Overview

Rabies is a deadly virus spread to people from the saliva of infected animals. The rabies virus is usually transmitted through a bite.

Animals most likely to transmit rabies in the United States include bats, coyotes, foxes, raccoons and skunks. In developing countries of Africa and Southeast Asia, stray dogs are the most likely to spread rabies to people.

Once a person begins showing signs and symptoms of rabies, the disease is nearly always fatal. For this reason, anyone who may have a risk of contracting rabies should receive rabies vaccines for protection.

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

Prevention

To reduce your risk of coming in contact with rabid animals:

  • Vaccinate your pets. Cats, dogs and ferrets can be vaccinated against rabies. Ask your veterinarian how often your pets should be vaccinated.
  • Keep your pets confined. Keep your pets inside and supervise them when outside. This will help keep your pets from coming in contact with wild animals.
  • Protect small pets from predators. Keep rabbits and other small pets, such as guinea pigs, inside or in protected cages so that they are safe from wild animals. These small pets can't be vaccinated against rabies.
  • Report stray animals to local authorities. Call your local animal control officials or other local law enforcement to report stray dogs and cats.
  • Don't approach wild animals. Wild animals with rabies may seem unafraid of people. It's not normal for a wild animal to be friendly with people, so stay away from any animal that seems unafraid.
  • Keep bats out of your home. Seal any cracks and gaps where bats can enter your home. If you know you have bats in your home, work with a local expert to find ways to keep bats out.
  • Consider the rabies vaccine if you're traveling. If you're traveling to a country where rabies is common and you'll be there for an extended period of time, ask your doctor whether you should receive the rabies vaccine.

    This includes traveling to remote areas where medical care is difficult to find.

Nov. 04, 2016
References
  1. Ferri FF. Rabies. In: Ferri's Clinical Advisor 2017. Philadelphia, Pa.: Elsevier; 2017. https://www.clinicalkey.com. Accessed Aug. 24, 2016.
  2. Longo DL, et al., eds. Rabies and other rhabdovirus infections. In: Harrison's Principles of Internal Medicine. 19th ed. New York, N.Y.: McGraw-Hill Education; 2015. http://accessmedicine.com. Accessed Aug. 24, 2016.
  3. AskMayoExpert. Rabies. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2015.
  4. Rabies. Centers for Disease Control and Prevention. http://www.cdc.gov/rabies/. Accessed Aug. 24, 2016.
  5. Papadakis MA, et al., eds. Viral and rickettsial infections. In: Current Medical Diagnosis & Treatment 2017. 56th ed. New York, N.Y.: The McGraw-Hill Companies; 2017. http://www.accessmedicine.com. Accessed Aug. 24, 2016.
  6. Rabies vaccine information statements. Centers for Disease Control and Prevention. http://www.cdc.gov/vaccines/hcp/vis/vis-statements/rabies.html. Accessed Aug. 24, 2016.