Rabies: A Preventable Disease
Rabies is a terrifying disease. Fortunately, human rabies is rare. This section contains the following information:
- What Is Rabies?
- Rabies Carrying Animals
- How Humans Get Rabies
- Problem Areas in the United States
- What to do if Exposed
- Improved Treatments
- Tips for High-Risk People
This serious public health concern is on the rise in animals in some parts of the United States, but it is preventable. Americans who are bitten by rabid animals can now be protected against rabies and avoid certain suffering and death with rabies exposure.
What is rabies?
Rabies is an acute viral disease that attacks the central nervous system. Commonly, referred to in years past as "hydrophobia," rabies has afflicted animals and humans since ancient times. It normally is passed from animal to animal through bites. Animals with rabies can have rabies virus in their saliva. Then, if a person is bitten or licked, the rabies disease can be transmitted.
From the time the infected animal saliva enters our bodies through bite wounds or open sores, it takes as little as nine days or up to a year for a person to actually contract rabies and begin experiencing the horrible symptoms that precede death. Most people who get rabies, however, develop symptoms within about a month after being exposed.
It is this delay between exposure and the start of symptoms (the "incubation period") that allows humans time to seek treatment. Treatment almost always allows our bodies to fight off the virus, but don't wait even a day if you suspect you have been exposed to rabies.
Just as there are misconceptions that rabid animals are dogs that foam at the mouth and that a bite means certain death, many Americans believe that rabies is under control in all parts of the country. The threat of rabies is still with us.
Rabies-carrying animals
Because wild animals move from place to place, there are few areas in the United States that are free of the threat of rabies. House pets such as dogs and cats are not the biggest problem. Nearly 85 percent of animal rabies cases come from wild animals.
The worst rabies culprits, in order of incidence of disease, are skunks, raccoons, bats, cattle, foxes, cats and dogs. Coyotes, horses and bobcats also are disease carriers in some places. Animals that very rarely are afflicted with rabies are rats, mice, squirrels, hamsters, guinea pigs, gerbils, chipmunks and rabbits.
It is wrong to think that rabid animals can be spotted easily because they all drool and foam at the mouth. In fact, that happens only some of the time and generally during the later stages of infection. Animals that appear or act abnormal should be avoided. Rabid animals may stagger, appear restless, be aggressive, act overly friendly, change the tone of their barks or howls, or appear to be choking.
These infected wild animals can pass rabies to pets. Human rabies results from exposure to infected animals, whether wild or domestic.
How humans get rabies
Humans rarely get rabies from other humans. Rabies commonly is transmitted by infectious saliva from rabies-infected wild or domestic animals. People are bitten. Or sometimes an infected animal's lick to an open scratch, wound or mucous membrane can result in the rabies virus entering our bodies.
Bites close to the head are the most dangerous. That is because the rabies virus fatally attacks the brain. Casual petting of animals generally is not thought to be dangerous. When an animal is acting strangely, however, caution should be used. If you have a question, seek professional advice on whether there is an animal rabies problem in your area.
Human rabies is not seen often by doctors in the U.S., however. Diagnosis sometimes is difficult because of the complexity and multiplicity of human symptoms. If there is any question at all about possible exposure to rabies, don't waste a minute. Call your doctor or local or state health department. They are experts on rabies. If you need treatment, they can get you started on treatment promptly to prevent the disease.
Problem areas in the United States
Rabies is on the rise in several parts of the country. No area is totally free of the disease. Since 1975 there has been a slow but steady spread of the disease in certain regions:
- Skunks in the country's midsection, ranging from Texas to North Dakota and Montana.
- Raccoons in the mid-Atlantic area ranging from Pennsylvania to Florida.
- Bats in the Southwest and other parts of the country.
- Foxes in the Northeast from Maine south to New York and Connecticut.
Depending on animal population and migration patterns, the disease can spread rapidly from state to state. Rabies generally is a bigger problem during late spring, summer and early fall because animals are more active and because humans are out in the wilds with the animals more often.
Health departments keep up with outbreak areas and are your best source of information about local problems and the increased need for precautions and treatment. Although increased pet vaccinations and tighter animal control laws are doing a good job in holding down the spread of rabies, the problem still exists. We all must work together, and individually, to take certain precautions:
- Vaccinate your pets regularly for rabies, as is required by law in many states, and follow the directions of your veterinarian.
