Definition

Rabies is a viral infection. It infects the brain and spine. Rabies is almost always fatal unless treated before symptoms appear.

The Nervous System

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Causes

Rabies is caused by a virus. It is found in infected, warm-blooded animals. Animals that commonly carry the virus include:

• Bats
• Raccoons
• Skunks
• Foxes
• Coyotes

The virus is in the saliva, brain, or nerve tissue of infected animals. Humans most often contract rabies through a bite or scratch from an infected animal. The virus may also be passed if infected tissue comes into contact with human mucus membranes. This tissue is found in the eyes, nose, or mouth.

Risk Factors

The only risk factor is contact with an infected animal.

In most parts of the US any contact with a bat may be considered a rabies risk factor. Seek medical advice if you find a bat anywhere inside your home.

Symptoms

Symptoms often start within 3-7 weeks. In some cases, the virus can incubate up to one or more years.

Death usually occurs within a week after symptoms appear.

Symptoms in humans may include:

• Pain, tingling, or itching at the site of the bite wound or other site of viral entry
• Stiff muscles
• Increased production of thick saliva
• Flu-like symptoms, such as headache, fever, fatigue, nausea
• Painful spasms and contractions of the throat when exposed to water (called hydrophobia)
• Erratic, excited, or bizarre behavior
• Paralysis

Symptoms in animals may include:

• Erratic behavior, often overly aggressive or vicious
• Disorientation (eg, nocturnal animal such as a bat or fox appearing in daylight)

Diagnosis

If you think you have been exposed to rabies:

• See a doctor or contact a public health official immediately

If the animal is available and appears well, it will be kept under observation for 10 days. If no symptoms develop, you are not at risk for rabies. If the animal is sick or dead, its head will be shipped to a special facility. There the brain will be examined for the presence of the virus. In the meantime, you may be advised to begin treatment.

If the animal is unavailable, treatment may be given. This could depend on:

• Animal's species
• Where the encounter took place
• Other factors

Treatment

If an animal has bitten you, immediately do the following:

• Wash the wound immediately with plenty of soap and water. This will remove saliva. It is the most important first step you can take in preventing rabies.
• Call your doctor or seek care in an emergency room.

If it is likely that you have been exposed to rabies, your doctor will recommend:

• Postexposure prophylaxis—treatment to prevent illness from developing

Prevention

To help prevent rabies:

• Vaccinate house pets.
• Avoid contact with wild animals.
• Do not touch any wild animal. Avoid it even if it appears to be dead.
• Seal basement, porch, and attic openings. This will prevent an animal from entering your home.
• Report any animal to your local animal control if it is acting strange or appears sick.
• If you often come in contact with potentially rabid animals, get the rabies vaccine before exposure. Booster doses are often needed.