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Understanding Rabies: Symptoms, causes and treatments

Dr. Ajay KohliDec 12, 2024

Rabies causes progressive inflammation of the brain and spinal cord. The disease claims an estimated 59,000 lives annually. A dog bite is a primary source of transmitting the infection to humans. Seizures, hallucinations, and paralysis are characteristic of Rabies. Even though the illness has no treatment, a simple step consisting of immediate and thorough washing of wounds with soap and water can save lives. Read ahead to know more about Rabies.

Contents

What is Rabies?
What causes Rabies?
Signs and Symptoms of Rabies
What Are the Effects of Rabies on the Body?
Types of Rabies
Treatment for Rabies
Why Is There No Cure for Rabies?
How Can I Prevent Rabies?
Risk factors for Rabies
Who is at Risk of Rabies?
How Prevalent is Rabies Worldwide?
Conclusion
Frequently Asked Questions (FAQs)

What is Rabies?

Rabies is caused by the Rabies virus (scientifically called lyssavirus) that spreads to people by the bite of an infected animal (domestic or wild). Left untreated, the virus affects the central nervous system, causing signs and symptoms which are virtually 100% fatal. Therefore, vaccinating dogs is an effective strategy that can't be overstressed for reducing deaths attributable to dog-mediated Rabies in people.

What causes Rabies?

Typically transmitted by saliva, the virus enters the body through the bite of an infected animal. While dog bites are often associated with the development of Rabies, other animals, including wild ones, have occasionally been found to transmit Rabies to people. Some high-risk animals in this regard are as follows.

Bats
Foxes
Racoon
Beavers
Skunks
Cats
Goats

The other rare possibility of getting Rabies is from non-bite exposure when a rabid animal licks a person's eyes, nose, or mouth, exposing the scratches, abrasions, or open wounds to infectious saliva.

Signs and Symptoms of Rabies

However, neurological function gradually decreases as the virus spreads and infects the brain and spinal cord, causing the patient to exhibit the following symptoms:

Anxiety
Confusion
Agitation
Excessive salivation
High level of excitement
Difficulty in breathing or swallowing
Photophobia (Fear of light)
Hallucination
Fear of water (Hydrophobia)
Trouble in speaking or understanding
Prolonged lack of sleep
Partial paralysis of leg muscles (starting at the site of the bite)
Coma

What Are the Effects of Rabies on the Body?

Fever, pain, and strange or inexplicable tingling, pricking, or scorching sensations at the wound site are typical early symptoms of rabies. As the virus spreads throughout the central nervous system, it gradually and fatally inflames the brain and spinal cord.

During the first two to ten days of rabies, a person may have symptoms that are more like to the flu, including the following:

Fever
Headache
Feeling queasy
Vomiting
At the biting site, there is pain and an odd tingling, prickling, or burning feeling (sensory loss).

Types of Rabies

Two clinical forms of Rabies exist - furious and paralytic.

The furious form comprises approximately 80% of Rabies cases. Its onset is characterised by hyperactivity, hydrophobia, and severe or uncontrollable excitability, which are caused by spasms of the throat and larynx when the virus affects regions of the brain that regulate speaking, swallowing, and breathing.

This phase may persist for hours or days, after which the patient will have episodes of anxiety as opposed to constant agitation. Alternatively, the paralytic form occurs in one in five cases. In this form, the patient is often quiet and lucid throughout. The stage has a more protracted course, beginning with tingling or paralysis of the bitten limb and progressing to the brain.

Treatment for Rabies

If you have been bitten by a dog, cat, or other unfamiliar animals, wash the bite wound thoroughly with soapy water for 15 minutes and apply the water-diluted povidone-iodine solution if available. Seek medical attention for wound assessment and to know if you need the vaccine.

Post-exposure prophylaxis (PEP) is the key treatment for preventing Rabies.

As part of this, you will receive Human Rabies Immune Globulin (HRIG) at the site distant from where the animal bit you. This will be followed by a strict regime of Rabies vaccine, wherein:

Patients who are not immunised will receive 4 doses of vaccine coupled with HRIG in 14 days.

Patients vaccinated already against Rabies will receive 2 shots alone.

People at high risk for Rabies exposure, i.e., veterinarians, laboratory workers, animal handlers (including bat handlers), animal rehabilitators, wildlife officers, and other people (especially children) living in or travelling to high-risk areas, get Rabies vaccine under pre-exposure prophylaxis. Under this protocol, the person would receive the vaccine over 28 days in three doses in the upper arm.

