RABIES - The Hows, Whos and Whats

Author: Vienna M Doenni, M. Sc.

Before the rabies vaccine was invented people were so scared of the horrible disease progression that they would end their own lives upon getting bit by a rabies-infected animal. Here we will discuss how can one get infected with the virus, who is at risk and what the rabies virus will do to an infected person or pet.


How can one get infected with the rabies virus?

The first image that comes to mind when thinking about rabies is a wild animal, snapping and trying to bite. And this is not far from the truth; bites are the most common route of infection. The saliva of the infected animal holds the virus and can infect someone else through the broken skin or through mouth or eyes. Less frequent routes are by inhalation, ingestion or through the blood, even from mother to baby.  


Who is most commonly infected?

The most commonly infected animals are skunks, raccoons, foxes, and especially bats. Domestic animals account for a smaller percentage (10%) of rabies-infected animals, however, they are more likely to bite a human and account for 95% of human infections.  The chances of getting in contact with the virus differ from country to country.  Bellow you can find a map from the World Health Organization, to assess your personal risk, depending on your residence or places you visit on vacation.  


What happens upon infection with the rabies virus?

Once bitten by an infected bat, skunk, raccoon or dog the virus infects the nerves around the bite and travels through the nervous system to the brain. Here it causes a severe inflammation called encephalomyelitis. The disease is accompanied by a number of bizarre symptoms:


1)    The area around the bite will start tingling within a few days. 

2)    Upon an infection animals and humans alike may start hypersalivating, this can lead to a build-up of foam in the mouth.

3)    In many cases, people develop so-called “hydrophobia” which is a fear of water; the sound, the idea of drinking it or the mere sight.

4)    One would feel a headache and maybe have a fever at first and then slowly progress to feel agitated and then delirious. People experience extreme anxiety and hallucinations going through the disease progression. Quite often infected will fall into a coma after the delirious state. 


Within 10 days of the first symptoms, most animals (and humans) will die of multiple organ failure as their brainstem function deteriorates. Sometimes, the disease can stay dormant over weeks and even years. However, after displaying symptoms it is very rare that humans and animals survive.


What should I do if a bat bites me?

Now in the US, the recommendation is, if you wake up and there is a bat in your room – get vaccinated. Bats are by far the most frequent transmitters of rabies in Northern America. If you do experience a bite, within 3 hours you have a good shot at averting a crisis. Call your doctor, and then clean the wound with soap and alcohol and get as much of the potential pathogen out. A thorough disinfection of the wound area with 3 hours of the bite will stop close to 100% of the infections. If for whatever reason this window is missed, vaccines can help stop a viral infection if administered on the same day.

Caution for precautions

Since Pasteur and Roux saved a young boy on July 6th, 1885 with their rabies vaccine, the number of deaths in developed countries has decreased to about two per year. Bats are immensely useful creatures and - despite the warning in the US - I would urge not to overreact. Vaccinate your pets, clean wounds and bites and hopefully, the sight of water will remain pleasant for the rest of your life!

September 28, 2017 marks the 11th world rabies day. The goal of the world rabies day is to raise awareness and eliminate death by rabies by the year 2030.  


Sources: NCBI and WHO