Rabies

• What is rabies?
• Is rabies still a serious health concern?
• How do I know if an animal is rabid?
• How do humans contract rabies?
• Where is rabies found?
• What precautions should I take?
• What should I do if exposed?
• How is rabies treated?
• Tips for high risk people

What is rabies?

Rabies is an acute viral disease that attacks the central nervous system of its victim. Sometimes called hydrophobia, or fear of water, rabies has afflicted animals and humans since ancient times.

Rabies is most often passed from animal to animal, or animal to human, through bites. The rabies virus in the attacker's saliva is passed through the puncture wound into the victim's skin. The virus also can be transmitted by licking when saliva is deposited on broken skin.

In humans it can take as little as nine days or as long as one year or more for the horrible symptoms of rabies to appear. Most people who contract rabies, however, develop symptoms within 60 days after being exposed.

The earliest symptoms of clinical rabies infection in humans are pain or numbness at the site of the bite, fever, sore throat, nausea, vomiting, diarrhea, abdominal pain, and lethargy. In some individuals, early nervous system effects may be indicated by apprehension, anxiety, agitation, nervousness, insomnia, or depression.

Symptoms progress rapidly, usually in a matter of days, to include paralysis, spasms of the throat, delirium, hallucinations, coma, cardiac arrhythmia, and finally, death.

The delay between exposure and the onset of symptoms, called the incubation period, permits humans the time to seek effective treatment. Modern rabies treatment, if begun in time, allows our bodies to fight off the virus.

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Is rabies still a serious health concern?

Rabies, although relatively rare in most parts of the United States, is nonetheless a terrifying disease and a serious public health concern.

Because of the success of rabies vaccination programs, domestic animals, especially dogs, are usually well protected from contracting rabies and from passing it on to humans.

It is important to be aware, however, that cats, dogs, cattle, horses, mules, sheep, goats and swine are all susceptible to contracting this disease. In fact, cats have accounted for the greatest proportion of rabies cases reported to the Center for Disease Control since 1988.

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How do I know if an animal is rabid?

Few areas in the United States are free from the threat of rabies because wild animals move from place to place. In recent years, 85 - 90% of reported animal rabies cases involved wild animals. Nonetheless, unvaccinated or stray domestic animals, such as dogs and cats, are still the greatest threat to humans.

Most people associate bats with the threat of rabies, but bats are only one of the species that carry and spread the disease. The worst rabies culprits, in order of incidents of reported exposures are: skunks, raccoons, bats, cats, foxes, cattle, dogs, horses/mules, mongooses (in Puerto Rico), groundhogs, sheep, goats and swine.

In contrast, rats, mice, squirrels, hamsters, guinea pigs, gerbils, chipmunks and rabbits are rarely infected with rabies.

Most people think rabid animals can easily be spotted because they drool excessively and foam at the mouth. In fact, most animals will display these symptoms only in the latter stages of infection, and sometimes not even then.

A better way to identify animals that pose a risk is to recognize unusual or abnormal behavior. Rabid animals, wild or domestic, may stagger, appear restless, be aggressive, change the tone of their barks or growls, or appear to be choking. Wild animals sometimes lose their fear of humans and act friendly. Animals that usually are active at night may become active during the day. Passive animals sometimes become fierce and aggressive.

Infected wild animals can easily pass rabies to pets or domestic animals. Grazing horses or cattle are infected when bitten by skunks, raccoons, or foxes they encounter in their pastures. Dogs and cats can also be exposed in encounters with infected wild animals. Humans who are later in contact with these animals are then placed at risk.

Any unfamiliar animal, wild or domestic, acting in a strange or unusual manner should be treated with caution and avoided.

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How do humans contract rabies?

Humans do not contract rabies from other humans. There has never been a recorded case of human-to-human rabies transmission.

Instead, rabies is transmitted in the saliva of rabies infected animals. When a person is bitten, or receives a lick to an open scratch, wound, or mucus membrane, the virus can enter the body. Bites on the head and neck are especially dangerous because of the proximity to the brain.

Human rabies is not often seen by physicians in the U.S. and is difficult to diagnose because of the complexity and variety of the symptoms. Every possible exposure must be evaluated by a medical professional.

If there is any question of possible exposure, don't waste a minute! Call your physician, or local health department. If you are at risk and require treatment, they can get you started promptly to prevent the disease.

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Where is rabies found?

Because of the migratory nature of many wild animals, rabies can be spread to all parts of the country. The expansion of civilization into wildlife habitats and the adaptation of wildlife to the urban setting also increase the potential for rabies transmission.

