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Understanding Rabies: Symptoms, causes and treatments

Dr. Ajay KohliNov 29, 2023

Rabies causes progressive inflammation of the brain and spinal cord. The disease claims an estimated 59,000 lives annually. A dog bite is a primary source of transmitting the infection to humans. Seizures, hallucinations, and paralysis are characteristic of Rabies. Even though the illness has no treatment, a simple step consisting of immediate and thorough washing of wounds with soap and water can save lives. Read ahead to know more about Rabies.

Contents

What is Rabies?
Signs and symptoms of Rabies
What causes Rabies?
Types of Rabies
Treatment for Rabies
Diagnosis of Rabies
How can I prevent Rabies?
Risk factors for Rabies
Frequently Asked Questions (FAQs)

What is Rabies?

Rabies is caused by the Rabies virus (scientifically called lyssavirus) that spreads to people by the bite of an infected animal (domestic or wild). Left untreated, the virus affects the central nervous system, causing signs and symptoms which are virtually 100% fatal. Therefore, vaccinating dogs is an effective strategy that can't be overstressed for reducing deaths attributable to dog-mediated Rabies in people.

Signs and symptoms of Rabies

The time before the symptoms appear usually lasts about 2 to 3 months in most Rabies cases, though periods up to 1 year have also been reported. The rapidity at which symptoms develop following the animal bite depends upon the following.

Site of infection: the nearer the bite is to the brain and spinal cord, the quicker the virus reaches the nervous tissue.
Severity of the bite.
Amount of virus injected at the bite site.

Initially, the symptoms of Rabies are more like flu which may last for 2 to 10 days, where a person may experience the following.

Fever
Headaches
Nausea
Vomiting
Pain and unusual tingling, pricking, or burning sensation (paraesthesia) at the site of the bite

But once the virus progresses and reaches the brain and spinal cord, neurological function slowly deteriorates, with the person parading the following symptoms.

Anxiety
Confusion
Agitation
Excessive salivation
High level of excitement
Difficulty in breathing or swallowing
Photophobia (Fear of light)
Hallucination
Fear of water (Hydrophobia)
Trouble in speaking or understanding
Prolonged lack of sleep
Partial paralysis of leg muscles (starting at the site of the bite)
Coma

Hereafter, death occurs in 2 to 3 days due to abrupt failure of the heart, respiratory weakening, and arrest of breath.

What causes Rabies?

Typically transmitted by saliva, the virus enters the body through the bite of an infected animal. While dog bites are often associated with the development of Rabies, other animals, including wild ones, have occasionally been found to transmit Rabies to people. Some high-risk animals in this regard are as follows.

Bats
Foxes
Racoon
Beavers
Skunks
Cats
Goats

The other rare possibility of getting Rabies is from non-bite exposure when a rabid animal licks a person's eyes, nose, or mouth, exposing the scratches, abrasions, or open wounds to infectious saliva.

Types of Rabies

Two clinical forms of Rabies exist - furious and paralytic.

The furious form comprises approximately 80% of Rabies cases. Its onset is characterised by hyperactivity, hydrophobia, and severe or uncontrollable excitability, which are caused by spasms of the throat and larynx when the virus affects regions of the brain that regulate speaking, swallowing, and breathing.

This phase may persist for hours or days, after which the patient will have episodes of anxiety as opposed to constant agitation. Alternatively, the paralytic form occurs in one in five cases. In this form, the patient is often quiet and lucid throughout. The stage has a more protracted course, beginning with tingling or paralysis of the bitten limb and progressing to the brain.

Treatment for Rabies

If you have been bitten by a dog, cat, or other unfamiliar animals, wash the bite wound thoroughly with soapy water for 15 minutes and apply the water-diluted povidone-iodine solution if available. Seek medical attention for wound assessment and to know if you need the vaccine.

Post-exposure prophylaxis (PEP) is the key treatment for preventing Rabies.

