Rabies is a rare but deadly infectious disease. The good news is that you can protect yourself by getting your pets vaccinated, and if you or a loved one gets exposed, you can get a treatment called post-exposure prophylaxis…but you have to act fast.
TL;DR Rabies cases are on the rise in some places. Understanding the risks of rabies and knowing what to do if you get exposed can save your life. Rabies is rare, but almost always fatal if treatment is not started right away. Fortunately, very few people in the US die of rabies.
You may have heard “don’t pet a stray dog” while you are on vacation because it might bite you and give you rabies. Did you know that less than 1% of rabies cases in the US happen from dog bites. People are more likely to get rabies from bites or other exposures by infected animals like racoons, foxes, or bats. However, around the world, dog bites still account for most (95 out of 100) human deaths from rabies so it is still a good idea to steer clear of stray dogs! Thanks to an effective vaccine program, rabies is no longer spreading from dogs to other dogs in the US. Be aware though, unvaccinated dogs can still get rabies from run-ins with wildlife that are infected and, if they lick or bite you, they can infect you. If you get infected, you need to start treatment right away.
What is rabies?
- 🐕🦺 ➡️🧍🏽♀️Rabies is called a zoonotic (zoo-o-not-ick) disease. This means it causes disease in people when it spreads from an animal to a person. It is not spread from person to person.
- 🦠 Rabies disease is caused by a virus called “rabies virus”. The name comes from Latin for madness.
- Rabies is a neuro-invasive disease meaning the virus can infect and cause permanent damage to the brain.
- Animals infected with rabies virus may behave in an unusual way. They can often be aggressive and therefore more likely to bite.
📝 Nerdy note: It is thought that the virus has evolved to cause this aggressive biting behaviour so it can spread to a new host.
- Infected animals may avoid water (called hydrophobia). Although the animal may be thirsty and try to drink, it will experience spasms in its throat and may produce a lot of spit that causes excess drooling. It can look like they ate bubbles. You may recognize this as the commonly mentioned sign of “foaming at the mouth”.
- ❗Not all infected animals will show signs of infection, so there is no way to be sure if an animal is infected or not.
- 🐕🦺 It is important to ask for proof of rabies vaccination if a bite occurs to reduce the need for treatment. If the rabies vaccination status is not known, post-exposure prophylaxis is usually recommended.
How do people get rabies?
- 🐶 Fewer than 1% of people who die of rabies in the US got infected by a dog bite, however dog bites are still the overwhelming way people get rabies in many other parts of the world. Be careful around stray dogs or other wildlife when you are on vacation.
- 🦇 In the US, bat bites are the more common way to get rabies, but bites by other wild animals, or even unvaccinated dogs, can happen.
- 🚨Sometimes bat bites are too small to notice. If there is exposure to a bat, for example in the house when people are sleeping, it is good to catch the bat for testing. Check in with your local health department to learn what you should do next.
- 💦 The virus sets up shop to make copies of itself in the salivary glands (where spit is made) of an infected animal. This means the virus is found in saliva and is usually passed on when the infected animal bites. However, your eyes, nose, and mouth are also ways the virus gets in if, for example, an infected dog licks your face.
- 💉 Vaccinating dogs other pets, and even some wild animals, has helped lower the number of people who get rabies. This is because the vaccine stops the animals from getting rabies and spreading it to people. This is the idea of “one health” where we can treat pets to also protect us.
How can I keep my family safe from rabies?
- 🚫 Do not touch any wild animals, stray dogs, or any animal that seems ill or is behaving unusually.
- Don’t try to help a bat on the ground get back into a tree.
- If you see an animal during the day that is normally active at night, go inside, and bring in your pets and children.
- If you are in another country that has many stray dogs, don’t pet them.
- 👮 If you see an animal behaving unusually, report it.
- 🦇If you find a bat in your home, contact your local health department to determine what to do next. Keep the bat since they will likely want to test it for rabies.
- 🙅 Do not approach unfamiliar pets without confirming with the owner that they are safe to pet and that they are up-to-date on their rabies vaccine.
- 💉 Make sure your pets are vaccinated against rabies and receive their booster vaccinations on schedule.
What happens if I get exposed?
- ‼️ The good news is that there is a treatment available, but you need to act fast.
- 🧼 As with any animal bite, immediately wash the bite site with soap and water.
- 🏥 Unless you are shown documentation that the animal that bit you is up-to-date on their rabies vaccine, go to the emergency room right away to get checked and ask if you should be treated.
- ‼️ If left untreated, rabies is fatal. There are only a few examples of people who survived rabies infection without treatment, and they had permanent brain damage.
- 💉 If the ER clinician or health department representative suspects a rabies virus exposure, they will give a treatment called post-exposure prophylaxis described more below.
- ‼️ After a bite or exposure it can take several days to several weeks or even months for the virus to get into the brain. You may think everything is ok, but the virus is sneakily making copies of itself and heading for the brain.
- 🧠 Once the virus gets into the nerves and the brain, it causes damage that can’t be undone.
- 🦠 Symptoms of rabies disease are confusion, fever, tingling or numbness. Once symptoms appear, it is too late for effective treatment.
- 📝Nerdy Note: There is something called the Milwaukee protocol where they put the person into an induced coma to help them, which works in a few cases. However, it is always better to prevent, rather than treat disease, especially for rabies.
What is post-exposure prophylaxis?
- Post-exposure prophylaxis is also called PEP [archived link] and is something given after exposure to rabies virus (post-exposure) to prevent rabies disease (prophylaxis).
- ⏱️ Once someone is exposed to rabies virus the clock starts to get PEP.
- ✔️ PEP is highly effective as long as it is started before there are any symptoms.
- ❗ You may have heard that PEP is many painful injections in the tummy, but today’s PEP is much simpler and far less uncomfortable.
- 💉 PEP is usually one injection of a medicine called human rabies immunoglobulin (HRIG) and one injection of a rabies vaccine followed by 3 additional rabies vaccine booster injections at days 3, 7, and 14. If there was a particularly large bite or concern for a large rabies exposure, there may be additional injections of HRIG around the site of the bite.
- 🚨Nerd Alert:
- Y The HRIG is human antibodies that detect rabies virus to give the immune system a head start fighting the virus.
- 🛡️ Receiving RIG is important because a person’s own immune system could take several days to a week to make protective antibodies after the vaccine, and that is too long to allow the virus a chance to get into the brain.
- 💉 The second part of PEP is a vaccine against the rabies virus to provide the last bit of needed protection.
- 🚨Nerd Alert:
If we have a good vaccine for rabies, why isn’t the rabies vaccine given to everyone?
- Some people–like veterinarians or lab workers–do get a rabies vaccine because their jobs put them at higher risk for exposure. But, the rabies vaccine does not provide lifelong protection and those people need to get a booster every 1-3 years to maintain protection.
- Most people don’t need the rabies vaccine because the chance of getting rabies is very low. If someone is exposed, there’s a treatment that works really well. The vaccine can also cause side effects like soreness at the injection site, dizziness, and vomiting, or, in rare cases, more serious problems.
✅ Don’t forget that your pets can get rabies too! The best way to protect them is to get them vaccinated against rabies, and it’s the law (at least in the US).
Rabies is rare, but be aware. We are lucky that we can still prevent rabies disease with PEP, after an exposure happens, but we need to act fast. Keep your pet’s rabies vaccine up-to-date and, if you know about an exposure, get PEP right away.
Stay well,
Those Nerdy Girls
