What Is Rabies?

Rabies is a viral disease that is most commonly transmitted through a bite or a scratch from an infected animal. Once the rabies virus finds its way inside the body, it infects the central nervous system, causing disease in the brain and then ultimately death.

There are two forms of rabies: furious rabies and paralytic rabies. These forms differ in what symptoms the animal/individual affected presents.

Furious rabies is characterized by hallucinations and hyperactivity, whereas paralytic rabies causes paralysis or a coma. The first type of rabies, furious rabies, is most common and occurs in 80% of human cases.

Rabies occurs worldwide, separating it from mosquito-borne illnesses, which are mainly present in the warm and humid climates favorable to mosquitos.

A Fear of Water?

Rabies has historically been known as hydrophobia, also known as a fear of water. As we now know, there’s a lot more to rabies than just a sudden fear of getting wet, but it is interesting how it manifests in this way.

The rabies infection causes intense spasms in the throat whenever someone tries to swallow. Even just the thought of swallowing water can cause these spasms, making it appear like someone is afraid of water.

In reality, rabies causes a fear of swallowing anything, not just water.

This is because rabies thrives in saliva, which is also the best way to spread the infection. However, swallowing reduces the amount of saliva in the mouth and therefore the spread of the virus. Because of this, rabies causes a fear of swallowing, making saliva build up in the mouth and increasing the virus’s ability to spread.

How Does Rabies Spread?

Rabies spreads when an animal with rabies, bites or scratches a person. Most rabies cases occur in wild animals, such as raccoons, bats, foxes, and skunks, although any mammal, including humans, can get this virus.

The most common cause of rabies in humans is the bite of an infected dog. Along those same lines, children are at a higher risk of rabies since they are more likely to play with dogs and are thus more likely to receive a bite.

Rabid animals are more likely to bite someone because they often have furious rabies, which makes them more aggressive. Unfortunately, these bites do more than tear the skin; they can also transmit and spread the virus.

Since the rabies virus is in the saliva of infected animals, any bites, which pierce the skin, can introduce the virus with the saliva into the wound. And not only bites, but literally any contact with an infected animal’s saliva can potentially transmit rabies. For instance, having infected saliva touch an open wound can also introduce the virus into the body.

How To Prevent Rabies

There is no effective treatment for rabies once clinical signs have appeared, the disease is almost always fatal.

But there are important ways to prevent rabies. First and foremost it is important to be aware of the disease and what it may look like in animals. However, not all infected animals display symptoms, which is why it is best to avoid unknown animals.

Otherwise, if you have a pet, the best way to prevent rabies is by vaccinating them against it and keeping these vaccines up to date.

I’ve Been Bitten, Now What?

There are five distinct stages of rabies:

1. Incubation
2. Prodrome
3. Acute Neurologic Period
4. Coma
5. Death

Incubation is the time before symptoms appear and usually lasts between 2-3 months. This is when you can intervene in rabies development before symptoms begin appearing in prodrome.

If you’ve been bitten or scratched by an animal, wash the bite site immediately with soap and water.  Through this intervention, the potential viral load in the bite wound can be decreased. Then contact a healthcare provider about postexposure prophylaxis, which is a series of rabies vaccines. Important is to be able to start the postexposure vaccinations within 24 hours of the bite or scratch. 

By taking action as soon as the bite occurs, you can disrupt the infection of rabies in your body and save your life. In this case, time truly is of the essence.

Those with rabies who enter prodrome may experience the following signs and symptoms:

• pain, discomfort, itching, or prickling at the bite site
• intolerance of bright life, noise, or drafts
• fear of water
• difficulty swallowing, vomiting, nausea
• neurological dysfunction that progresses within days (e.g., confusion, anxiety, agitation)
• localized weakness
• coma

Death from rabies results from cardiac or respiratory failure and generally occurs within 7-10 days of the first signs if no intensive care and supportive measures are begun.

Protect Yourself from Rabies

When it comes to rabies, the most important tool you have for protection is remaining aware. By this, we mean staying aware of the animals around you and if they are exhibiting off behavior.

For instance, if you are traveling and see a dog, it’s best to avoid petting it, no matter how cute it may be. If the dog is snarling and looks agitated, it’s even more important to steer clear entirely to ensure you don’t get bitten. Even if the dog does not have rabies, a bite can easily send you to the hospital for stitches, tetanus shot or bacterial wound infection if you aren’t careful.

Above all else, if you get bitten by an animal, quickly clean the cut and head to the doctor as fast as possible. This way, if you are exposed to rabies, you can quickly get a vaccine and interfere with the virus before the infections spreads in your body.

To keep yourself safe when traveling, make sure that you and your kids adopt a “look, don’t touch” policy when it comes to animals, and leave them be. Rabies can be a severe disease if you get it, but remaining aware can go a long way in keeping this “biting” virus away.

References

Human rabies prevention and management. (2023). https://www.who.int/activities/human-rabies-prevention-and-management

Rupprecht CE. Rhabdoviruses: Rabies Virus. In: Baron S, editor. Medical Microbiology. 4th edition. Galveston (TX): University of Texas Medical Branch at Galveston; 1996. Chapter 61. Available from: https://www.ncbi.nlm.nih.gov/books/NBK8618/

Hemachudha, T., Ugolini, G., Wacharapluesadee, S., Sungkarat, W., Shuangshoti, S., & Laothamatas, J. (2013). Human rabies: neuropathogenesis, diagnosis, and management. The Lancet Neurology, 12(5), 498-513. doi: 10.1016/s1474-4422(13)70038-3

Tongavelona, J., Rakotoarivelo, R., & Andriamandimby, F. (2018). Hydrophobia of human rabies. Clinical Case Reports, 6(12), 2519-2520. doi: 10.1002/ccr3.1846