What Is Rabies?
Rabies is a serious disease that is caused by a virus. Each year, rabies kills more than 50,000 people and millions of animals around the world. Nerve cells are the targets of the rabies virus. Nerve cells are one part of the body’s nervous system. The rabies virus infects the body usually through a bite from a rabid animal. Once inside the body, the virus travels along the peripheral nerves (the nerves that run throughout the body). Its main target is the central nervous system, which is made up of the brain and spinal cord. Rabies develops in two stages. During the first stage, which can last up to 10 days, the individual may have a headache, fever, decreased appetite, vomiting, and general malaise, along with pain, itching, and tingling at the wound site. Symptoms of stage two include difficulty in swallowing, agitation, disorientation, paralysis, and coma. At this point, there is no known, effective treatment.
People who develop a rabies infection often have a history of being bitten by an animal about a month before rabies symptoms began. Any mammal can get rabies. Raccoons, skunks, foxes, bats, dogs, and cats can get rabies. Cattle and humans can also get rabies. Animals that are not mammals -- such as birds, snakes, and fish -- do not get rabies. Rabies is a disease that affects only mammals (such as raccoons, bats, dogs, horses, and humans).
What are the causes of Rabies ?
Rabies is caused by a virus. Usually transmitted to humans through the bite from an infected animal (rabid dogs) and less frequently by cats. An animal gets rabies from saliva, usually from a bite of an animal that has the disease. You cannot get rabies from blood.
Action of virus
The virus enters the muscles to the nerves and goes via the spinal cord to the brain, where it multiplies before spreading from there to the salivary glands, lungs, kidneys etc.
Rabies Treatment
When bitten by an animal, you should always care for the wound immediately by washing it out with soap, water, and some sort of commercial antiseptic iodine solution, if available. This will help kill the common bacterial germs that may be passed by the bite but also has been shown to decrease the likelihood of transmission of the rabies virus, should the animal be rabid.
1- If the animal is a pet, get the owner's name, address, and phone number, if possible. This information will aid the local public health authorities as they monitor the animal.
2- If the animal is a wild animal, or stray dog or cat, contact the local animal control authorities (your local humane society or city or county public health office) immediately. They will attempt to safely capture the animal for examination. The victim or other bystanders should not attempt to capture or subdue the animal. This might lead to further bites or exposures.
3- If the animal is a bat, and the exposure occurred in a building, the doors and windows should be shut in the room containing the bat after all other people are evacuated. If this cannot be done without risk of repeat exposure to the bat, then the most important thing is to minimize the chance of contact between that bat and other people. Once again, call local animal control authorities, and they will capture the bat.
4- Bat exposures are different from any other animal. There does not necessarily have to be a detectable bat bite to constitute a significant exposure.
5- If a bat bite or direct contact cannot be ruled out, then there may have been a significant exposure, such as in the following circumstances:
6-A sleeping person awakens to find a bat in the room.
7-An adult sees a bat in the room of a previously unattended child, mentally disabled person, or intoxicated person.
Medical Treatment
1-Treatment to prevent rabies has 3 essential components if a high probability of disease exists. Depending on the likelihood the animal has rabies and, in some cases, the availability of the animal for observation, your doctor may not initiate the latter 2 steps involving shots against the rabies virus.
2- Wound care involving soap and a virus-killing cleanser (this should always be done)
3- Injection of rabies immune globulin around the wound. This is a substance that provides rapid, short-term protection against rabies
4- Injection of the first of a series of vaccine doses to provide protection against rabies after an exposure.
5- The decision to treat for rabies: The likelihood of an animal having rabies depends heavily on the species of the animal, its behavior, and where you were exposed to the animal. For example, in some areas of the country, such as the Texas-Mexico border, stray dogs have an extremely high likelihood of being rabid. In other areas, stray dogs may have little chance of being rabid.
6- Domestic dogs, cats, and ferrets have a well-defined incubation period for the rabies virus. If you have been bitten by 1 of these 3 animals, and the animal does not appear overtly ill at the time, then the animal will be observed by local health authorities for 10 days. If the animal remains well during that period, you will not need rabies shots.
7- If the animal has the potential for rabies and is available for sacrifice and immediate examination by the local health department, then treatment may be withheld pending the results of that test. This would include animals such as any wild animal, or an unwanted stray dog or cat, if you know where the animal is (dead or alive).
8- If the animal has the potential for rabies and is unavailable for sacrifice and examination, then you will be given rabies shots in the emergency department.
Special situations
1- Rabies vaccination and pregnancy: Both human rabies immune globulin (HRIG) and the various rabies vaccines are safe in pregnancy.
2- Immune suppression: If you are taking medicines (such as prednisone or steroids) or have a disease that interferes with the body's response to the rabies vaccine, discuss these situations with your doctor. The doctor will then determine if you will need additional blood tests to ensure that an adequate response to the vaccine has occurred and that protection against rabies is developing.