First aid and Emergencies

Rabies - Symptoms, Diagnosis, and Treatment

Written by
Dr. Vishnu K R
and medically reviewed by iCliniq medical review team.

Published on May 31, 2017 and last reviewed on Aug 31, 2019   -  2 min read

Abstract

Abstract

Here is an attempt to cover a never ending loop of doubts, which patients present regarding a recent encounter with an animal. The encounter ranges from being playful with the pet to a tiger attack.

Rabies - Symptoms, Diagnosis, and Treatment

Rabies:

The incubation period of rabies is four days to four years. It is sad that our media, movies, and storybooks have depicted a fearsome image of this disease. Rabid animals are hydrophobic, and their brain cells are damaged by the virus. It loses its fear of humans. A rabid dog goes out in the open and behaves like a maniac. But, will a rabid dog's bite cause a human to bark like the dog and go mad? Actually, that is not the outcome. Humans with rabies will have hydrophobia. They will have muscle spasms because this virus attacks the brain cells. These spasms are interpreted as the person being crazy and mentally violent. The cases of rabies are becoming past stories, thanks to Louis Pasteur for his vaccine.

Do I Have Rabies?

It depends on what the animal did to you. The most important questions are:

Which Animal? Reptiles do not cause rabies. According to guidelines, rat, mouse, squirrel,etc., which are included in the category of small rodents are not listed under rabies causing animals. But a bandicoot (larger and bigger form of rat) comes on the list. All other mammal bites are classified as probable rabies causing factors, for example, dogs, cats, wild mammals, etc., are all suspicious. Till date, a bird to human rabies transmission has not been recorded.

What Did the Animal Do? It the animal scratched you, although it is not a big risk, it is better to get vaccinated. Rabies can be transmitted through the scratch wound. If the animal bit you, then you have to get vaccinated. A lick over your healthy skin is not problematic. But if the licking was done over a fresh wound, mouth, inner nose, eyes, anal opening, genitals, then go for the vaccine.

Where Is the Wound?The fact is simple, 'shorter distance to the brain means it is more dangerous.' Face, scalp, neck, shoulders, and arm are dangerous areas. Even a small scratch there should ideally require anti-rabies serum administration around the wound. The virus travels along the nerves to the brain with a speed of 1 to 2 millimeter per hour. That is why this disease has the widest incubation period range. A virus in the toe would take years to get to the brain. But, a wound in your eyes just requires days.

Why Did the Animal Bite You? Was there an abnormal behavior? Did the animal attack you without any provocation? Rabid dogs attack you with no provocation at all. A rabid dog bites multiple people in the same day.

Local Treatment of the Wound:

Whenever you get a scratch, bite or lick, wash it with soap and water immediately. As I said, it travels very slowly. The maximum concentration of the virus is at the wound itself. Whatever you forget from this article, do not forget about soap and water cleansing. The viruses are destroyed with immediate local treatment.

Treatment:

Rabies vaccine is the specific treatment, which is given as an intradermal or intramuscular injection over both shoulders. Combined with an antibiotic, the treatment is almost complete.

The anti-rabies serum is an injectable solution, which is given sometimes. It is a horse, or human derived anti-rabies serum, which is to be injected at the wound site as deep infiltration. Not all attacks require anti-rabies serum.

What Should I Do?

Locally treat the wound with soap and water. Do not tie the wound. Identify the animal if possible after the bite. Get treatment and observe the animal for 10 days. If the animal survives 10 days post-bite, it is good. And if you have a pet, vaccinate the animal and train it properly. It is good to have a pet that behaves well.

For more information consult a preventive medicine physician online --> https://www.icliniq.com/ask-a-doctor-online/preventive-medicine-physician

Last reviewed at:
31 Aug 2019  -  2 min read

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Related Questions & Answers


Is rabies a contagious disease?

Query: Hello doctor, I was bitten by a dog 13 days ago. I took anti-rabies vaccine after 25 hours of the bite. I have taken three vaccines until now. I had oral sex with my wife and by mistake, I bit her at neck two days ago. Should she also receive the anti-rabies vaccine? The dog is still alive.  Read Full >>


Dr. Kakkar
Dermatologist, HIV AIDS Specialist, Venereologist

Answer: Hello, Welcome to icliniq.com. Contact with someone who is receiving rabies vaccination does not constitute rabies exposure and does not require post-exposure prophylaxis. For more information consult a dermatologist online --> https://www.icliniq.com/ask-a-doctor-online/dermatologist  Read Full

A healthy dog scratched my leg. Do I have to worry about rabies?

Query: Hello doctor,Yesterday, my dog who is around two months accidentally scratched my leg. The scratch is negligible but I lost half a drop of blood. The dog looks healthy and has not been bitten by other dogs. He has not been given antirabies injection because my vet told us he is too young to get one....  Read Full >>


Dr. Md. Kais Haider Chowdhury
General Practitioner

Answer: Hello, Welcome to icliniq.com. If a dog scratches or bites you, you need to have a vaccine. As you have a history of exposure (bites or scratches), then it is better to get the vaccine for post-exposure treatment. Post-exposure treatment consists of five injections by intramuscular route on Day 0,...  Read Full

I took antirabies vaccine only 13 days after a shrew mouse bite. Am I at risk?

Query: Hello doctor,I had taken two antirabies shots ten and three months back for a dog bite. A shrew that had entered the house bit me on my back two weeks back. There was no bleeding even on applying pressure on the area, but the next day I noticed a small clot on my back like the one we have after a sc...  Read Full >>


Dr. Jyotisterna Mittal
Dermatologist

Answer: Hello, Welcome to icliniq.com. Rabies vaccination should ideally be started on day 0. But, you have not developed any symptoms. So, it is not late to start vaccination now. You should complete the five-injection rabies schedule. Since it was a category-2 exposure, the immunoglobulin is not requ...  Read Full

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