Symptoms and Signs of Rabies

Medical Author:
Medically Reviewed on 8/12/2021

Doctor's Notes on Rabies

Rabies is a disease seen in humans and other animals due to an animal bite from an animal infected with the rabies virus. The most important sign and symptom of rabies is not seen in the person who gets bitten but in recognizing the signs and symptoms of rabies in an animal that bites you. In addition, some animals that may bite you may not show any signs and symptoms other than aggression. Most human rabies cases worldwide involve bites from rabid dogs. In the U.S., wild animal bites (raccoons, bats, skunks, foxes, and coyotes) are the most common sources of rabid animal bites. Signs and symptoms of rabies in animals include vicious, crazed, and/or sick-appearing animals (for example, muscle spasms, excessive spittle or foam at the mouth). However, some wild animals may appear overly friendly, docile, or confused. If you are bitten by an animal, even a dog that has supposedly been vaccinated against rabies, it is important to quickly do two things: go to an emergency department for evaluation and call animal control to determine if the animal has rabies. It is important to do these things quickly because if you wait until you develop signs and symptoms of rabies instead of being treated, the disease is likely to cause your death. Signs and symptoms of rabies in humans include pain, tingling, and/or itching at the bite site, followed by the development of fevers, chills, fatigue, muscle aches, and irritability. Gradually, the individual becomes extremely ill with high fevers, confusion, agitation, spasms of the respiratory musculature when exposed to water or puffs of air (termed hydrophobia or aerophobia), and eventually, seizures, coma, and death.

Rabies is a viral infection that spreads through the bite or scratch of an animal infected with the rabies virus. Rarely, rabies may be acquired by contamination of mucous membranes of the nose and mouth by bat secretions in the air of a cave or by laboratory workers studying rabies.

What Is the Treatment for Rabies?

There is no effective treatment for rabies once infection is established. Almost all people who do not get preventive shots before signs and symptoms appear die. However, postexposure prophylaxis (PEP) is effective in preventing rabies if given early (usually the same day as rabies exposure). PEP is made up of a rabies vaccine and human immune globulin (HRIG). This is given on the day of exposure and then a dose of vaccine on days 3, 7, and 14. Changes in this schedule are not recommended. This schedule is recommended for both bite and non-bite exposures. Inform your doctor and health officials about your exposure to rabies, as it is a medical emergency.

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.