Rabies: Everything you need to know

Rabies is a virus, commonly spread by an animal’s bite or scratch. In fact, it is too late to save the patient by the time the signs begin.

However, if they seek treatment at once a person who may have been exposed to rabies will typically be handled effectively.

Per year between 1 and 3 people in the United States contract rabies. The US saw 23 human cases from 2008 to 2017, eight of which were contracted outside of the world. Medicine advancements, educational campaigns, and vaccine services have reduced the occurrence of rabies since the 1970s.

Globally, however, it remains a concern and every year tens of thousands of deaths result from rabies, mainly in Southeast Asia and Africa’s rural areas. Dogs are responsible for over 95 percent of infections.

Important facts about rabies

  • Rabies is a viral disease that is nearly always transmitted by an infected animal bite.
  • Anyone who receives a bite in a geographical area where rabies occurs should seek treatment at once.
  • For treatment to be successful, it must be given before symptoms appear.
  • Symptoms include neurological problems and a fear of light and water.
  • Following the vaccination requirements for pets helps prevent and control rabies.

What is rabies?

Healthy dog
Vaccinate dogs and cats to protect them from rabies.

Rabies is a viral infection that spreads from an infected animal mainly via a bite. It is the family rhabdovirus RNA virus.

It is normally fatal, without early treatment.

The virus may have one of two ways to affect the body:

  • It enters the peripheral nervous system (PNS) directly and migrates to the brain.
  • It replicates within muscle tissue, where it is safe from the host’s immune system. From here, it enters the nervous system through the neuromuscular junctions.

Once within the nervous system the infection causes the brain to become acutely inflamed. Next come Coma and death.

Two types of rabies do exist.

Furious, or encephalitic rabies: It occurs in 80% of human cases. More likely the individual will experience hyperactivity and hydrophobia.

Paralytic or “dumb” rabies: The primary form of paralysis.

Transmission

Rabies is most common in countries with large numbers of stray dogs, most notably in Asia and Africa.

It is transmitted by saliva. Rabies can occur when a person gets a bite from an infected animal, or when saliva from an infected animal gets into an open wound, or through a mucous membrane, such as the eyes or mouth. It can’t penetrate unbroken skin.

In the U.S. the species most likely to spread the virus are raccoons, coyotes, rabbits, skunks, and foxes. Rabies-carrying bats were present in all 48 bordering states.

Each mammal can harbor and transmit the virus but smaller mammals, such as rodents, are rarely infected or transmit rabies. Rabbits are unlikely to spread rabies.

Symptoms

Rabies progresses in five distinct stages:

  • incubation
  • prodrome
  • acute neurologic period
  • coma
  • death

Incubation period

This is the time before symptoms appear. It usually lasts from 3 to 12 weeks, but may take as little as five days or more than two years.

The closest the bite is to the brain, the quicker the symptoms show.

The rabies are usually fatal by the time signs begin. Anyone who might have been exposed to the virus should seek medical assistance immediately, without waiting for symptoms.

Prodrome

Coughing lady
During the prodrome stage of rabies, a person may experience coughing and fever.

Early, flu-like symptoms, include:

  • fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or above
  • headache
  • anxiety
  • feeling generally unwell
  • sore throat and a cough
  • nausea and vomiting
  • discomfort may occur at the site of the bite

These can last from 2 to 10 days, and they worsen over time.

Acute neurologic period

Neurologic symptoms develop, including:

  • confusion and aggression
  • partial paralysis, involuntary muscle twitching, and rigid neck muscles
  • convulsions
  • hyperventilation and difficulty breathing
  • hypersalivation or producing a lot of saliva, and possibly frothing at the mouth
  • fear of water, or hydrophobia, due to difficulty swallowing
  • hallucinations, nightmares, and insomnia
  • priapism, or permanent erection, in males
  • photophobia, or a fear of light

Toward the end of this phase, breathing becomes rapid and inconsistent.

Coma and death

Death can occur within a matter of hours if the person enters a coma, unless they are connected to a ventilator.

Rarely, a person may recover at this late stage.

Why does rabies cause a fear of water?

Rabies used to be called hydrophobia, since it appears to be causing fear of water.

When attempting to swallow, intense spasms in the throat are triggered. Only the thought of swallowing water can lead to spasms. It is from this that the fear comes.

The excess saliva that occurs is possibly due to the nervous system effect of the virus.

That would reduce the risk of spreading the virus to a new host if the individual could swallow saliva easily.

