Rabies is a viral disease that affects the central nervous system and is transmitted through the bite or scratch of an infected animal. It is almost always fatal once symptoms appear, so checking if you may have been exposed to rabies is extremely important. Here are some key points about rabies and how to check if you might be infected:
- Rabies causes about 59,000 deaths worldwide per year. It is present on all continents except Antarctica.
- The rabies virus is transmitted through the saliva of an infected animal via a bite or scratch. In rare cases, it can be transmitted through contact with saliva of an infected animal on mucous membranes or an open wound.
- The incubation period (time between exposure and onset of symptoms) is typically 1-3 months but can range from under a week to over a year. The shorter the incubation period, the worse the prognosis.
- Rabies is preventable if the rabies vaccine and immunoglobulin treatment are administered shortly after exposure. However, once symptoms appear, it is nearly 100% fatal.
- Due to the long incubation period, checking for rabies involves investigating any recent contact with wild mammals or bats to determine if exposure may have occurred.
Key steps for checking if you may have rabies include:
Carefully Review Any Recent Animal Exposures
If you suspect you may have been exposed to rabies, the first critical step is to try to identify the animal involved and determine if the exposure warrants concern:
- When and where did the exposure occur? Note the date and location.
- What type of animal was it? Was it a wild mammal like a bat, raccoon, skunk or fox or a domestic animal like a dog or cat?
- Did the exposure involve a bite or scratch that broke the skin or contact between saliva and your mucous membranes or an open wound?
Any bite, scratch or other direct contact with the saliva of a potentially infected animal should be evaluated for rabies risk. Bats and wild carnivorous mammals like foxes are considered high risk. Even domestic pets can transmit rabies. Cats are more commonly infected than dogs in the United States.
Focus the history on encounters with wild mammals and bats or contact with stray or unvaccinated pets. Also note any encounter where an animal seemed unusually aggressive or sick.
Assess if the Animal Can Be Captured for Testing
When possible, capturing the animal for observation and rabies testing is ideal. Steps include:
- Contact animal control or public health officials for assistance capturing the animal safely.
- The animal should be humanely euthanized and a veterinarian can remove the head/brain for rabies testing.
- Rabies can only be confirmed by direct fluorescent antibody testing of brain tissue. Other samples like blood or saliva cannot confirm rabies.
- If the test is negative and the animal is a dog, cat or ferret, it can be observed for 10 days to rule out rabies. Other animal types should not be ruled out based on a negative test.
Outcomes Based on Animal Testing
| Test Result | Outcome |
|---|---|
| Positive | Rabies vaccination should be started |
| Negative | No treatment needed as long as animal species is dog, cat or ferret |
| Animal not available for testing | Vaccination may be warranted based on type of exposure |
Evaluate the Type of Exposure
If the animal cannot be captured, the type of exposure should be carefully considered along with the species involved to determine if rabies vaccination is recommended.
Bite Exposures
Any bite from a potentially rabid animal should be treated as a possible rabies exposure. Bites often carry the highest risk.
Scratches
Scratches may warrant treatment if they are deep and broke the skin. Superficial scratches are lower risk.
Other Exposures
If saliva got in contact with open wounds or mucous membranes, rabies vaccination may be considered based on the animal species involved and the amount of contact that occurred. For example, a bat flying overhead would not require treatment, but waking to find a bat in your room would warrant evaluation.
Seek Medical Evaluation
If you have had a possible rabies exposure, seek medical care promptly. Timeliness is key because the rabies vaccine and immunoglobulin treatment are highly effective shortly after exposure.
- Contact your physician or visit an emergency department or urgent care clinic. Share the details of the exposure.
- With a high-risk exposure, the provider will administer a dose of rabies immune globulin and the first dose of the four-dose vaccine series promptly.
- Additional vaccine doses are given on days 3, 7, and 14. The vaccine stimulates your immune system to produce antibodies against the rabies virus.
- Immunoglobulin gives immediate temporary protection until the vaccine starts working.
- These post-exposure treatments are extremely effective when received promptly following an exposure, preventing the onset of rabies in nearly 100% of cases.
What if it has been longer since the exposure?
Don’t rule out treatment. Even if it has been several weeks or more since exposure, vaccination may still provide protection or prolong the incubation period. Exposure to bats and other wildlife often goes unnoticed. Even delayed treatment can be life-saving when a known exposure has occurred.
Prevention
Some tips for preventing rabies exposure:
- Avoid contact with wild mammals like bats, raccoons, skunks and foxes.
- Report stray animals to animal control. Don’t touch or approach them.
- Keep pet dogs, cats, and ferrets up to date on rabies vaccinations.
- Seek prompt medical care for any animal bite or scratch before symptoms start.
The rabies vaccine is also available as a preventive measure for those at high risk of exposure like veterinarians, animal handlers, and travelers to areas with high rabies rates.
Conclusion
Once rabies infection is established, it is a devastating and fatal disease. However, it can be readily prevented if exposures are identified quickly and appropriate treatment is given. Carefully reviewing any recent incidents with animals and seeking prompt medical help for possible rabies exposures can save your life. If you may have been exposed, don’t wait – call your doctor or visit an emergency department immediately for evaluation. With timely treatment, exposures can be effectively managed so that the development of rabies is avoided.
