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Rabies

Centers for Disease Control (CDC) Recommendation for Travelers

Rabies vaccination is not a requirement for entry into any country. However, a pre-exposure immunization may be recommended for persons traveling to developing countries of Africa, Asia, and Central and South American, where rabies is not well controlled.

The danger of animal bites:

Animal bites and scratches, even when they are minor, can become infected and spread bacteria to other parts of the body. Whether the bite is from a family pet or an animal in the wild, scratches and bites can carry disease. Cat scratches, for examples, even from a kitten can carry "cat scratch disease," a bacterial infection. Other animals can transmit rabies and tetanus. Bites that break the skin are even more likely to become infected.

Immediate care for animal bites:

  • Wash the wound with soap and water under pressure from a faucet, but do not scrub - this bruises the tissue.
  • If the bite or scratch is bleeding, apply pressure to it with a clean bandage or towel to stop the bleeding.
  • Dry the wound and cover it with a sterile dressing, but, do not use tape or butterfly bandages - they can trap harmful bacteria in the wound.
  • Call your physician or healthcare professional for guidance in reporting the attack and to determine whether additional treatment, such as antibiotics, a tetanus booster, or rabies vaccination is needed.
  • If possible, locate the animal that inflicted the wound. Some animals need to be captured, confined, and observed for rabies. Do not try to capture the animal yourself; instead contact the nearest animal warden or animal control office in your area.
  • If the animal cannot be found, or if the animal was a high-risk species (skunk or bat), or the animal attack was unprovoked, the victim may need a series of rabies shots.

What is rabies?

Rabies is a widespread, viral infection of warm-blooded animals. Caused by a virus in the Rhabdoviridae family, it attacks the nervous system and, once symptoms develop, it is 100 percent fatal in animals.

In North America, rabies occurs primarily in skunks, raccoons, foxes, coyotes, and bats. In some areas, these wild animals infect domestic cats, dogs, and livestock. In the United States, cats are more likely than dogs to be rabid.

Individual states maintain information about animals that may carry rabies. it is best to check for region specific information if you are unsure about a specific animal and have been bitten.

In the mid-Atlantic states, where rabies is increasing in raccoons, woodchucks can be rabid.

How does rabies occur?

The rabies virus enters the body through a cut or scratch, or through mucous membranes (such as the lining of the mouth and eyes), and travels to the central nervous system. Once the infection is established in the brain, the virus travels down the nerves from the brain and multiplies in different organs.

The salivary glands and organs are most important in the spread of rabies from one animal to another. When an infected animal bites another animal, the rabies virus is transmitted through the infected animal's saliva. Scratches by claws of rabid animals are also dangerous because these animals lick their claws.

What are the symptoms of rabies?

The incubation in humans from the time of exposure to the onset of illness can range anywhere from five days to more than a year, although the average incubation period is about two months.

Rabies: Stage 1

Rabies: Stage 2

  • initial period of vague symptoms, lasting two to 10 days
  • vague symptoms may include:
    • fever
    • headache
    • malaise
    • decreased appetite
    • vomiting
  • pain, itching or numbness and tingling at the site of the wound
  • patients often develop difficulty in swallowing (sometimes referred to as "foaming at the mouth") due to the inability to swallow saliva - even the sight of water may terrify the patient
  • some patients become agitated and disoriented, while others become paralyzed
  • immediate death, or coma resulting in death from other complications, may result

How is rabies diagnosed?

In animals, the direct fluorescent antibody test (dFA) is most frequently used to diagnose rabies. Within a few hours, diagnostic laboratories can determine whether an animal is rabid and provide this information to medical professionals. These results may save a patient from unnecessary physical and psychological trauma if the animal is not rabid.

In humans, a battery of tests is necessary to confirm or rule out rabies, as no single test can be used to rule out the disease with certainty. Tests are performed on samples of serum, saliva, spinal fluid, and skin biopsies taken from the nape of the neck.

Treatment for rabies:

Unfortunately, there is no known, effective treatment for rabies once symptoms of the illness have developed. However, there is an effective new vaccine, which provides immunity to rabies when administered after an exposure, or for protection before an exposure occurs (for persons such as veterinarians and animal handlers).

How can animal bites and rabies be prevented?

  • Do not try to separate fighting animals.
  • Avoid strange and sick animals.
  • Leave animals alone when they are eating.
  • Keep pets on a leash when out in public.
  • Select family pets carefully.
  • Never leave a young child alone with a pet.
  • All domestic dogs and cats should be immunized against rabies and shots kept current.
  • Do not approach or play with wild animals of any kind, and be aware that domestic animals may also be infected with the rabies virus.
  • Supervise pets so they do not come into contact with wild animals. Call your local animal control agency to remove any stray animals.

Reporting the incident to your healthcare provider:

If you or someone you know is bitten by an animal, remember these facts to report to your healthcare provider:

  • location of the accident
  • type of animal involved (domestic pet or wild animal)
  • type of exposure (cut, scratch, licking of open wound)
  • what part of the body did the exposure occur
  • number of exposures
  • whether or not the animal has been immunized against rabies
  • was the animal sick or well - if "sick," what symptoms were present
  • is the animal available for testing or quarantine

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