RABIES

Rabies is a preventable viral disease most often transmitted through the bite of a rabid animal. The rabies virus infects the central nervous system of mammals, ultimately causing disease in the brain and death. The vast majority of rabies cases reported to the Centers for Disease Control and Prevention (CDC) occur in wild animals like bats, raccoons, skunks, and foxes, although any mammal can get rabies.

Clinically, it has two forms:

Furious rabies – characterized by hyperactivity and hallucinations.
Paralytic rabies – characterized by paralysis and coma.

Although fatal once clinical signs appear, rabies is avoidable; vaccines, medicines, and technologies have long been available to prevent death from rabies. Nevertheless, rabies still kills tens of thousands of people each year. Of these cases, approximately 99% are acquired from the bite of an infected dog.

To reduce your risk of coming in contact with rabid animals:

Vaccinate your pets. Cats, dogs, and ferrets can be vaccinated against rabies. Contact a veterinarian for more information.
Keep your pets confined. Keep pets inside and supervise them when outside, which will help keep them from coming in contact with wild animals.
Protect small pets from predators. Keep rabbits and other small pets, such as guinea pigs, inside or in protected cages to be safe from wild animals. These small pets cannot be vaccinated against rabies.
Report stray animals to local authorities. Call local animal control officials or other local law enforcement to report stray dogs and cats.
Don't approach wild animals. Wild animals with rabies may seem unafraid of people. It is not normal for a wild animal to be friendly with people.
Keep bats out of your home. Seal any cracks and gaps where bats can enter the house.
Consider the rabies vaccine if you're traveling or often around animals that may have rabies. If traveling to a country where rabies is common and being there for an extended time, contact a healthcare provider to determine whether the rabies vaccine is recommended. This includes traveling to remote areas where medical care is challenging to find.

After a bite or other rabies exposure, the rabies virus has to travel through the body to the brain before it can cause symptoms. This time between the exposure and the appearance of symptoms is called the incubation period, and it may last for weeks to months.

A unique symptom of rabies infection is a tingling or twitching sensation in the area around the animal bite. After the virus leaves the local bite area, it travels up a nearby nerve to the brain and can cause such symptoms as:

Pain.
Fatigue.
Headaches.
Fever.
Muscle spasms.
Irritability.
Excessive movements.
Agitation, aggressiveness.
Confusion.
Seizures.
Bizarre or abnormal thoughts.
Hallucinations.
Weakness, paralysis.
Increased production of saliva or tears.
Extreme sensitivity to bright lights, sounds, or touch.
Difficulty speaking.

At advanced stages of the infection, the following symptoms can develop:

Double vision.
Problems moving facial muscles.
Abnormal movements of the diaphragm and muscles that control breathing.
Difficulty swallowing and increased saliva production, causing the "foaming at the mouth" usually associated with rabies infection.

The Rabies vaccine is given to people at high risk of rabies to protect them if they are exposed. People at increased risk of exposure to rabies should be offered pre-exposure rabies vaccination, including:

Veterinarians, animal handlers, and veterinary students
Rabies laboratory workers
Spelunkers (people who explore caves), and
People whose activities bring them into frequent contact with rabies virus or possibly rabid animals.
International travelers who are likely to come in contact with animals in parts of the world where rabies is common and immediate access to appropriate care is limited.

For pre-exposure protection, three doses of the rabies vaccine are recommended. People who may be repeatedly exposed to the rabies virus should receive periodic testing for immunity, and booster doses might be necessary.

Rabies vaccine can prevent rabies if given to a person after they have had an exposure.

Anyone who has been bitten by an animal suspected to have rabies or who otherwise may have been exposed to rabies should clean the wound and see a health care provider immediately regardless of vaccination status. The health care provider can help determine if the person should receive a post-exposure rabies vaccination.

For post-exposure protection:

A person exposed and has never been vaccinated against rabies should get four doses of the rabies vaccine. The person should also get a rabies immune globulin (RIG) shot.
A person who has been previously vaccinated should get two doses of rabies vaccine and does not need Rabies Immune Globulin.

Your health care provider can give you more information.

In some regions of the world, including but not limited to parts of Africa, Asia, and Central and South America, rabies in dogs is still a significant problem, and access to preventative treatment may be hard to get. The importance of rabid dogs in these countries, where tens of thousands of people die of the disease each year, cannot be overstated.