Rabies (Hydrophobia)

Rabies, or hydrophobia, is an acute, highly lethal viral disease that can affect the central nervous system of any warm-blooded animal, including humans. It is almost always transmitted through the bite of a rabid animal, although it can also be contracted if saliva containing the virus enters the body through an open sore, the eyes, or the mucous membranes of the mouth.

Once inside the body, the virus travels along nerves until it reaches the spinal cord and brain, where it multiplies, destroys tissue, and eventually causes paralysis and death. In humans, the average incubation period between exposure to the virus and onset of symptoms is 30 to 50 days, although it can range from 10 days to a year.

Typically, rabies begins with fever, headache, muscle aches, vomiting, and malaise, followed by uncontrollable agitation, drooling, and painful spasms of throat muscles, which prevent drinking despite tremendous thirst (hence the name hydrophobia). Death usually occurs from widespread paralysis that leads to suffocation.

The disease is found in all states except Hawaii; it also occurs in most other countries in both hemispheres. Worldwide, rabid dogs present the greatest risk, but in the United States, immunization has almost eradicated rabies in dogs and cats. The disease is widespread, however, among raccoons, skunks, foxes, and bats. Rabies has also been reported in squirrels, chipmunks, and other rodents. These animals rarely pose a threat to humans, but may infect an unimmunized pet.

Diagnostic Studies and Procedures

Diagnosis centers on trying to determine whether or not a bite was inflicted by a rabid animal. If it came from a seemingly healthy cat, dog, or other pet, the animal should be given to a veterinarian or local health department for 10 days of observation and an antibody test. If the test is negative and the animal remains healthy, it can be assumed that the animal was not rabid and treatment is not necessary.

If the bite has been inflicted by a wild animal or a domestic animal that seems rabid or sick, the animal should be killed and its brain examined for signs of rabies. Only laboratory proof that the animal in question is not rabid justifies foregoing a course of preventive treatment for a person who has sustained a suspicious animal bite.

Medical Treatments

For Humans. Immediately wash the area several times with a strong antiseptic soap and warm water. Flush a deep puncture wound with soapy water. Then seek medical treatment, either in a hospital emergency room or from a private physician.

When a doctor has decided that preventive treatment is advisable, a series of shots will be given, usually beginning with rabies immune globulin or antirabies serum for passive immunization; this will be followed by active immunization with five or six injections, and then testing for immunity. The vaccine is usually injected into the arm muscle and may cause local swelling, itching, and other adverse reactions, which can be minimized by taking antihistamines and other medications.

At one time, onset of rabies invariably ended in death. Recently, aggressive treatment to control symptoms that affect breathing, circulation, and the brain has resulted in a few survivals.

For Animals. Wear protective gloves, wash the bite area thoroughly with soap and hot water, and take the animal to a veterinarian at once.

Alternative Therapies

There are no alternative therapies that can be used to prevent or treat rabies.

Self-Treatment

Health officials stress the importance of rabies immunization for all cats and dogs, as well as for horses and other domestic animals that might come in contact with a wild rabid animal. To further protect pets, keep cats indoors, and keep a dog on a leash or in a pen or fenced yard when outdoors.

In areas where rabies has been reported, try to avoid contact with stray cats and dogs and be alert for any wild animal that acts strangely. A rabid animal may be aggressive and attack people, animals, or objects. But sometimes the animal simply behaves strangely. For example, a bat, raccoon, or other normally nocturnal animal might come out during the day and appear friendly and unafraid of humans. It may have an unsteady gait and seem to be sick or disoriented; possibly, it will be drooling or foaming around the mouth, symptoms caused by jaw and throat paralysis.

If you suspect that an animal has rabies, do not attempt to catch it yourself. Instead, notify your local animal warden or health department so that the animal can be captured.

Other Causes of Rabies Symptoms

Hysteria following an animal bite can sometimes mimic rabies, but symptoms subside when the person is assured that the disease can be prevented.