- Avoid strange-acting animals--both domestic and wild animals. A skunk or raccoon that acts friendly or is seen during daylight hours is unusual, for example. Unprovoked attacks frequently are clear evidence or rabies.
- Teach your children to stay away from wild animals and unknown dogs and cats. Make sure they tell you if they are bitten or scratched by any animal.
- Obey animal control laws such as leash laws.
- Don't touch dead animals. If you have to, wear gloves.
- Don't try to determine yourself whether an animal is rabid or whether a bite could be dangerous. Your doctor and health department are the experts.
- Be aware that there are safe and effective vaccinations available for persons exposed to rabies.
- Know what to do if you are exposed to rabies.
What to do if exposed
Doctors call it "exposure" when people are bitten or licked by potentially rabid animals or when they suspect such contact. Exposure sometimes is difficult to determine because rabid animals who bite us may not have started showing signs of rabies. Or people forget vital details of contact with an animal.
Because doctors do not want to treat every patient without solid evidence that a problem may exist, you and your doctor must weigh some important factors before treatment.
- Wash the bite from an animal species that is highly susceptible to rabies, such as a skunk or raccoon? Wild animal bites always should be suspect.
- Was the domestic animal acting strangely? That's a sign there may be a problem.
- Was the animal vaccinated against rabies?
- Was the lick near an open scratch or mucous membrane such as the mouth, nose or eyes?
- Is rabies prevalent in the area?
You and your doctor must quickly collect the answers to these questions. You also should immediately wash the wound thoroughly with soap and water. If the animal is dead, it is important to save it for examination (always wear gloves when handling the carcass). If the animal is alive, call Animal Control to capture it for testing or quarantine by authorities. Be careful to prevent further risk during the attempted capture. If the animal escapes, especially if it is a dog or cat, try to recall how it looked so that you can recognize it later.
Most importantly, tell your doctor everything. And try to discover every bit of information from your children if they are the ones involved.
Improved treatments
Some people are afraid to seek treatment for rabies exposure because they've read or heard about 23 painful shots in the stomach. That is not true anymore.
"Post-exposure" treatment is called for after a bite or lick from a suspected rabid animal. Since the 1980s, in the United States, it has consisted of a series of only five fairly painless shots in the arm. A shot of specific anti-rabies globulin is also administered in the buttocks once at the start of treatment.
The anti-rabies treatment with vaccine and globulin has been proved 100 percent effective if administered within 14 days of the bite or lick. Doctors don't want you to wait that long, however. Treatment if necessary, should start as soon as possible. Most people do not react adversely to the rabies vaccine. There may be some swelling, redness or soreness. The minor adverse effects should go away, and generally there is no need to stop treatment.
In addition to effective post-exposure treatment, effective "pre-exposure vaccinations" (preventive are available to those people who may be at high risk of exposure to rabies, usually is their work (zoo workers, postal workers, animal control workers, veterinarians) or in their hobbies (hunters, cave explorers, amateur taxidermists). Human pre-exposure immunization against rabies is relatively inexpensive, and it only takes three relatively painless shots in the arm.
You may want to ask you doctor or health department about your own risk factors and whether preventive vaccination makes sense. Taking common-sense precautions is the best prevention.
Tips for high-risk people
Rabies can be a danger for people who are regularly around animals that are not their own pets. Mail carriers, veterinary students, animal handlers, zoo workers, campers, hunters, and armed forces personnel who spend a lot of time in the field also may be at risk.
Following is a summary of simple ways to avoid rabies:
- Be careful. An animal's bite may be worse that its bark or growl.
- Report any bites or licks to open wounds to your superior, doctor and health department.
- Use gloves when handling live and dead animals.
- If exposed, try to catch the animal for inspection, testing or quarantine by health authorities.
- Don't try to assess you own exposure. Let the experts do that.
- Inquire about pre-exposure vaccination which could help prevent a problem before it starts. If exposed after vaccination, you still need prompt medical help.
- Use common sense, follow suggested precautions, and remember that rabies is not a disease to be taken lightly.