Understanding Rabies: How People Get It and What to Do After Exposure

Rabies is a viral disease that affects the central nervous system. Once symptoms appear, it is almost always fatal, making prevention and prompt treatment vital. This guide explains how rabies spreads, what to do if you’re exposed, and practical steps to protect yourself and loved ones.

How Rabies Spreads

Rabies virus is carried in the saliva of infected animals. People most often get rabies through:

• Animal bites
  Bites from mammals such as dogs, bats, raccoons, skunks, foxes, cats and livestock can introduce the virus directly into the body.

• Scratches or open wounds
  Even minor scratches or abrasions contaminated with infected saliva may transmit the virus.

• Mucous membrane contact
  Rabid saliva splashed into the eyes, nose or mouth (for example, when handling a wild animal) can lead to infection.

• Aerosol exposure
  Rarely, inhaling virus-laden droplets in bat-infested caves has caused infection in spelunkers and lab workers.

• Organ or tissue transplantation
  In very rare cases, rabies has been transmitted through infected tissues.

High-Risk Animals

• Bats (small bites can go unnoticed)
• Wild carnivores (raccoons, skunks, foxes, wolves)
• Unvaccinated domestic dogs and cats in areas where rabies is common
• Livestock (cattle, horses, goats) when in contact with rabid wildlife

Recognizing Potential Exposure

Any of these scenarios warrants immediate attention:

1. You are bitten or scratched by an animal behaving strangely (e.g., unprovoked aggression, paralysis, disorientation).
2. You find a bat in your living space, especially if you were sleeping or intoxicated.
3. You are exposed to animal saliva on broken skin or mucous membranes.

Even if you cannot identify the animal, assume risk and seek medical advice.

Immediate Steps After Possible Exposure

Time is critical. Acting quickly can prevent the virus from reaching the central nervous system.

1. Wash the wound

   • Use running water and soap for at least 15 minutes.
   • Apply a disinfectant (povidone-iodine or alcohol-based solution) if available.

2. Control bleeding

   • Gently apply pressure with a clean cloth.
   • Avoid tourniquets or deep probing.

3. Seek medical care right away

   • Any bite or scratch from a potentially rabid animal should be evaluated.
   • Even minor wounds warrant professional assessment.

4. Report the incident

   • Contact local public health authorities or animal control.
   • If possible, safely capture or observe the animal without risk to yourself.

Post-Exposure Prophylaxis (PEP)

PEP is nearly 100% effective when started promptly. It involves:

• Rabies immune globulin (RIG)
  Provides immediate antibodies.
  • Administered once, infiltrated around the wound and injected intramuscularly.

• Rabies vaccine series
  Triggers the body’s own antibody response.
  • Four doses given over 14 days (days 0, 3, 7 and 14).
  • A fifth dose on day 28 for immunocompromised people.

Key Points About PEP

• Start within 24 hours of exposure when possible.
• Do not delay for laboratory confirmation of animal rabies.
• Complete the entire vaccine series even if wounds heal.
• Inform your healthcare provider of any allergies or immune problems.

Preventive Measures

Pre-Exposure Prophylaxis (PrEP)

Recommended for:

• Veterinarians, animal handlers, wildlife researchers
• Travellers to areas with limited access to medical care
• Cave explorers (potential bat exposure)
• Laboratory personnel working with live rabies virus

PrEP involves three vaccine doses (days 0, 7 and 21 or 28). Blood testing for antibody levels may be advised for ongoing risk.

Vaccination of Pets and Livestock

• Dogs, cats, ferrets: Follow local vaccination schedules.
• Livestock: Vaccinate in regions where rabies is common among wildlife.

Safe Animal Practices

• Avoid contact with unfamiliar or wild animals.
• Never handle sick or orphaned wildlife.
• Keep pets on leashes and supervise outdoor activities.
• Use gloves and protective gear when handling animals or cleaning up after them.

Recognizing Rabies Symptoms

Symptoms can take weeks to months to appear. Early signs resemble a flu-like illness:

• Fever, headache, fatigue
• Discomfort or tingling at the bite site

Later symptoms indicate central nervous system involvement:

• Agitation, confusion, hallucinations
• Excessive salivation, difficulty swallowing (“hydrophobia”)
• Muscle spasms, paralysis

Once neurological signs develop, rabies is almost always fatal within days. This underscores the importance of PEP before symptoms start.

When to Use a Symptom Checker

If you’re unsure whether your bite or symptoms warrant immediate medical care, consider a free, online symptom check, using the doctor approved Ubie Symptom Checker. It can help you weigh your risk and decide on the next steps. For serious or life-threatening situations, always seek in-person medical attention.

Aftercare and Monitoring

• Attend all follow-up vaccine appointments.
• Watch the wound for signs of infection (redness, swelling, pus).
• Report any new symptoms—especially neurological changes—to your healthcare provider immediately.
• Keep records of your rabies vaccinations for future reference.

When to Speak to a Doctor

• Any bite, scratch or saliva exposure from a wild or unvaccinated animal
• Development of fever, headache or neurological symptoms after animal contact
• Difficulty accessing immunoglobulin or rabies vaccine in your area
• Concerns about allergies or immunocompromised status affecting PEP

Always err on the side of caution. Rabies is preventable, but once symptoms appear, treatment options are extremely limited.

Final Thoughts

Rabies remains a global health concern, but knowledge and swift action can stop the virus in its tracks. Remember to:

• Wash wounds immediately
• Seek medical evaluation for any potential exposure
• Complete the full post-exposure vaccine series
• Keep pets and livestock vaccinated

If you ever face uncertainty about your risk or symptoms, you might consider a free, online symptom check, using the doctor approved Ubie Symptom Checker. Above all, speak to a doctor about anything that could be life threatening or serious. Vigilance and prompt care are your best defenses against rabies.