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Rabies

Rabies is a viral disease that affects the nervous system of humans and other mammals, and is typically transmitted through the bite of a rabid animal. A person can also become infected with the rabies through non-bite exposure or human-to-human transmission. The principal rabies hosts today are wild carnivores and bats, but the virus can also affect pets and other domestic animals. Treatment for rabies is available, but must begin before the symptoms of rabies develop. If symptoms of rabies develop before treatment begins, the disease is almost always fatal.

 

What Is Rabies?

Rabies is a preventable disease that occurs in mammals. It is most often transmitted through the bite of a rabid animal (an animal with rabies). Rabies affects the nervous system (including the brain) of humans and other animals.
 
Tens of thousands of people are successfully treated each year after being bitten by an animal that may have rabies. A few people die of rabies each year in the United States, usually because they do not recognize the risk of rabies from the bite of a wild animal, and do not seek medical advice.
 

Cause and Transmission of Rabies

Rabies is an infection caused by the rabies virus. This virus attacks the brain, causing severe inflammation (encephalitis) and death.
 
A person or animal can become infected with the rabies virus in one of a few ways, including:
 
  • Bites
  • Non-bite exposure
  • Human-to-human transmission.
     
A bite from a rabid animal (an animal with rabies) is the most common way in which rabies transmission occurs. Non-bite exposure and human-to-human exposure are both rare.
 
(Click What Causes Rabies? for more information about how the rabies virus causes rabies.)
 
(Click Rabies Transmission for more information about how rabies is spread.)
 

What Animals Have Rabies?

Although all species of mammals can become infected with the rabies virus, only a few species are best able to spread the rabies virus to other animals. The animals that most commonly transmit rabies to other animals include:
 
Domestic animals can also get rabies. Cats, cattle, and dogs are the most frequently reported rabid domestic animals in the United States (see Rabies and Pets).
 
Only mammals get rabies. Birds, reptiles, amphibians, and fish do not get the disease.
 

Rabies: Incubation Period

The rabies incubation period may vary from a few days to several years, but is typically one to three months. During this time, the rabies virus is multiplying within the body.
 
At some point, the rabies virus will travel along nerve cells to the brain. It multiplies in the brain very quickly, causing the end of the rabies incubation period and the beginning of rabies symptoms. When the rabies virus reaches the brain, it multiplies quickly and rabies symptoms begin. Over the next week, the rabies virus causes encephalitis and ultimately death.
 

Symptoms of Rabies

Early rabies symptoms are similar to the flu (e.g., fever, muscle aches, headache). As the rabies worsens, symptoms of rabies can include brain and nervous system problems.
 
(Click Rabies Symptoms for more information on symptoms of rabies.)
 

Treatment for Rabies

If you believe that you have been exposed to rabies, seek medical attention immediately. A rabies treatment is available, but must be administered before symptoms develop. If symptoms of rabies occur, there is no cure. Death usually occurs within days of the onset of the symptoms of rabies.
 
If you are bitten by an animal, you should seek care immediately. This will allow the doctor to assess the risk for rabies exposure and begin rabies treatment, if necessary.
 
Two decades ago, research scientists developed an extremely effective new treatment regimen that provides protection against rabies when administered after an exposure (post-exposure prophylaxis), or for protection before an exposure occurs (pre-exposure prophylaxis). One medicine used in this treatment for rabies is the rabies vaccine.
 

Rabies: Diagnosis and Testing

In order to make a rabies diagnosis, the doctor will assess the risk for exposure to the virus. The following information will help the healthcare provider assess the risk:
 
  • The geographic location of the incident
  • The type of animal that was involved
  • How the exposure occurred (provoked or unprovoked)
  • The vaccination status of animal
  • Whether or not the animal can be safely captured and tested for rabies.
     
If the healthcare provider strongly suspects rabies exposure, he or she will order certain tests to help in diagnosing rabies. If the animal was captured, it can also be tested.
 
(Click Rabies Testing for more information on tests used to diagnose rabies in humans and animals.)
 

Rabies: Prognosis

No one in the United States has developed rabies when the currently recommended post-exposure rabies treatment regimen was followed. Therefore, as long as treatment begins before symptoms of rabies develop, the prognosis is excellent. When rabies treatment is started after symptoms begin, the prognosis is poor. Death is almost certain to occur within one to two weeks.
 

How to Prevent Rabies

There are a number of ways to prevent an infection with the rabies virus. Some of these suggestions are important for pet owners. Other suggestions are commonsense ways to avoid contact with potential rabid animals.
 
(Click How to Prevent Rabies for more information about preventing rabies infections.)
 

Rabies: Statistics

In 2001, 7,437 cases of rabies were reported in the United States. Raccoons accounted for almost 40 percent of reported cases. There was one case of rabies in humans during 2001, and three cases in 2002.
 

History of Rabies

Over the last 100 years, rabies in the United States has changed dramatically. More than 90 percent of all animal rabies cases reported annually to the Centers for Disease Control and Prevention (CDC) now occur in wildlife. Before 1960, the majority of rabies cases were in domestic animals. The principal rabies hosts today are wild carnivores and bats.
 
The number of rabies-related human deaths in the United States has declined from more than 100 annually, at the turn of the century, to one or two per year in the 1990s. Modern-day prophylaxis has proven nearly 100 percent effective. In the United States, human fatalities associated with rabies occur in people who fail to seek medical assistance, usually because they were unaware of their exposure.
 

Other Information About Rabies

Other articles on the eMedTV Web site feature additional information concerning rabies. Some of these articles include:
 
Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD