Rabies

What is rabies?

Rabies is a disease that affects the body's central nervous system. The central nervous system is made up of the brain, spinal cord, and nerves.


What causes rabies?

Rabies is caused by a virus. You may get the virus if you come into contact with the saliva or other tissue of a rabid animal, usually through a bite wound. Animals that may spread rabies include dogs, cats, coyotes, raccoons, foxes, skunks, and bats.

What increases my risk of rabies?

Rabies can affect anyone of any age. The following factors may place you at a higher risk of getting this disease:

  • You are bitten on the head, face, neck, or hands, you get bitten many times during an attack, or you have deep bite wounds. In the case of a bat bite, even a small bite can increase your risk of rabies.

  • You have a weak immune system. The immune system is the part of your body that fights infection. Medicine such as steroids or a disease such as HIV can weaken a person's immune system.

  • You travel to places where rabies is common.

  • You have a job 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?

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. 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. You may have one or more of the following signs and symptoms for up to 10 days:

    • Weakness, fever, headache, and irritability

    • Loss of appetite, nausea, and vomiting

    • 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

  • Late: Over time, rabies may affect the brain. Symptoms may include any of the following:

    • Confusion or insomnia

    • Dizziness, seeing double, or seeing something that is not really there

    • Restlessness, anxiety, and hyperactivity, which is increased by thirst, fear, light, or noise

    • Seizures or twitching

    • Slurred speech, drooling, swallowing problems, and a fear of water

    • Tiredness, muscle cramps, trouble moving, or severe weakness that may be only on one side of the body or face

How is rabies diagnosed?

Your caregiver will ask about your medical history. This includes information on medicines you take, vaccinations you have received, and your past travels or activities. He will ask you if you have been bitten by an animal and how the animal behaved before it bit you. You may have any of the following tests:

  • Blood tests: A blood test is done to look for antibodies to the rabies virus. Antibodies are substances that the immune system makes to protect the body from outside organisms. The blood can be taken from a blood vessel in your hand, arm, or the bend in your elbow. You may need to have blood drawn more than once.

  • Biopsy: Your caregiver may do a skin biopsy. 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.

  • Cultures: This test is done to help your caregiver learn about the germ that is causing your illness. Samples of your saliva, tears, or fluid around the brain and spinal cord may be collected and tested.

  • 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: This scan uses powerful magnets and a computer to take pictures of your brain. It will also take pictures of the blood vessels and structures in your head. You may be given dye, also called contrast, before the test. Tell caregivers if you are allergic to dye, iodine, or seafood. Remove all jewelry, and tell caregivers if you have any metal in or on your body. Metal can cause serious injury. Tell caregivers if you cannot lie still or are anxious or afraid of closed spaces.

How is rabies treated?

The main goal of treatment is to prevent the virus from spreading inside the body. Treating rabies as soon as possible may prevent more serious problems and increase the chance of recovery. Treatment may include the following:

  • Clean the bite wound: Clean the bite wound with povidone-iodine solution mixed with water or with soap and water. Your risk of infection and rabies decreases if your wound is cleaned soon after you are bitten. Caregivers may need to close the wound with stitches.

  • Vaccine: A rabies vaccine helps your body make antibodies to fight the virus and help prevent rabies. The vaccine may be given if you will be exposed to rabies (preexposure). It also can be given when you have been exposed to rabies (postexposure).

    • If you have been exposed to the rabies virus and you have not been given the vaccine in the past, you will be given 4 different doses. These will be given on 4 different days within a 1-month period. You will also be given a shot of rabies immune globulin.

    • If you have been given the rabies vaccine in the past and have now been exposed to the virus, you will receive 2 doses, given 3 days apart.

    • If you are at risk of being exposed to rabies, you will be given 3 doses on different days. These are given within a 1-month period.

  • Rabies immune globulin medicine: If you have been exposed to rabies, you may be given rabies immune globulin to attack the virus. This medicine will also help your immune system fight the infection. You will not be given this medicine if you have been given the rabies vaccine in the past.

  • Td vaccine: This vaccine is a booster shot used to help prevent diphtheria and tetanus. The Td booster may be given to adolescents and adults every 10 years or for certain wounds and injuries.

What are the risks of having or treating rabies?

Rabies vaccinations may cause headaches, muscle aches, or fever. The area where the shot was given may be painful, red, swollen, or itchy. You may get rabies even after you have the rabies shot. Immune globulin medicine can cause pain and a fever. Bite wounds can damage nerves and tendons in the body. Bite wounds can also cause an infection in the area of the wound, or in the bloodstream. Without early treatment, rabies damages the brain and other organs. You may have brain swelling, seizures, and paralysis (being unable to move). Rabies can be life-threatening.

How can rabies be prevented?

  • Get vaccinated 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. Ask your caregiver for more information on rabies shots.

  • Avoid contact with wild animals. Do not approach any tame or wild animal that you have not seen before. Do not try to take them home with you. Cover windows and other openings in your home with screens so wild animals cannot get inside.

  • Get medical care if you get bitten by an animal, even if the wound is very small.

  • Get your pet vaccinated against rabies.

What should I do if an animal bites me?

  • Clean the bite wound. Clean the bite wound well with soap and water or a povidone-iodine solution mixed with water. Your risk of infection and rabies decreases if your wound is cleaned soon after you are bitten.

  • Cover the wound with a clean bandage.

  • Contact your caregiver.

When should I contact my caregiver?

Contact your caregiver if:

  • You have a fever.

  • Your signs and symptoms do not get better after treatment.

  • You have questions or concerns about rabies and rabies treatment.

When should I seek immediate help?

Seek immediate help or call 911 if:

  • You may or have been exposed to rabies.

  • You have been bitten by an animal.

  • After exposure to rabies, you have trouble swallowing, slurred speech, double vision, or you see things that are not really there. You may also begin twitching, have muscle cramps, or have a seizure.

  • After exposure to rabies, you feel weak, tired, dizzy, confused, restless, or anxious.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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