Rabies

 

Rabies is a devastating disease which, if allowed to progress, will almost certainly result in death. Thankfully the disease is extremely rare in the United States today, and would probably have already been eradicated if it didn't spread in animal populations which are practically impossible to monitor and control effectively. It is also treatable if addressed quickly, before symptoms arise. 

  

What Causes Rabies?

Rabies is caused by a virus, which acts on the brain and nervous system if allowed to progress uninterrupted. 
  • It is transmitted via direct contact with saliva of an infected animal or individual
    • This contact typically occurs through broken skin or other wounds
    • Transmission can also occur if infected saliva contacts mucous membranes of an infected person, such as the eyes or the inside of the nose (although this form of transmission is much rarer)
  • A bite from an infected animal is by far the most common route of transmission of the virus.
    • In the past, dog bites were the most common way rabies was spread to humans (this is still the case in some countries outside the United States)
    • Successful campaigns to increase rabies vaccinations in pets have led to a massive decline of the virus in the U.S.
    • Bites  from infected bats are currently the most common route of exposure in the United States. 

  

What are the Symptoms and Effects if Untreated?

  • Before symptoms occur, the virus must make its way to the brain. This is known as the incubation period.

    • The incubation period can last anywhere from a couple of weeks weeks to around a year

    • Incubation period length depends on many factors including bite location, how much of the virus was transmitted in the bite, and the individual's immune system strength.

    • If you believe you or someone you know may have been exposed to a rabid animal, there is no safe length of time to wait to seek treatment. Contact a healthcare provider as soon as possible for treatment. 

  • Symptoms vary widely and depend on the specific case. 

  • Fever along with a tingling, prickling, or burning sensation at the wound site are common early symptoms

  • As the disease progresses, the brain an spinal cord become inflamed, along with a wide variety of more significant symptoms including:

    • Anxiety

    • Confusion

    • Agitation

    • Delirium

    • Hydrophobia (fear of water)

    • Insomnia

    • Muscle spasms

    • Muscle weakness/paralysis

    • Excessive saliva production ("foaming at the mouth" often associated with rabies)

  • As mentioned previously recovery from clinical rabies is extremely rare, with less than 20 cases of recovery after symptoms develop to date according to the Centers for Disease Control. 

  

Prevention and Treatment

  • As far as prevention is concerned there is very little that is required in the U.S. to prevent contraction of rabies. 

    • Humans aren't typically vaccinated against rabies because of the rarity of the disease

    • Vaccinating pets is the most effective way to prevent the spread of rabies

    • In certain circumstances, high-risk individuals (such as animal handlers or veterinarians) may be vaccinated in advance if there's a reasonable chance they could come into contact with a rabid animal. 

  • Treatment consists of thoroughly washing any potentially exposed wound and vaccinating the potentially exposed individual.

    • The rabies vaccine is effective as long as it is administered before symptoms appear

    • As mentioned earlier, the incubation period varies but typically lasts for weeks to months, allowing plenty of time for a vaccine to be administered. 

    • If an animal suspected of having rabies bites someone, it is important to thoroughly wash the wound afterwards. This can reduce the viral load the individual is exposed to and also delay the onset of symptoms. 

      • Bites/scratches/etc. should be cleaned for a minimum of 15 minutes with soap and water, detergent, povidone iodine or other substances that remove and kill the rabies virus according to the World Health Organization. 

  • If you believe you've been exposed to rabies, all you need to do is clean the wound following the above procedure (if applicable) and contact a healthcare professional to discuss your exposure and the potential need for a vaccination. 

    • Once this basic procedure is completed it is also helpful to notify the health department, law enforcement, or another similar agency to properly track the animal and potentially capture it and test it for rabies.