Rabies – Causes, Symptoms, Diagnosis and Treatment

Rabies refers to the deadly virus affecting people transmitted from the saliva of an infected animal. The virus spreads to a new host through the saliva. So, the virus is usually spread through the bite or scratch caused by the infected animal. The condition is also referred to as hydrophobia. In developing countries, the disease is spread by stray dogs who bite people and pass the infection. While in developed countries like the USA, foxes, bats, raccoons, coyotes, and skunks spread the infection. When a person starts to show symptoms, it means no chance of curing it. In the majority of cases, people showing signs associated with the infection face death. Due to the seriousness of the disease, health officials’ instruction getting preventive vaccination for protection. Want to know more about the infection? The article offers you information to ensure you can take adequate preventive measures to avoid the dangerous infection.

Virus Triggering Rabies

The infection is caused by the rabies virus, now known as rabies lyssavirus. It is a bullet-shaped, single-stranded virus. The enveloped RNA virus comes under the genus named after the Greek goddess Lyssa. She is the goddess of rage, madness, and frenzy. When you get infected by the virus, it establishes itself in your muscle cells first. It starts to replicate from your muscle cells and produces virions. They are the most active as well as an infectious form of the virus. The virions enter an affected person’s central nervous system (CNS) through acetylcholine. Then, it starts to replicate in the infected person’s motor neurons. So, it reaches the brain of the patient and results in severe complications. After reaching the brain, the virus reaches the salivary gland. Subsequently, the virus is transmitted through an infected person’s saliva.

Symptoms Of Rabies

The viral infection starts affecting a person in stages. People who experience a bite or scratch from an infected animal can go through the following phases:

Incubation period

It is the phase when the rabies virus lays dormant in your body. The virus can remain in the body without causing any symptoms for one to three months. In some cases, people develop symptoms within five days or take more than two years to see any signs. You see signs only when the virus starts affecting your central nervous system. It is observed that the closer the bite occurs to the brain, the sooner you see signs associated with it. By the time you observe the symptoms, the condition becomes fatal. So, anyone who is exposed to the virus needs to seek immediate medical treatment without waiting for the symptoms to appear.

Prodrome

The stage can trigger flu-like symptoms. It is the early stage, leading to signs like:

• Headache
• High fever (100.4 F and above)
• Anxiety
• Nausea
• A general feeling of unwell
• Sore throat
• Cough
• Vomiting
• Discomfort at the site of the bite

The symptoms may persist for two to ten days. It can worsen over time.

Acute Neurologic Period

During the stage, the patient develops neurologic symptoms. The signs include the following:

• Aggression
• Confusion
• Involuntary muscle twitching
• Partial paralysis
• Rigid neck muscles
• Fear of water due to difficulty swallowing
• Convulsions
• Difficulty breathing and hyperventilation
• Insomnia
• Hallucinations
• Fear of light (Photophobia)
• Producing a lot of salivae (Hypersalivation) or frothing at the mouth
• Fear of light (photophobia)
• Inconsistent or rapid breathing

Coma And Death

The patient enters the final and fatal stage by entering a coma. After the stage, death can occur in a matter of hours. So, hospitals can place the patient on the ventilator to prevent death. Patients only recover from the stage rarely.

When To Contact Your Doctor For Rabies

You need to understand the seriousness of the disease. So, seek immediate medical attention after getting bitten or scratched by any animal. You need medical help when you suspected direct contact (exposure) to an infected animal. Your doctor checks your injuries and assesses the situation to ensure you need treatment to prevent hydrophobia. You need to talk to your doctor about your choices and make the right decision.

Even with no conclusive knowledge of rabies virus presence, you need to get medical help. In some cases, people can suffer from bites or scratches while they sleep. You may find the animal in your room. But, have no knowledge of getting bitten. In such cases, you need to talk to your doctor. It is also important to get medical help when you find mammals causing the transmission of the virus near a disabled person or small child. So, you need to take steps thinking you have a virus in your body. It helps get prompt medical attention and avoid any severe complications.

Causes Of Rabies

Hydrophobia occurs due to the infection caused by the rabies virus. The virus transmits from an infected animal through its saliva. So, when you come in contact with the saliva of the infected animal, you get the infection. It is usually spread when the infected animal bites or scratches another animal/person. In rare cases, it is noted that the infection also spreads when infected saliva from the animal gets into an open wound or mucous membranes. So, it can transmit through infected saliva coming in contact with eyes or mouth. It commonly occurs when the infected animal licks an open cut on an individual’s skin.

