Symptoms and causes

Symptoms

The first symptoms of rabies may be very similar to the flu and may last for days. Later signs and symptoms may include:

  • Fever
  • Headache
  • Nausea
  • Vomiting
  • Agitation
  • Anxiety
  • Confusion
  • Hyperactivity
  • Difficulty swallowing
  • Excessive salivation
  • Fear of water (hydrophobia) because of the difficulty in swallowing
  • Hallucinations
  • Insomnia
  • Partial paralysis

When to see a doctor

Seek immediate medical care if you're bitten by any animal, or exposed to an animal suspected of having rabies. Based on your injuries and the situation in which the exposure occurred, you and your doctor can decide whether you should receive treatment to prevent rabies.

Even if you aren't sure whether you've been bitten, seek medical attention. For instance, a bat that flies into your room while you're sleeping may bite you without waking you. If you awake to find a bat in your room, assume you've been bitten. Also, if you find a bat near a person who can't report a bite, such as a small child or a person with a disability, assume that person has been bitten.

Causes

Rabies infection is caused by the rabies virus. The virus is spread through the saliva of infected animals. Infected animals can spread the virus by biting another animal or a person. In rare cases, rabies can be spread when infected saliva gets into an open wound or the mucous membranes, such as the mouth or eyes. This could occur if an infected animal were to lick an open cut on your skin.

Animals that can transmit the rabies virus

Any mammal (an animal that suckles its young) can transmit the rabies virus. The animals most likely to transmit the rabies virus to people include:

Pets and farm animals

  • Cats
  • Cows
  • Dogs
  • Ferrets
  • Goats
  • Horses

Wild animals

  • Bats
  • Beavers
  • Coyotes
  • Foxes
  • Monkeys
  • Raccoons
  • Skunks
  • Woodchucks

In rare cases, the virus has been transmitted to tissue and organ transplant recipients from an infected organ.

Risk factors

Factors that can increase your risk of rabies include:

  • Traveling or living in developing countries where rabies is more common, including countries in Africa and Southeast Asia
  • Activities that are likely to put you in contact with wild animals that may have rabies, such as exploring caves where bats live or camping without taking precautions to keep wild animals away from your campsite
  • Working in a laboratory with the rabies virus
  • Wounds to the head or neck, which may help the rabies virus travel to your brain more quickly