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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 Jul 29, 2021   -  2 min read

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.

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Frequently Asked Questions


1.

What Is the Effect of Rabies on Humans?

After a bite from an infected dog, the virus enters the body through the nerve cells and reaches the brain. The virus then reproduces rapidly, resulting in brain and spinal cord inflammation, eventually leading to deterioration and death of the individual.

2.

After How Many Days Do the Symptoms Occur In Rabies?

The incubation period can differ from person to person depending on previous exposure to the rabies virus. The incubation period of the virus is usually between two to eight weeks. However, it can be between ten days to two years in some individuals. Also, the period is longer in children.

3.

How Does Rabies Spread?

The initial route of transmission of rabies is through the bite of a rabies-infected animal. It can be either from one animal to another or from an animal to a human. Rabies can also be transmitted through saliva by licking, in which the saliva of a rabid animal comes in contact with open wounds or mucous membranes like eyes or mouth.

4.

Can a Scratch From an Infected Dog Result in Rabies?

Rabies transmission is almost improbable from scratch by an infected animal. However, it can occur if the nails are infected with the saliva of that rabid animal.

5.

What Are The Initial Manifestations of Rabies In Humans?

The initial symptoms of rabies are similar to the flu symptoms that include fever, fatigue, discomfort, headache, etc. There might also be an itching sensation in the bitten area. On progression, it causes stress, agitation, confusion, delirium, hallucination, abnormal behavior, hydrophobia, insomnia, etc.

6.

Should I Be Concerned About Rabies?

Rabies is a dangerous virus as there is no treatment for it once the infection begins. It is highly recommended to take the vaccine within 24 hours of being bitten by an infected animal or a highly suspected animal.

7.

Can Rabies Result From All Dog Bites?

Rabies cannot be contracted from all dogs, but it is advisable to treat all dogs as rabies-infected animals unless proved otherwise.

8.

What Is the Consequence of a Delayed Rabies Vaccine?

If the second dose of the rabies vaccine is delayed for more than four days and the third dose is delayed for more than 14 days from the scheduled date, a new course should be started. If it is within two days of the planned second dose date or seven days of the scheduled third dose date, it is advised to get the vaccine on the visit and follow the original plan. In other cases, the doses are adjusted with respect to the prescribed interval.

9.

How Long Should Rabies Vaccine Be Taken in Humans?

In humans, the rabies vaccine should be taken in five doses, one on the day of contact with the rabies virus (day), followed by doses on days 3, 7, 14, and 28.

10.

Is It Possible to Contract Rabies From a Healthy Dog?

A healthy dog cannot transmit the rabies virus. For a dog to be free of rabies, it should be vaccinated every three years after the initial three doses, which are to be taken between 3-4 months, first year, and then at the third year.

11.

Can a Person With Rabies Survive?

As there is no effective treatment for rabies, it usually results in death except for very sparse numbers. Therefore, it is suggested to get the vaccine as soon as possible after being infected.

12.

Can Rabies Spread From One Human to Another?

A human cannot transmit the virus to another human. It is usually spread from an infected animal to animal either by biting or open wound contact with the saliva.

13.

What Causes Fear of Water in Rabies Patients?

Severe spasms in the throat while swallowing water are seen in rabies infection, creating fear for water in rabies-affected individuals called hydrophobia.

14.

Can Rabies Be Incurred From Dog Licks?

If an infected animal licks the open wounds or mucous membranes like eyes or mouth, it can result in the transmission of the virus. Also, if the animal licks its nails and scratches a person, it can spread the virus.

Last reviewed at:
29 Jul 2021  -  2 min read

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