Animal Transmitting Rabies Virus

Lyssavirus In Bats

Any animal of the mammal category (the animals suckling the young) transmits the virus. So, the animals most likely transmit the deadly virus include:

• Pets And Farm Animals
• Cows
• Dogs
• Cats
• Horses
• Goats
• Wild Animals
• Coyotes
• Bats
• Beavers
• Foxes
• Raccoons
• Monkeys
• Woodchucks
• Skunks
• In rare cases, recipients receiving tissue and organ transplant from an infected person can suffer from the infection. It is because the rabies virus infects the organ.

Common Rabies Transmission Mode

A dog bite is the common transmission of the virus. The disease is prevalent in countries with a large number of stray dogs. So, hydrophobia is common in countries of Africa and Asia. When the infected dog bites a person, the virus gets transmitted through the saliva into the body. An open wound or mucous membrane is a common way for the virus to get inside the body. The virus cannot pass through unbroken skin. In countries like the US, the following animals spread the disease:

• Bats
• Raccoons
• Skunks
• Coyotes
• Foxes

While any mammal can harbor and transmit the virus, smaller animals may not do so. So, animals like rodents rarely become infected or transmit the virus. Rabbits are unlikely to spread the virus to others.

Risk Factors Associated With Rabies

Not everyone faces the risk of hydrophobia. The risk of getting infected by the virus increases when you experience the following factors:

• Make a trip or live in developing countries in Africa and Southeast Asia
• You indulge in activities putting in direct contact with wild animals suffering from the infection. So, people who go hiking or camping in the wild without any precautions to keep wild animals away from the campsite or explore caves with bat habitat are at risk.
• Work in a laboratory with a high risk of coming in contact with the rabies virus.
• Suffer wounds to the neck or head, which aids the traveling of the virus to the brain quickly.

Rabies Virus And Fear Of Water

Rabies is also known as hydrophobia because it appears to cause a fear of water. The virus can cause muscle paralysis. So, it causes immense pain to the patient when they try to swallow fluids. The inability to swallow saliva due to paralysis of the associated muscle can result in fear. So, even the thought of swallowing can invoke great fear in the infected people. The intense muscle spasm leads to hydrophobia. You may have observed the infected individuals drooling. It is because the virus affects the nervous system. So, it leads to excess saliva production. If the infected people can swallow with ease, then it reduces the risk of spreading the virus. Unfortunately, it is not the case.

Diagnosing Rabies

When you get bitten or scratched by an animal, you have no idea if the animal has transmitted the dangerous virus to you. If your pet or farm animal bites, you then your doctor can detect the presence of the virus in the animals

Diagnosis Of Rabies In Animals

The common detection method involves checking for the virus from any part of the affected brain. But, to rule out the condition, the doctors require tissue from two locations in the brain. Cerebellum and the brain stem are the most favored parts for detecting the virus’s presence. To conduct the test, the veterinarian euthanizes the affected animal. The test may take only a few hours. But, it requires more time to remove the sample from the brain and send it for testing. To detect the problem, the technicians send the sample to the veterinary diagnostic laboratory or state public health.

Diagnosis In Humans

To detect the virus’s presence in humans, your doctor suggests different tests. Ante-mortem testing involves the use of several techniques. A single test alone is not sufficient to detect viral infections. So, your doctor can test the following:

• Testing saliva to detect the virus using reverse transcription or virus isolation followed by RT-PCR (polymerase chain reaction).
• Your doctor takes samples of hair follicles at the nape of the neck to detect the presence of the rabies virus. Skin biopsies can reveal the presence of the viral antigen in the hair follicle’s cutaneous base.
• Test serum and spinal fluid in the laboratory for the presence of antibodies of the virus.
• Technicians examine the skin biopsy specimens for rabies antigen in the cutaneous nerves at the base of hair follicles.

Since the tests can take more time for revealing the presence of the virus, your doctor starts the therapy by thinking you have hydrophobia. So, your doctor starts treatment like you have the infection due to the virus.

Treatment For Rabies

No effective treatment is available once you get diagnosed with the condition. Once you develop symptoms, it can end in fatality. But, a small number of people have survived hydrophobia. But, the result of the condition is death. So, if you doubt about exposure, then you need to take steps to prevent it from getting infected.

Immediate Care After Getting Bitten/ Scratched

If you get scratched or bitten by any animal with no evidence of rabies or see the animal licks an open wound, then you need to wash the area scratched or bitten with water. Use soap, detergent or povidone-iodine to wash the wound. It minimizes the number of viral particles. See a doctor immediately to prevent any further complications.

Treatment When Bitten By Animals With Rabies

For people who have received a scratch or bite from animals with a known case of rabies, you need to see a doctor immediately. You receive a series of shots to prevent the virus from infecting. If you are unable to find the animal that caused the bite or scratch, then your doctor starts treatment assuming it has the virus. But, your doctor takes the decision after considering the type of animal and the circumstances pertaining to the bite or scratch. The immediate strategies adopted by healthcare professionals include:

Get Fasting Acting Shot

You get an effective and fast-acting shot of rabies immune globulin. It prevents the virus from infecting your body. Your doctor provides a part of the injection near the area of scratch or bite. If possible, it is given immediately after getting the bite.