Since 1975, there has been a slow but steady spread of the disease in certain regions:

• Skunks in the country's midsection, ranging from Texas and New Mexico to Montana and east to Ohio.
• Raccoons in the mid Atlantic area ranging from Pennsylvania, New Jersey, and Delaware south to Florida.
• Foxes in the Northeast ranging from Maine south to New York and Connecticut, and also in Alaska.
• Bats, concentrated in the southwest, but present in nearly every state.

Migratory patterns are responsible for the spread of rabies into the highly populated areas of eastern Pennsylvania, Delaware, and New Jersey. Raccoons pose a special hazard in these densely populated areas.

Rabies is a greater danger in late spring, summer, and early fall. Wild animals are more active during these times and more people are outdoors where they are exposed to them.

Health departments are an important source of information about local problems and risks of exposure. They are also your best source for information on the need for precautions and treatment.

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What precautions should I take?

Although pet vaccinations and tighter animal control laws are doing a good job of limiting the spread of rabies, the danger still exists. We should all observe some simple, basic precautions to protect ourselves:

• Follow your veterinarian's recommendation to vaccinate your pets regularly. Regular vaccinations protect you, your pet, and your family.
• Avoid animals that are acting in an unusual manner. A skunk or raccoon that acts friendly or is seen during daylight hours is unusual and should be avoided.
• Unprovoked attacks are frequently clear evidence of rabies. Seek expert treatment immediately.
• Teach your children to stay away from wild animals and unknown cats and dogs. Make sure they tell you immediately if they are bitten or scratched by an animal.
• Obey animal control ordinances. Vaccination requirements and leash laws protect everyone.
• Avoid touching dead animals. If you must do so, wear gloves.
• In the event of a bite or other potential exposure, seek expert treatment and advice from your physician or health department.

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What should I do if exposed?

Doctors call it "exposure" when people come in contact with potentially rabid animals saliva."

If you think you may have been exposed to rabies, wash the affected area immediately with soap and water. Then call your doctor or health department.

Exposure is sometimes difficult to determine because rabid animals who bite humans may not have begun to display outward signs of infection.

Because doctors do not want to treat a patient for rabies without solid evidence of exposure, you and your doctor must weigh some important factors before treatment:

• Was the bite from an animal species that is susceptible to rabies? Wild animal bites, especially from skunks or raccoons, are always suspect.
• If a domestic animal was involved, was it acting strangely?
• Was the animal vaccinated against rabies?
• If the exposure was from a lick, was it near an open scratch, wound, or mucous membrane such as the mouth, nose, or eyes?
• Is rabies present in your area?

You and your physician must quickly evaluate the answers to these questions. If the animal is dead, you should save the carcass for examination (remember to wear gloves). If the animal is alive, try to capture it for examination or observation. Be careful to avoid further risk during the capture. If the animal escapes, note its description for later identification.

Tell your physician everything about the potential exposure.

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How is rabies treated?

Some people are afraid to seek treatment for exposure to rabies because they have heard about a long series of painful shots in the stomach. Thankfully, that is ancient history!

"Post-exposure" treatment is administered after a bite or lick from a suspected rabid animal. In the United States, it consists of a series of only five injections in the arm. An injection of anti rabies globulin is also administered at the time of the first treatment.

This anti rabies treatment with vaccine and globulin has proven 100% effective if administered within 14 days of exposure. Doctors don't want you to wait that long. Treatment should start as soon as possible.

Most people do not react adversely to the rabies vaccine, but there may be some swelling, redness or soreness.

In addition to post exposure treatment, effective "pre-exposure vaccinations" are available to those people who may be at high risk of exposure to rabies. This group includes veterinarians, animal control workers and zoo workers who are frequently exposed to strange animals. Cave explorers (spelunkers) and taxidermists may also be in higher risk situations and wish to consider the benefits of immunization.

Human pre-exposure immunization against rabies requires only three, relatively painless shots in the arm. Individuals who have undergone pre-exposure immunization require only two additional injections if they are later exposed to rabies.

You may want to discuss your own risk factors with your doctor or health department to determine whether preventative vaccination makes sense for you.

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Tips for high risk people

Some simple ways to protect yourself from rabies:

• Be careful. An animal's bite may be worse than its bark or growl.
• Report any bite, or lick to exposed tissue, to your doctor and health department.
• When handling strange animals, either alive or dead, use gloves and other protective equipment.
• If exposed, try to capture the animal for examination, testing or observation.
• Don't try to assess your own exposure. Let the experts determine the seriousness of the exposure.
• Inquire about pre-exposure vaccination. Remember, if exposed after vaccination, you still require prompt medical attention.
• Use common sense, follow suggested precautions, and remember that rabies is not a disease to be taken lightly. Protect yourself.

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