Rabies is a viral infection that causes over 50,000 deaths per year, primarily in Asia, Africa, and South America according to the Merck Manual. In a majority of cases, dogs are the carriers. Saliva from an infected animal can enter humans through a bite, the licking of a cut or abrasion, and rarely if it gets into the eyes or mouth.
Other animal carriers of rabies are bats, raccoons, cats, mongooses, jackals, foxes, wolves and other carnivorous animals. Rabies due to monkey and rat bites is rare. Horses and donkeys can be infected with rabies according to the World Health Organization (WHO).
Once saliva enters the body, it goes directly to the brain and nerves. Interestingly, it can take months or over a year to develop symptoms.
- May take weeks or months, after bitten, to develop.
- Initially, may cause a headache, fatigue, and fever.
- Eventually progresses to either an encephalitic (brain) form in 80% of cases or a paralytic form in 20%. The latter form may resemble other neurologic conditions with ascending paralysis (Guillain Barre). This is often seen as a numbness or weakness in the hands or feet that progresses towards the trunk.
- The encephalitic form causes confusion, agitation, psychotic symptoms, hallucinations, lack of sleep, pain and spasms of the throat when attempting to drink water, and excessive salivation.
- The paralytic form doesn’t cause severe mental, or brain symptoms, but a generalized paralysis of the body.
Without treatment, and once symptoms begin, rabies is 99% fatal in 3-10 days. The WHO reports only 7 survivors in the world.
Recognition of rabid animals:
- In dogs you may see erratic behavior, foaming at the corners of the mouth, running for no reason, eating odd things such as sticks, feces, nails, and unusual sounds like grunting or a hoarse bark.
- Other animals may show similar behavior as well as being agitated, vicious, partially paralyzed, and showing no fear of humans.
- Nocturnal animals (wolves, raccoons, bats, and skunks) may be seen acting erratically in the day time.
- Immediately wash the wound with soap and water for 15 minutes.
- Flush out the wound with a needleless syringe and water.
- Irrigate the wound with rubbing alcohol or iodine solution.
- Once symptoms begin, treatment with the rabies vaccine and immunoglobulins may speed up death.
- Never cover the wound with a bandage.
Before being bitten:
- There is a series of vaccinations available for those at high risk (spelunkers, travelers to endemic areas, veterinarians, animal handlers).
After being bitten:
- Get to a medical facility as soon as possible.
- Following treatment guidelines, above, is absolutely the most import step in preventing rabies.
- The deeper the bite or more saliva in contact with a wound or abrasion, the higher the risk of rabies.
- Rabies vaccine and immune globulin are available for skunk, bat, fox, dog, cat, ferret, and raccoon suspected of rabies.
- Squirrel, hamster, rat, mice, guinea pig, and gerbil bites almost never require treatment unless the animal displays odd behavior.
- Rabies vaccine and immune globulin can be given to nursing and pregnant mothers.
Dogs should be vaccinated at 2-3 months, 9 months, and annually.
Tests are available to detect rabies.
Think it never occurs? September 28 is World Rabies Day.
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