Rabies
GENERAL INFORMATION:
What is rabies? Rabies (RAY-beez) is a serious disease, caused by a virus (germ), that affects the central nervous system. The central nervous system is made up of nerves, the brain, and the spine. Rabies usually spreads through the bite of a rabid animal. Animals that may spread rabies include dogs, cats, raccoons, foxes, skunks, and bats. Rabies occurs when the virus enters the skin and goes to the muscles or nerves. The virus may then go to the brain or other body parts by traveling through the nerves.
What causes rabies? Rabies is usually caused by contact with the saliva of a rabid animal, usually through their bites. Sometimes, the saliva of an infected animal may get into a person's wound, eyes, or mouth. Breathing in the virus, such as when inside bat caves and laboratories, may also cause a rabies infection. People who handle and skin the body of an infected animal may get the virus. The virus can also be passed from one person to another through organ transplants, such as eye transplants.
What puts me at risk of getting rabies? Rabies can affect anyone of any age. The following factors may place you at a higher risk of getting this disease:
- Being bitten on the head, face, neck, or hands, getting bitten many times, or having deep bite wounds. In the case of a bat bite, even a small bite can increase your risk of rabies.
- Having a weak immune system, such as having HIV or while taking steroids. The immune system is the part of your body that fights infection.
- Traveling to places where rabies is commonly found.
- Work that includes handling the virus or working with animals. These jobs may include laboratory workers, veterinarians, forest rangers, and animal control and wildlife workers.
What are the signs and symptoms of rabies? Signs and symptoms of rabies may appear weeks, months, or even years after the infection. They are usually divided into early and late signs and symptoms.
- Early: During the early stages of rabies, you may feel like you have the flu. It may include any of the following:
- Loss of appetite, irritability, fever, headache, nausea (upset stomach), and vomiting (throwing up).
- Pain, numbness, or a burning or tingling feeling at the bite site, which may slowly spread to other areas.
- Severe itching at the bite site. Scratching often leads to large areas of scratches or breaks in the skin.
- Loss of appetite, irritability, fever, headache, nausea (upset stomach), and vomiting (throwing up).
- Late: Over time, rabies may cause symptoms that show that the brain may be affected. Symptoms may include any of the following:
- Confusion (cannot think clearly) or increased sleepiness.
- Dizziness, seeing double, or seeing something that is not really there.
- Restlessness and activity, which is increased by thirst, fear, light, or noise. Anxiety and panic attacks may also happen.
- Seizures (convulsions) or twitching.
- Slurred speech, drooling, swallowing problems, and a fear of water.
- Tiredness, muscle cramps, problems with movement, or severe weakness. Weakness may be seen only on one side of the body or face.
- Confusion (cannot think clearly) or increased sleepiness.
How is rabies diagnosed? Your caregiver will take a detailed health history from you. This includes information on medicines taken, vaccinations (shots) received, and past travels or activities. He may ask you about any contact with an animal or infected person that you may have had. If you were bitten, your caregiver may ask whether or not something was done to cause the animal to attack. This is to find out if rabies may have caused the animal to bite you.
- Tests: Different tests may be done to help caregivers look for a rabies infection. You may have any of the following:
- Biopsy: Your caregiver may do a skin biopsy on you. A biopsy is done by removing a small piece of tissue and then sending it to the lab for tests. A skin sample is usually taken from the back of the neck. A biopsy can help caregivers learn the cause of your symptoms.
- Blood tests: You may need blood taken for tests. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. These tests will look for the rabies virus or any antibodies to the rabies virus. Antibodies are substances that the immune system makes to protect the body from outside invaders. It can give your caregivers more information about your health condition. You may need to have blood drawn more than once.
- Cultures: This is a test to grow and identify the germ that is causing your illness. Samples may be taken from your saliva, tears, or fluid in the brain and spine.
- Lumbar puncture: A lumbar puncture, or spinal tap, may be done to check the fluid around your brain and spinal cord for the rabies virus.
- MRI: A magnetic resonance imaging (MRI) test may be done to take pictures of the brain.
- Biopsy: Your caregiver may do a skin biopsy on you. A biopsy is done by removing a small piece of tissue and then sending it to the lab for tests. A skin sample is usually taken from the back of the neck. A biopsy can help caregivers learn the cause of your symptoms.
- Animal watch: The animal that bit you may need to be watched for a few days. Sometimes, the animal may need to be killed so that further tests may be done. This is usually done if a rabies infection seems very likely. The brain tissue of a dead animal may show if the animal had rabies.
How is rabies treated? Stopping and preventing the virus from spreading inside the body is the main goal of treatment. Cleaning the bite wound with soap and water may help decrease your risk of spreading the infection. You may also have the following:
- Vaccine: A rabies vaccine may be given to help your body make antibodies to fight the virus. This is given before it is known if you have the rabies virus. It is called pre-exposure prophylaxis.
- Medicines: If you have been exposed to rabies, you will be given rabies immune globulin (medicine) to attack the virus. It will also help your immune system fight the infection. This is called post exposure prophylaxis. You may also be given tetanus shots and antibiotic medicine.
- Rehabilitation programs: A rehabilitation program may include mental, speech, and physical exercises. These exercises may help improve and maintain functions that are important to your daily living, such as self-care.
- Aiding devices: These may include respirators and oxygen to help with your breathing.
- Medicine: Medicines to calm and relax, ease pain, headaches, and fever, or to control seizures, may be given. Caregivers may also give you antiviral medicines and interferon. These medicines may help boost the body's immune system and may stop the infection. Ask your caregiver for more information about these medicines.
How can rabies be prevented?
- Avoid contact with bats or going to places where they are likely to be found. Avoid contact with wild animals. Do not try to take them home with you.
- Cover windows and other openings in your home with screens. This may help keep bats from getting into your house.
- Get vaccinated (shots) against rabies to prevent infection. This may be needed if your work puts you at risk of getting rabies. You may also get shots if you plan to travel to places where the chance of getting rabies is high. If you are going to travel, visit your caregiver 3 to 4 weeks before you leave. You may need to get a booster shot after some time. Ask your caregiver for more information on rabies shots.
- Have your pet vaccinated against rabies.
- Seek care if you get bitten by a wild animal or a bat, even if the wound is very small. Talk with your caregiver if you wake up and find a bat in the room, even if you think you have not been bitten.
What to do if you get an animal bite:
- Clean the wound right away with soap and water. Do this as best as you can for 15 to 20 minutes. Cleaning the wound may help decrease the risk of infection.
- Apply a cleaning solution, such as providone solution or 40 to 70 percent alcohol.
- Cover the wound with a clean bandage.
- Consult your caregiver as soon as possible.
Where can I find more information? Accepting that you have a Rabies infection may be hard. You and those close to you may feel scared, sad, or angry. These are normal feelings. Contact the following for more information about rabies and its prevention:
- Centers for Disease Control and Prevention
National Center for Infectious Diseases
Phone: 1-888-4437232
Web Address: http://www.cdc.gov/ncidod/
- National Institute of Allergies and Infectious Diseases
NIAID Office of Communications & Public Liaison
6610 Rockledge Drive, MSC 6612
Bethesda, Maryland 20892-6612
Phone: 1-301-496-5717
Web Address: www3.niaid.nih.gov
- American Academy of Family Physicians
PO Box 11210
Shawnee Mission, KS 66207-1210
Phone: 1-913-906-6000
Web Address: http://www.aafp.org
CARE AGREEMENT:
You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.
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