Diagnosis

There’s usually no way to tell for sure at the time of a bite whether an animal is rabid, or if it’s passed on an infection.

Laboratory tests may display antibodies, but these may not appear until later in disease development. The virus may be separated from saliva, or by a biopsy of the skin. By the time a diagnosis is confirmed, however, intervention can be too late.

Because of this, the patient should usually initiate a prophylactic treatment plan at once, without waiting for a verified diagnosis.

When a person experiences viral encephalitis symptoms after an animal bite, they should be treated as if they may have rabies.

Treatment

When a person is bitten or scratched by an animal that may have rabies, or if the animal licks an open wound, the patient should wash any bites and scratches with soapy water, povidone iodine or detergent for 15 minutes at once. It could decrease viral particle number.

Then they must seek medical help at once.

A series of shots can prevent the virus from thriving after exposure, and before symptoms begin. Typically, that is efficient.

Strategies include:

A fast-acting dose of immune globulin rabies: This will prevent the virus from infecting the patient, delivered as soon as possible, close to the bite wound.

A series of vaccines for rabies: These will be injected into the arm for the next 2 to 4 weeks. This will train the body in battling the virus once it is detected.

It’s usually not possible to find out if the animal has rabies or not. Thinking the worst is best, and beginning the shots course.

A few people have survived rabies, although most cases are fatal once the symptoms begin. There is currently no effective treatment.

This should make a person with symptoms as comfortable as possible. They may need help breathing.

Prevention

In some areas the vaccination of humans is necessary to prevent the spread of rabies.
In some areas the vaccination of humans is necessary to prevent the spread of rabies.

Rabies is a deadly disease, but individuals and governments can and do act to control and prevent it, and in some cases completely wipe it out.

Strategies include:

  • regular antirabies vaccinations for all pets and domestic animals
  • bans or restrictions on the import of animals from some countries
  • widespread vaccinations of humans in some areas
  • educational information and awareness

Agencies in rural Canada and the U.S. have removed baits carrying an oral vaccine to minimize the number of rabies-borne wild raccoons.

In Switzerland, vaccine laced chicken heads have been spread in the Swiss Alps by authorities. By receiving the vaccine, the foxes immunized themselves and the country is now virtually free of rabies.

Individual precautions

Individuals should obey other health guidelines to lessen the risk of rabies contracting.

  • Vaccinate pets: Find out how often you need to vaccinate your cat, dog, ferret, and other domestic or farm animals, and keep up the vaccinations.
  • Protect small pets: Some pets cannot be vaccinated, so they should be kept in a cage or inside the house to prevent contact with wild predators.
  • Keep pets confined: Pets should be safely confined when at home, and supervised when outside.
  • Report strays to the local authorities: Contact local animal control officials or police departments if you see animals roaming
  • Do not approach wild animals: Animals with rabies are likely to be less cautious than usual, and they may be more likely to approach people.
  • Keep bats out of the home: Seal your home to prevent bats from nesting. Call an expert to remove any bats that are already present.

A woman died from rabies in 2015, after being attacked in the night by a bat. She didn’t know she was bitten.

People are advised to seek medical attention following a wild animal experience, even though there are no bite marks or any visible signs of damage.

The World Health Organization (WHO) considers rabies a “100 percent vaccine-preventable disease,” adding that to interrupt the transmission cycle, at least 70 percent of dogs in an area must be vaccinated.

In the U.S., domestic dogs are vaccinated to prevent rabies. Nevertheless, following contact with suspect animals, between 30.000 and 60.000 people try prophylaxis of post-exposure rabies every year. Hundreds of thousands of animals get tested and observed.

Throughout the United States, between 60 and 70 dogs and about 250 cats are confirmed annually to be rabid. Most of these were not vaccinated, and were exposed to the virus by wild animals, such as bats.

Traveling

The prevalence of rabies varies significantly from country to country. The rates are considerably lower in nations with no feral dog population.

In 150 countries and on all continents except Antarctica and the Arctic, rabies is present. Islands such as New Zealand , Australia, the Seychelles and Mauritius are enabled by their natural isolation.

Africa and Asia are the most common continents with rabies. India has the highest number of cases.

Due to rabies prevention initiatives, in recent years , the prevalence of rabies in South America and the Caribbean has dropped significantly. Official figures show that there were 250 cases in 1990 but less than 10 by 2010.

Everyone who travels to an area where rabies are common, or who takes part in activities where they are likely to come into contact with wild animals that may have rabies, such as caving or camping, should ask their doctor about vaccination.

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