Why Is There No Cure for Rabies?

Once rabies has spread to your brain, it cannot be cured because the blood-brain barrier protects it. The membrane that separates your brain from the blood vessels in your skull is called the blood-brain barrier. Its function is to protect your brain by preventing poisons and other harmful chemicals from entering your bloodstream. It resembles an extremely delicate strainer.

Researchers don't know how, but rabies further imprisons this barrier, making it impossible for drugs that could break it to pass through.

How Can I Prevent Rabies?

Preventing rabies requires increasing public awareness of the disease. Participate in your neighbourhood to learn about pet safety, rabies symptoms, and what to do if you are bitten. A suspected rabid animal should never be touched; instead, seek assistance from the local authorities. Removing stray animals from your neighbourhood and avoiding wildlife are important. Ensure that livestock and pets are vaccinated against rabies and that their vaccinations are current. Keep your pets indoors, and encourage kids not to approach animals they don't know. If bitten or exposed to rabies, follow proper wound care and consult a doctor immediately. If you work as a veterinarian or in a lab handling the rabies virus, consider getting vaccinated as a preventive measure.

Risk factors for Rabies

Numerous factors can increase a person's likelihood of Rabies. Here’s a list.

Inadequate animal vaccination and control.

Limited or no knowledge about Rabies.

Travelling to or living in areas with high Rabies density.

Participating in activities such as camping or exploring caves that are likely to put you in contact with wild animals that may have Rabies.

Inability to access proper medical care after being bitten by an infected animal.

Poor management of wounds and poor adherence to post-exposure prophylaxis.

Working as a veterinarian or laboratory staff.

Children, in general, are at a higher risk of getting Rabies because they are more likely to be bitten by dogs in high-risk body areas like the neck and face.

Who is at Risk of Rabies?

Vaccination can prevent rabies, an infectious, viral disease that attacks the central nervous system. Up to 99 percent of rabies infections in humans are spread by dogs.Victims typically range in age from 5 to 14. Mammals, such as dogs, cats, livestock, and wildlife, are susceptible to rabies. Through bites, scratches, or direct contact with mucosa (such as the mouth, eyes, or open wounds), rabies is typically transmitted to humans and animals through saliva. Almost all cases of rabies are deadly once clinical signs manifest.

How Prevalent is Rabies Worldwide?

Although dogs continue to provide the greatest risk of human rabies transmission worldwide, rabies is also spread by other wildlife species in many regions of the world. Regardless of whether dogs have rabies or not, animals such as bats, foxes, jackals, mongooses, skunks, and others can spread the disease in some regions of the world.

Key points

Rabies kills 70,000 people worldwide each year.
Outside of the United States, 99% of human rabies deaths are caused by dogs.
Despite successfully providing vaccines for humans and animals for over a century, rabies prevention efforts are limited in some areas due to a lack of public health resources.
CDC works with international partners to support worldwide efforts to eradicate and control Rabies.

Conclusion

The fatal virus known as rabies is spread by the saliva of infected animals. It starts with flu-like symptoms and then develops into a fever, stupor, muscle spasms, and finally death.

Vaccines against rabies are generally helpful in preventing infections, but there is no effective treatment once symptoms start to show. But instead of waiting for symptoms to appear, individuals need to get therapy right away.

Frequently Asked Questions (FAQs)

Here’s a list of common questions and answers related to Rabies.

How long does it take to show symptoms of Rabies after an animal bites you?

The signs of rabies usually take two to three months to manifest in most people. However, it may take up to a year in certain situations.

Can Rabies transmit through the air?

Most people are unlikely to encounter Rabies through the air, although laboratory workers can get infected if they inhale aerosols of the Rabies virus while working, which is fundamentally a non-bite route of Rabies exposure.

Can Rabies survive on surfaces?

Unlike diarrhoea or respiratory viruses, Rabies is a fragile virus that cannot survive more than a few hours at room temperature. It can get easily killed by the most common detergents and disinfectants, including household bleach.

What should I do If my pet gets bitten by a wild animal?

Call your veterinarian immediately. Your pet will be kept in isolation for 10 days and monitored for signs of Rabies. If your pet shows any signs of Rabies, euthanising it is the best way to prevent the Rabies virus from infecting others.

When should you seek medical attention?

If you've been scratched or bitten by an unfamiliar animal, call your doctor immediately to know your risk of developing the illness and the need for vaccination. But remember, Rabies is a medical urgency. Any delay in the decision can be dangerous.

References

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.