Rabies is almost always fatal once symptoms start, but it can be prevented with prompt post-exposure vaccination. Seek medical care immediately after a bite from a suspect animal.
Course
Rabies is almost always fatal once symptoms appear. Early signs are fever, headache and tingling at the bite. Later come confusion, hydrophobia and paralysis.
Prevention
Wash the wound with soap for 15 minutes, then get post-exposure prophylaxis: rabies immune globulin and 4 vaccine doses over 14 days.
Time
Treatment works when given before symptoms start.
Cases
About 59,000 people die of rabies every year worldwide. Few cases occur in the US, about 1 to 3 a year.
Symptoms timeline
The incubation period is usually 1 to 3 months but can range from days to over a year. Early signs are fever, headache, weakness and tingling or itching at the bite site. Later symptoms include anxiety, confusion, agitation, hallucinations, excess salivation and difficulty swallowing, with fear of water (hydrophobia).
Outcome
Once symptoms appear, rabies is almost always fatal. Fewer than 20 people worldwide have been documented to survive symptomatic rabies, often with intensive care.
How it spreads
The virus spreads in saliva through bites or scratches from infected animals. In the US, bats are the most common source, followed by raccoons, skunks and foxes. Worldwide, dogs cause about 99% of human cases, according to the WHO.
Burden
Rabies kills about 59,000 people each year worldwide, mostly in Asia and Africa, and many victims are children.
Post-exposure prophylaxis
If bitten, wash the wound with soap and water for 15 minutes and seek medical care immediately. Treatment is rabies immune globulin and a series of vaccine doses (four doses over 14 days in the US). It is nearly 100% effective if given before symptoms.
Pre-exposure vaccine
Recommended for veterinarians, lab workers, cave explorers and travelers to areas with canine rabies.
US cases
The US reports 1 to 3 human cases per year, according to the CDC. Most are due to bat exposures, sometimes unnoticed.
Pets
Vaccinate dogs, cats and ferrets. Keep distance from wildlife, and contact animal control for animals acting strangely.
Bats
If you wake up with a bat in your room, seek advice from health officials even without a visible bite.
Global burden and prevention
Rabies kills an estimated 59,000 people every year worldwide, according to the World Health Organization, and about 99 percent of human cases are caused by dog bites, mostly in Asia and Africa. In the US, 1 to 3 human cases occur each year, often from bats. The virus travels along nerves to the brain, and the incubation period is typically 1 to 3 months but can range from days to over a year. Once symptoms such as agitation, fear of water, hallucinations and paralysis appear, the disease is almost always fatal, with only a handful of known survivors.
Post exposure treatment
After a bite or contact with saliva from a suspect animal, wash the wound with soap and water for at least 15 minutes and seek care immediately. Post exposure prophylaxis includes rabies immune globulin and a series of four vaccine doses on days 0, 3, 7 and 14 for people not previously vaccinated, and it is nearly 100 percent effective if started promptly. Pre exposure vaccination is advised for veterinarians, lab workers and some travelers. Vaccinating pets, avoiding wild animals and not touching bats help prevent infection. Report any bat found in a room with a sleeping person, since bites can go unnoticed.
Based on data from the World Health Organization and the CDC
