Cause
The rabies virus causes an infection of the nervous system. It is usually transmitted by an animal bite. Human cases are extremely rare in the United States; most years, there are no reported cases.
Symptoms
The first stage usually lasts 2 to 10 days. Symptoms include fever, headache, muscle aches, loss of appetite, nausea, vomiting, sore throat, cough, and fatigue. There may be a tingling or twitching sensation around the area of the bite. The second stage, lasting 2 to 21 days, begins with a fever as high as 105 degrees Fahrenheit and any of the following: irritability; excessive movement or agitation; confusion; hallucinations; aggressiveness; muscle spasm; seizures; weakness or paralysis; extreme sensitivity to light, sounds, or touch; increased saliva or tears; and an inability to speak as vocal cords become paralyzed. In the last phases, there may be double vision, abnormal movements of the muscles that control breathing, and difficulty swallowing. Swallowing problems and increased saliva lead to foaming at the mouth.
How It Spreads
The rabies virus is carried in the saliva of infected animals and is usually transmitted to humans through an animal bite. In rare cases, it can be spread when an infected animal’s saliva touches mucous membranes, like the mouth or eyelids, or comes in contact with a cut or broken skin. In the United States the most common carriers are bats, raccoons, skunks, and foxes; cases have been reported with wolves, coyotes, bobcats, and ferrets as carriers. Animals not expected to carry rabies include small rodents, rabbits, and hares. In Central and South America, dogs are the main carriers.
Incubation Period
The incubation period is usually 20 to 180 days, with the peak at 30 to 60 days.
How Long Symptoms Last
Recovery is rare in humans who have developed symptoms.
When to Call Your Child’s Doctor
Call your child’s doctor immediately if your child has any signs or symptoms of rabies, especially if he has been bitten recently by an animal. Call the doctor as well if your child has been bitten by an animal or has been exposed to a cat, dog, bat, or other animal that might have rabies. Also, call if you are planning a trip abroad where you might come in contact with infected animals.
How the Diagnosis Is Made
The doctor will ask about recent animal exposure and look for symptoms.
Treatment
There is no specific effective treatment once symptoms have developed. The person receives supportive care in an intensive care setting. Only a few individuals who have developed the disease have survived.
Prevention
If your child is bitten by an animal, wash the area of the bite thoroughly with soap and water for 10 minutes and call your child’s doctor, who will clean the wound thoroughly and check to make sure tetanus shots are up to date. You may also call the local animal control authorities to help find the animal that caused the bite. If the doctor decides to treat your child to prevent rabies, the treatment will involve shots of human diploid cell vaccine and human rabies immune globulin into a muscle, which should begin the day the child was bitten to be most effective. Part of human rabies immune globulin is usually injected near the bite area. Warn your child not to touch or feed stray animals, even dogs or cats. Report any stray animals to local health or animal control authorities, especially if they are acting strangely.