About Rabies
The disease causes of rabies involve the transmission of the rabies virus through exposure to infected saliva, usually via a bite, scratch, or lick. After an incubation period, the virus moves into the neurological phase, which can happen in two forms:
- Encephalitic (furious) rabies, which affects the brain and causes aggression
- Paralytic (dumb) rabies which causes muscle weakness and paralysis
The exact cause of these forms is not fully understood, but the body's immune response is believed to play a role, with stronger inflammation seen in paralytic rabies cases.
Non-modifiable risk factors of rabies cannot be changed or controlled. These include:
- Acquiring rabies from donated organs (very rare)
Modifiable risk factors of rabies can be influenced or changed. These include:
- Exposure to an infected animal's saliva through bites, scratches, or licks. A person’s risk for rabies can be reduced by avoiding contact with wild or stray animals and vaccinating pets against rabies
Remember, rabies is a serious condition. If you suspect exposure or have been bitten by an animal, seek medical attention immediately.
Common early symptoms of rabies include:
- Itching or tingling around the bite
- Flu-like symptoms such as fatigue, headache, reduced appetite, achy muscles, and nausea
As rabies progresses or becomes more severe, the following symptoms may occur:
- Foaming at the mouth: This happens because the virus affects the nervous system, making swallowing difficult.
- Agitation or difficulty staying still
- Aggression
- Hallucinations (seeing or hearing thing that aren’t real)
- Hydrophobia (fear of water): This is a fear of drinking water due to painful throat spasms caused by the virus.
- Muscle spasms
- Seizures
- Paralysis
- Fever
- Extreme weakness
- Difficulty swallowing
It's important to note that once clinical signs of rabies appear, the disease is nearly always fatal. Treatment is typically supportive. If you suspect you have been exposed to rabies, it is crucial to seek medical attention immediately.
To diagnose rabies, the following examinations, tests, and procedures are commonly performed:
- Physical exam: During this exam, healthcare providers look for signs like difficulty swallowing, excessive drooling, muscle weakness, or neurological symptoms such as confusion, agitation, or paralysis. They also consider your history of exposure to animals. It’s important to monitor the animal for signs of rabies, if possible.
- Direct fluorescent antibody (DFA) test: This test detects the presence of rabies virus antigen in fresh brain tissue using immunofluorescence. It is most commonly performed after death in animals or, in rare cases, through a biopsy in humans.
- Viral RNA detection: RT-PCR (reverse transcriptase polymerase chain reaction) tests, especially real-time versions, can detect the virus’s genetic material (RNA) and are very sensitive tools for diagnosing rabies. These tests can also provide information about the type of virus by analyzing longer pieces of RNA through sequencing.
- Indirect immunofluorescent tests: These use special antibodies called monoclonal antibodies to identify the strain of the rabies virus and provide information about the type of virus.
- Spinal tap: A procedure that collects spinal fluid to test for antibodies or signs of infection in the central nervous system.
Additional examinations, tests, and procedures to determine the severity of rabies may include:
- Imaging studies:
- X-rays may be used to rule out other problems, like bone or structural issues that could cause similar symptoms
- MRI (magnetic resonance imaging) scans look for brain swelling or damage caused by the rabies virus.
It's important to consult with your healthcare provider for specific recommendations based on your individual situation.
The goals of treatment for rabies are to manage the disease process and provide supportive care to the patient. Here are the recommended treatment approaches and their intended outcomes:
- It’s important to clean the bite wound immediately with soap and water. Then, contact a healthcare professional immediately for vaccination and to immunoglobulin treatment (a shot of antibodies to fight the virus right away).
- People in high-risk jobs may need pre-exposure rabies vaccination to protect themselves.
- Neuronal degeneration management: Rabies affects the nervous system, leading to neuronal degeneration (damage to nerve cells, which can affect how the brain and body work). To address this, therapies are used to protect and support nerve cells. These therapies may include neuroprotective agents or interventions that promote nerve cell survival.
- Inflammation management: Rabies triggers an inflammatory response in the body. Controlling inflammation is crucial to minimize tissue damage. Anti-inflammatory medications or treatments may be used to reduce inflammation and its harmful effects.
- Systemic compromise management: Rabies can cause systemic complications, such as organ dysfunction or metabolic imbalances. Therapeutic procedures focus on maintaining organ function and addressing any systemic issues that arise.
- Supportive care: Patients with rabies require comprehensive supportive care to manage symptoms and maintain overall well-being. This includes measures like pain management, hydration, nutritional support, and respiratory support if necessary.
It's important to note that there is currently no specific cure for rabies, but these treatment approaches aim to alleviate symptoms, manage complications, and support the patient's overall health during their illness. Consultation with a healthcare professional is crucial for personalized treatment recommendations.
Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Side effects can occur. Check with your health care professional or read the information provided with your medication for side effect information.