Rabies

Condition Basics

What is rabies?

Rabies is an infection caused by a virus. It affects the brain and spinal cord (central nervous system) of mammals, including humans. It is nearly always deadly if not treated before symptoms begin.

Animals that are infected with rabies—rabid animals—can spread the disease through their saliva or through brain tissue.

It is rare for people in the United States or Canada to get rabies. It is more common in developing nations.

What causes it?

People usually get rabies when a rabid animal bites them. People in the U.S. and Canada are most likely to get rabies from bats. People in many other countries are most likely to get rabies from dog bites.

Bats, raccoons, skunks, foxes, and coyotes are the animals most likely to have rabies in the U.S. and Canada. Small mammals such as mice and squirrels almost never have rabies.

Sometimes the rabies virus can spread to pets, such as dogs, cats, and ferrets. But household pets rarely get rabies, because most of them get rabies vaccines. Pets that stay indoors are very unlikely to get rabies.

It's possible to get rabies even when you don't see an animal bite. For example, bat bites or scratches may be so small that you don't notice them. If you or your children come in direct contact with a bat, or if you find a bat in a closed room with a sleeping person, call your doctor right away.

What are the symptoms?

Signs of rabies in animals may include drooling, foaming at the mouth, or paralysis. A pet with rabies also may behave differently than usual, such as acting shy when the pet usually is friendly. A wild animal with rabies may have no fear of humans.

Rabies in humans begins with symptoms such as fever, cough, or sore throat. Later, symptoms become more serious and can include restlessness, hallucinations, and seizures. The final stage is coma and death.

The time from exposure to the virus until symptoms appear usually is 2 to 3 months. In rare cases, it may be shorter or much longer.

How is rabies treated?

The treatment for someone who has been exposed to rabies is a series of shots known as postexposure prophylaxis (PEP). These shots help the body's immune system destroy the disease in its early stages. Getting PEP before symptoms appear usually prevents infection, and you are likely to recover.

If you think you've been exposed to the rabies virus, it's very important to get medical care before symptoms begin. If symptoms appear, it's too late for a cure, and the infection will probably lead to death.

In the U.S. and Canada, PEP has two parts, usually given at the same time:

• A shot of human antibodies against rabies, called human rabies immunoglobulin (HRIG)
• The rabies vaccination series

What should you do if you think you have rabies?

First, wash the animal bite, scratch, or open sore with soap and water. Then call your doctor and local health department right away. They can advise you on what to do next.

How can you prevent it?

To avoid contact with the rabies virus:

• Have pet dogs, cats, and ferrets vaccinated against rabies. (If you aren't the first owner of your pet, ask for a certificate of rabies vaccination. If no document exists, confirm with the pet's veterinarian that the pet got the vaccine.)
• Avoid contact with stray dogs, especially in rural areas of countries where rabies is a risk.
• Avoid contact with bats.
• Never touch or try to pet or catch a wild animal. This includes raccoons, skunks, foxes, and coyotes. Teach children to avoid these animals.
• Secure garbage and other items that attract animals.
• Secure open areas of your home, such as pet doors, chimneys, unscreened windows, or any place that wild or stray animals could enter.
• Never handle a dead animal. Avoid any contact with its brain tissue.

Preventive rabies vaccination may be recommended if you are at high risk of exposure because of your work or hobbies. It may also be recommended if you plan to travel in areas where rabies is a risk, such as parts of Asia, Africa, and Central and South America. Contact your doctor or local public health department for more information.