Series Of Vaccine

Your doctor provides a series of vaccination. It is to aid your body in identifying and fighting the virus. Doctors inject vaccinations in the form of injections. You get four injections on your arm over a period of fourteen days.

Detecting Rabies In Animals

In some cases, you can determine if the animal causing the bite has the neurotropic virus. It is beneficial when before you start the series of shots. So, if you eliminate the viral infection in the animals, you never need the shots. The detection methods vary by situation. So, the procedure to determine the infection status of the animals are:

Pets And Farm Animals

If your farm or pet animals bite or scratch you, then you can observe it for ten days to see signs of the virus. The method is ideal to detect virus ferrets, dogs, and cats. A normal-appearing animal means it is healthy. So, you never need the shots. Other pets, as well as farm animals, need thorough checking for detecting the virus on a case-by-case basis. You need to talk to your doctor and local public health officials to check the necessity for the shots.

Wild Animals Easy To Catch

You can find and capture wild animals to test for the virus. The method is ideal for animals like the bat that come into your home. After killing it, the technicians can test the animal’s brain to reveal the virus’s presence. The absence of the virus means no need to take shots.

Wild Animals Difficult To Catch

Some wild animals are difficult to find. So, if you face such an issue, then you need to discuss the particular condition with your doctor as well as the local health department. So, your doctor safely assumes it is a rabid animal and starts the shots. In other cases, the chances of the animal suffering from the virus are low. So, you may not require shots.

Preventing Rabies

To reduce hydrophobia, you need to avoid coming in contact with rabid animals. So, follow the steps suggested below to avoid the problem:

Vaccinate Pets

You need to vaccinate your pets like dogs, cats, and ferrets to protect them from the virus. So, follow the instructions from your veterinarian on how often the pets need vaccination.

Preventive Vaccination For People

Doctors recommend human vaccination for people who come in close contact with the virus. Pre-exposure immunization is recommended for people in high-risk occupations like laboratory workers handling live rabies virus or lyssavirus. People who work as wildlife rangers or animal disease control staff. So, people whose professional or personal activities that bring them in contact with the virus (infected carnivores, bats, or other mammals) need the vaccination.

Confine Your Pets

You need to restrict the roaming of your pets. Try to keep them inside and supervise when they venture outside. It will restrict pets from coming in contact with wild animals.

Keep The Pets From Predators

Protect your small pets from predatory animals. So, you need to keep small animals like rabbits, guinea pigs or others by keeping them inside a protected cage. It will keep the animals safe from wild animals. Since you cannot vaccinate small animals, it is better to take the necessary precautions.

Report Stray Animals

You need to report to local authorities about the stray animals. It is important to report about the stray dogs and cats to the local animal control officials or other law enforcement in your locality.

Never Approach Wild Animals

Wild animals affected by the virus never seem afraid of people. It is not normal for wild animals to become friendly with people. Therefore, you need to stay away from the unafraid animal.

Keeps Bat Away

You need to keep bats away from home by sealing any gaps and cracks. It will avoid any chance of the animals getting into your home. If you have a bat habitat in your home or near it, then contact a professional expert to keep them away.

Vaccination Before Traveling

You need to consider getting the vaccination before traveling. You need to get vaccination when you go to a region suffering from hydrophobia. It is necessary when you are planning to stay for an extended period. You can consult with your doctor about the vaccination. You must also get the vaccination when you travel to remote areas with difficulty to get medical care.

Awareness of Rabies

Educating people on animal behavior, especially dog behavior can help prevent a bite. It is also important to spread awareness regarding the pre-exposure vaccination program. It can decrease the incidents of hydrophobia and the financial burden associated with treating animal bites. The awareness program covers the following topics:

• Educating and informing people about responsible pet ownership
• The necessary steps needed to prevent animal bites, especially dog bites
• Immediate aftercare measures needed after you suffer from animal bites

It is important to include key people in the program to ensure the engagement of people at the community level. So, more and more people can become aware of the program and uptake key messages.

Conclusion

Rabies is a neglected but dangerous tropical disease. It is prevalent among the vulnerable and poor populations who live in remote locations. While effective vaccination and immunoglobulins exist for managing severe complications associated with the condition, it is not readily accessible to people in need. Sustainable and a wide-spread anti-rabies programs are the key to preventing and overcoming the condition in rural areas. Government agencies need to engage in such a program to ensure its success. Affected communities can get results from the local programs and stimulus packages and prevent life-threatening complications.

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