Rabies

Rabies : What it is, Causes, Symptoms, Diagnosis and Treatment

Rabies is a serious viral disease that affects the central nervous system of humans and animals. It is caused by the virus, which is usually transmitted through the bite of an infected animal. It is a zoonotic disease, meaning it can be transmitted from animals to humans.

Rabies virus transmitted by infected saliva through bite of wound

Rabies virus is transmitted by infected saliva throgh bite or wound

  • Rabies spreads through saliva from infected animals, usually via bites.
  • Common carriers of rabies in the U.S. include bats, coyotes, foxes, raccoons, and skunks.
  • In developing countries, stray dogs are major transmitters.
  • As symptoms appear, it almost always leads to death.
How rabies travels

You usually have no symptoms of rabies for several weeks after it enters your body. When it makes to your central nervous system (prodromal phase), then you experience flu-like symptoms. Finally, you have neurological (brain) symptoms.

Sign and symptoms of rabies
  1. Normally early symptoms resemble the flufever, headache, nausea, and vomiting.
  2. Later signs include:
    • Agitation, anxiety, confusion.
    • Hyperactivity, difficulty swallowing.
    • Excessive salivation.
    • Fear of drinking due to swallowing difficulties.
    • Hallucinations, insomnia, partial paralysis.
  3. Stages of Infection:
    • Incubation: No symptoms; treatment during this phase prevents rabies.
    • Prodromal: Flu-like symptoms; nerve damage near the bite site.
    • Acute Neurologic: Furious (aggression, seizures) or paralytic (progressive weakness).
    • Coma: Final stage leading to death
Incubation period
Incubation:

Rabies virus can spend days to weeks in your body before it gets into your nervous system (incubation). You don’t have any symptoms during this time. If you receive treatment early in the incubation period, you won’t get it.

Prodromal phase

Normally RABV travels through your nerve cells into your brain and spinal cord, causing nerve damage as it goes. The prodromal phase starts when the rabies virus has entered your nervous system. Your immune system tries to fight back, causing flu-like symptoms. Nerve damage might cause tingling, you may feel pain or numbness at bite place. This lasts two to 10 days. There aren’t any effective treatments when it reaches this phase.

Acute neurologic phase

In this phase, the virus starts damaging your brain and spinal cord. About two-thirds of people have furious rabies, with symptoms like aggression, seizures and delirium. Others have paralytic rabies, with weakness and paralysis progressing from the bite wound to the rest of their body.

Coma

Many people enter a coma in the final stages of this infection. Rabies eventually leads to death.

Unlike most illnesses, you shouldn’t wait for symptoms to diagnose it. In case you get a bite or or scratch by a wild animal or a pet that might have rabies, talk to your healthcare provider right away. They’ll examine your wound and ask questions to determine whether there is a need of treatment. They may test for signs of rabies.

Tests for rabies might include:

Saliva test:

You’ll spit into a tube and your medical provider will send it to a lab to look for signs of rabies

Skin biopsy:

Your provider will take a small sample of skin from the back and send it to a lab to look for signs of rabies.

Cerebrospinal fluid test (lumbar puncture):

Your provider will use a needle to take a cerebrospinal fluid (CSF) from your lower back and send it to a lab to look for signs of rabies.

Blood tests:

Your provider will use a needle to take blood from your arm and they will send your blood to a lab to look for signs of rabies.

MRI:

You’ll lie in a machine that takes pictures of your brain. Your provider will use the pictures to help determine what’s causing your symptoms.

4.Management and Treatment

There’s no approved treatment for rabies once you have symptoms. If you’ve been exposed to it (were bitten by or been in contact with an infected animal), contact a healthcare provider as soon as possible.

Clean the wound gently but thoroughly with soap and water. Ask your provider for additional instructions on cleaning the wound.

Your provider will give you a series of shots (vaccinations) to prevent the virus from causing rabies. They’ll also give you an antibody treatment directly to the wound if you are not vaccinated before.

5.Medication

Medications prevent an infection from traveling to your brain if you’ve been exposed to rabies (post-exposure prophylaxis/PEP). These medications are often combined:

Rabies vaccine. Your healthcare provider will give you four shots over 14 days. Even if you’ve already been vaccinated before exposure, yet you’ll need two shots. The vaccine teaches your body to destroy the virus before it enters your brain.

Human rabies immune globulin (HRIG). Your provider will give you shots around the wound. HRIG gives you antibodies (molecules that fight infection) that will destroy the virus near the wound until your body takes over. You shouldn’t get HRIG if you’ve been vaccinated before your exposure.

6.Side effects of treatment

You might have mild side effects of vaccines, including:

Pain, itching or swelling where you received the shots.

Nausea.

Headache.

Muscle pain.

Dizziness.

What should I do if I’ve been bitten by an animal?

Firstly, wash the wound right away with soap and water. Secondly, use a 10% povidone-iodine solution if available.

Why is there no cure for rabies?

There’s no cure for rabies once it’s moved to your brain because it’s protected by your blood-brain barrier.

Your blood-brain barrier is a layer between your brain and the blood vessels in your head. Its job is to protect your brain by keeping toxins and other dangerous substances from getting into your brain from your blood. It’s like a very fine strainer.

Further, researchers aren’t sure how, but rabies locks this barrier down even further, so medications that might destroy it can’t get through.

7. Prevention

As rabies is preventable, so keep your pets safe and stay away from wild animals Obviously, this will help prevent you from being exposed to it. If you’re exposed, you can get a vaccine to prevent it before symptoms start.

Further, make sure your pets’ vaccinations are up-to-date. This includes dogs, cats and ferrets.

Furthermore, don’t let your pets roam free without supervision.

As a precautionary measure, leave wildlife alone and don’t touch injured animals or try to capture animals yourself.

If you find a bat in a room where someone was sleeping, assume they’ve been bitten, because bat bites are small and fade quickly, so you might not notice them. Further, contact a healthcare provider right away.

If you’re bitten or scratched by a wild animal or have been exposed to rabies in some other way, contact a healthcare provider as soon as possible.

If you’re at high risk for being exposed to rabies, it’s recommended that you get vaccinated on a regular basis (pre-exposure prophylaxis/PREP).

8. Pre-exposure prophylaxis (PREP)

If you’re at higher risk for rabies, you may get vaccine before exposure based on the recommendations of your local health authority. This is called pre-exposure prophylaxis (PREP) and it’s a series of two shots. How frequently you need boosters depends on how high your risk of exposure is.

You’re usually at higher risk for rabies if you:

Work with wildlife or domestic animals (this includes veterinarians, veterinary technicians, wildlife biologists, animal control officers and others).

Are around bats or in caves often.

Work in a lab where you handle virus.

Travel to areas where rabies is common in dogs.

9. Conclusion

In conclusion, rabies is a serious and potentially fatal disease and you may prevent it through vaccination and prompt medical treatment. It is important to be aware of the causes, symptoms, diagnosis, and treatment of it to protect yourself and your loved ones from this deadly virus.

In short, remember to take precautions when interacting with animals and seek medical attention, if you suspect you may have exposure to rabies. Stay safe and stay informed about rabies and other preventable diseases.

Link: https://my.clevelandclinic.org/health/diseases/13848-rabies


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