As part of this, you will receive Human Rabies Immune Globulin (HRIG) at the site distant from where the animal bit you. This will be followed by a strict regime of Rabies vaccine, wherein:

Patients who are not immunised will receive 4 doses of vaccine coupled with HRIG in 14 days.
Patients vaccinated already against Rabies will receive 2 shots alone.

People at high risk for Rabies exposure, i.e., veterinarians, laboratory workers, animal handlers (including bat handlers), animal rehabilitators, wildlife officers, and other people (especially children) living in or travelling to high-risk areas, get Rabies vaccine under pre-exposure prophylaxis. Under this protocol, the person would receive the vaccine over 28 days in three doses in the upper arm.

Diagnosis of Rabies

Diagnosing Rabies in a living person before the onset of illness is difficult, as no one test is considered sufficient to date. But a few tests that can still provide a reliable diagnosis for the disease include the following.

Test for detection of the whole virus in saliva and spinal fluid
Reverse transcription polymerase chain reaction (RT-PCR), again for detecting Rabies virus in saliva and skin biopsy
Fluorescent Antibody test (FAT) to detect the virus in skin and brain tissue

Again, to diagnose Rabies in suspected animals, the most frequently used lab test is a direct fluorescent antibody (DFA), where the brain tissue of the Rabies suspected animal is usually evaluated.

How can I prevent Rabies?

Despite the high death rate, Rabies is 100% preventable. You can avoid being infected with the virus by sticking to these tips.

Become aware of the Rabies disease by engaging in communities to understand how to prevent Rabies in pets, when to suspect Rabies, and what to do when you get accidentally bitten.
Do not touch a suspected rabid animal; instead, contact local authorities for assistance.
Stay away from wildlife as far as possible.
Remove stray animals away from the neighbourhood.
Immunise your pets and livestock against Rabies and keep their vaccination status up to date.
Do not allow your pet to roam free or unattended.
Teach children not to approach or handle any unfamiliar animal, even if they look friendly.
If you are exposed to Rabies, follow wound management, and speak to the doctor.
Consider yourself getting vaccinated if you work as a veterinarian or in a lab where the Rabies virus is present.

Risk factors for Rabies

Numerous factors can increase a person's likelihood of Rabies. Here’s a list.

Inadequate animal vaccination and control.
Limited or no knowledge about Rabies.
Travelling to or living in areas with high Rabies density.
Participating in activities such as camping or exploring caves that are likely to put you in contact with wild animals that may have Rabies.
Inability to access proper medical care after being bitten by an infected animal.
Poor management of wounds and poor adherence to post-exposure prophylaxis.
Working as a veterinarian or laboratory staff.

Children, in general, are at a higher risk of getting Rabies because they are more likely to be bitten by dogs in high-risk body areas like the neck and face.

Also read: cashless family health insurance policy

Frequently Asked Questions (FAQs)

Here’s a list of common questions and answers related to Rabies.

How long does it take to show symptoms of Rabies after an animal bites you?

For most people, it takes approximately 2 to 3 months for the Rabies symptoms to appear. But, in some cases, it can take up to a year.

Can Rabies transmit through the air?

Most people are unlikely to encounter Rabies through the air, although laboratory workers can get infected if they inhale aerosols of the Rabies virus while working, which is fundamentally a non-bite route of Rabies exposure.

Can Rabies survive on surfaces?

Unlike diarrhoea or respiratory viruses, Rabies is a fragile virus that cannot survive more than a few hours at room temperature. It can get easily killed by the most common detergents and disinfectants, including household bleach.

What should I do If my pet gets bitten by a wild animal?

Call your veterinarian immediately. Your pet will be kept in isolation for 10 days and monitored for signs of Rabies. If your pet shows any signs of Rabies, euthanising it is the best way to prevent the Rabies virus from infecting others.

When should you seek medical attention?

If you've been scratched or bitten by an unfamiliar animal, call your doctor immediately to know your risk of developing the illness and the need for vaccination. But remember, Rabies is a medical urgency. Any delay in the decision can be dangerous.

References

Disclaimer: The content on this page is generic and shared only for informational and explanatory purposes. Please consult a doctor before making any health-related decisions.