What is rabies?

Rabies is an infection caused by a virus. It affects the brain and spinal cord (central nervous system) of mammals, including humans. It is nearly always deadly if not treated before symptoms appear.

Animals that are infected with rabies—rabid animals—can spread the disease through their saliva.

Bats are the most likely to infect people in North America. Raccoons, skunks, foxes, and coyotes can also spread rabies to people or can give it to pet dogs and cats. Rabies in dogs is still the most common source in many developing countries.

Rabies is not spread from person to person.

What causes it?

People usually get rabies when a rabid animal bites or scratches them. Bats, raccoons, skunks, foxes, and coyotes are the animals most likely to have rabies in the U.S. and Canada, but people are most likely to get rabies from bats. People in many developing countries are most likely to get rabies from dog bites.

Small mammals such as mice and squirrels almost never have rabies.

Sometimes the rabies virus can spread to pets, such as dogs, cats, and ferrets. But household pets rarely get rabies, because most of them get rabies vaccines. Pets that stay indoors are very unlikely to get rabies.

It's possible to get rabies even when you don't see an animal bite or scratch. For example, bat bites or scratches may be so small that you don't notice them. If you or your children come in direct contact with a bat, or if you find a bat in a closed room with a sleeping person, contact your doctor right away. The doctor can advise you on what to do next.

What are the symptoms?

Rabies in humans begins with flu-like symptoms such as fever, headache, or weakness. There may also be pain or itching at the site of the bite or scratch. Later, symptoms become more serious and can include anxiety, confusion, hallucinations, and seizures. The final stage is coma and death.

The time from exposure to the virus until symptoms appear usually is several weeks to several months. People who believe they may have been exposed to the rabies virus should get medical care right away.

How is rabies treated?

The treatment for someone who has been exposed to rabies is a series of shots known as postexposure prophylaxis (PEP). These shots help the body's immune system destroy the disease in its early stages. Getting PEP before symptoms appear usually prevents infection, and you are likely to recover.

If you think you've been exposed to the rabies virus, it's very important to get medical care right away. Rabies is nearly always fatal if not treated before symptoms appear.

In the U.S. and Canada, PEP has two parts:

• A shot of human antibodies against rabies, called human rabies immunoglobulin (HRIG)
• The rabies vaccination series, with the first shot given at the same time as HRIG antibodies

What should you do if you think you have rabies?

First, wash the animal bite, scratch, or open sore with soap and water. Then contact your doctor right away. They can advise you on what to do next. You'll likely need a series of shots called postexposure prophylaxis (PEP). Rabies is nearly always fatal if not treated before symptoms appear.

How can you prevent it?

To avoid contact with the rabies virus:

• Have pet dogs, cats, and ferrets vaccinated against rabies. (If you aren't the first owner of your pet, ask for a certificate of rabies vaccination. If no document exists, confirm with the pet's veterinarian that the pet got the vaccine.)
• Avoid contact with stray dogs, especially in countries where rabies is a risk.
• Avoid contact with animals that are likely to have rabies. And teach your children to avoid these animals too. These animals include bats, raccoons, skunks, foxes, and coyotes.
  • Signs of rabies in animals may include excessive saliva or sometimes foaming at the mouth and paralysis. A pet with rabies also may behave differently than usual, such as acting shy when the pet usually is friendly. A wild animal with rabies may have no fear of humans.
• Make sure garbage and other items that attract animals are in closed containers that animals can't open.
• Secure open areas of your home, such as pet doors, chimneys, unscreened windows, or any place that wild or stray animals could enter.
• Never handle a dead animal without protecting yourself with thick gloves and other protective gear. Avoid any contact with its body fluids or brain tissue.

Preventive rabies vaccination may be recommended if you are at high risk of exposure because of your work or hobbies. It may also be recommended if you plan to travel in areas where rabies is a risk, such as parts of Asia, Africa, and Central and South America. Contact your doctor or local public health department for more information.