and expatriates living in areas with a significant risk of exposure.
Pre-exposure immunization is also recommended for people in certain high-risk occupations such as laboratory workers dealing with live rabies virus and other rabies-related viruses (lyssaviruses), and people involved in any activities that might bring them professionally or otherwise into direct contact with bats, carnivores, and other mammals in rabies-affected areas. As children are considered at higher risk because they tend to play with animals, may receive more severe bites, or may not report bites, their immunization could be considered if living in or visiting high-risk areas.
Clean the wound well with soap and water, and seek professional medical help. You will need a doctor to thoroughly clean the wound and remove any foreign objects. Most of the time, stitches should not be used for animal bite wounds.
If there is any risk of rabies, you will be given a series of a preventive vaccine. The vaccine is generally given in 5 doses over 28 days.
Most patients also receive a treatment called human rabies immunoglobulin (HRIG). This treatment is given the day the bite occurred.
Call your doctor right away after an animal bite or after being exposed to animals such as bats, foxes, and skunks. They may carry rabies.
Call even when no bite took place.
Immunization and treatment for possible rabies are recommended for at least up to 14 days after exposure or a bite.
There is no known effective treatment for people with symptoms of a rabies infection, but there have been a few reports of people surviving with experimental treatments.