Rabies (patient information)

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Rabies is a deadly animal disease caused by a virus. It can happen in wild animals, including raccoons, skunks, bats and foxes, or in dogs, cats or farm animals. People get it from the bite of an infected animal.

What are the symptoms?

Most patients will present after a documented, highly suspected, or likely exposure from a rabid animal. Clinical illness is compatible with acute, progressive encephalitis. After infection, the incubation period is highly variable, but it lasts approximately 1–3 months. The disease progresses acutely from a nonspecific, prodromal phase with fever and vague symptoms, to a neurologic phase, characterized by anxiety, paresis, paralysis, and other signs of encephalitis; spasms of swallowing muscles can be stimulated by the sight, sound, or perception of water (hydrophobia); and delirium and convulsions can develop, followed rapidly by coma and death. Once clinical signs manifest, most patients die in 7–14 days.

What are the causes?

It can happen in wild animals, including raccoons, skunks, bats and foxes, or in dogs, cats or farm animals. People get it from the bite of an infected animal.

Who is at highest risk?

It can happen in wild animals, including raccoons, skunks, bats and foxes, or in dogs, cats or farm animals. People get it from the bite of an infected animal.

Diagnosis

Diagnosis is straightforward in an encephalitic patient recently exposed to a rabid animal. However, in lieu of a history of a documented exposure and the potential for long incubation periods of weeks to months after initial viral transmission, clinical diagnosis may be complicated by the variety of symptoms and the differential exclusion of other etiologic agents associated with encephalitis. Definitive diagnosis can be made by demonstrating virus in neuronal tissue, corneal impressions, or nuchal biopsy, either by detecting viral antigens or amplicons. Additional detailed information on diagnostic testing may be obtained from CDC (www.cdc.gov/rabies). A specific serologic response to virus can also support the diagnosis in an encephalitic patient.

Treatment options

No treatment is effective after the development of clinical signs, but the extremely rare case of recovery after extensive medical interventions offers hope that future experimental therapeutics may be developed.In people, symptoms of rabies include fever, headache and fatigue, then confusion, hallucinations and paralysis. Once the symptoms begin, the disease is usually fatal. A series of shots can prevent rabies in people exposed to the virus. You need to get them right away. If an animal bites you, wash the wound well; then get medical care. To help prevent rabies

• Vaccinate your pet. Rabies vaccines are available for dogs, cats and farm animals
• Don't let pets roam
• Don't approach stray animals. Animals with rabies might be aggressive and vicious, or tired and weak

What to expect (Outlook/Prognosis)?

No treatment is effective after the development of clinical signs, but the extremely rare case of recovery after extensive medical interventions offers hope that future experimental therapeutics may be developed.

Possible complications

Infection in brain and spinal cord, death

Sources

http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/rabies.htm