RABIES (Hydrophobia)

General Information

DEFINITION--A serious virus infection of the central nervous system, transmitted by the bite of infected animals. Rabies occurs rarely in the United States, but there is still public fear and substantial prevention efforts continue.

BODY PARTS INVOLVED--Brain and central nervous system; body parts bitten by the rabid animal.

SEX OR AGE MOST AFFECTED--Both sexes; all ages.

SIGNS & SYMPTOMS--

In two-thirds of patients, symptoms may appear 1 to 3 months after the bite. Sometimes it can be as short as 5 days or as long as 5 years. Early symptoms are:

• Restlessness and irritability.
• Fatigue.
• Slight fever.
• Cough.
• Sore throat.
• Increased saliva and tears. 2 to 10 days later:
• Violent spasms of throat muscles that make swallowing impossible.
• Hyperactivity and violent behavior.
• Confusion.
• High fever.
• Irregular heartbeat.
• Irregular breathing.

CAUSES

• A virus in the saliva of infected animals passes to humans through broken skin or a mucous membrane. The virus travels slowly from the bite area to the brain.
• Animals that are commonly infected include dogs (especially wild dogs), bats, skunks, foxes, coyotes and raccoons. Cats can become infected, sometimes from contact with a rabid bat (such as playing with one that is ill and on the ground). Other animals can also be infected, so consult your local health department after any animal bite.

RISK INCREASES WITH--Professions or activities that may involve exposure to wild animals (cave exploration, hunting, farm or ranch workers, forest rangers, some laboratory workers, veterinarians).

HOW TO PREVENT

• Vaccinate your dog or cat against rabies.
• Report stray animals in the neighborhood, and teach children to avoid them.
• Have a rabies immunization, if your work involves animals.
• Keep tetanus immunizations up-to-date.
• Avoid wild animals. In the U.S., bats, skunks and raccoons are the most likely to be infected, but any carnivore can carry the disease.

What To Expect

DIAGNOSTIC MEASURES--

• Medical history and exam by a doctor.
• Diagnostic tests may include laboratory blood tests and fluid and electrolyte measurements.
• Pathological exam of the animal's tissue and your own observation of the animal's behavior. Determine if the animal was provoked. Attacking animals are more likely to be infected.

APPROPRIATE HEALTH CARE

• Treatment will be determined by type of exposure (bite or nonbite), the possibility of rabies in the type of animal, circumstances of the biting incident, and vaccination status of animal.
• Surgery to clean and repair the bite wound (sometimes).
• Hospitalization, if symptoms develop.

POSSIBLE COMPLICATIONS--Once symptoms begin, survival is unlikely.

PROBABLE OUTCOME--Rabies can be prevented with early treatment following bites.

How To Treat

GENERAL MEASURES--

• Wash the bite area for 10 minutes with soap and water to remove all saliva.
• Cover the wound with a clean bandage.
• Call your doctor or local emergency room for advice.
• Call your local animal-control center to catch the animal, if possible.
• If the animal is killed, remove the head and refrigerate or freeze it until it can be examined by pathologists.
• Don't panic. The incubation period allows time for diagnosis and treatment.

MEDICATION--Your doctor may prescribe one of the following:

• Injections of rabies-immune globulin.
• Injections of human-diploid-cell-strain vaccine, if the animal is proven rabid.
• Tetanus booster. Painful injections in the abdomen are no longer necessary.

ACTIVITY--No restrictions unless symptoms begin. If they do, bed rest in a hospital is necessary.

DIET--No special diet during treatment before symptoms begin. Intravenous fluids and nutrients are necessary during hospitalization.

Call Your Doctor If

Anyone is bitten by an animal.