|SSM Cardinal Glennon Children's Medical Center|
Rabies infections in people are rare in the United States. However, worldwide about 50,000 people die from rabies each year, mostly in developing countries where programs for vaccinating dogs against rabies don't exist. But the good news is that problems can be prevented if the exposed person receives treatment before symptoms of the infection develop.
Rabies is a virus that in the U.S. is usually transmitted by a bite from a wild infected animal, such as a bat, raccoon, skunk, or fox. If a bite from a rabid animal goes untreated and rabies develops, it is almost always fatal.
If you suspect that your child has been bitten by a rabid animal, go to the emergency department immediately. Any animal bites — even those that don't involve rabies — can lead to infections and other medical problems. As a precaution, call your doctor any time your child has been bitten.
About 7,000 cases of rabies in animals are reported each year to the Centers for Disease Control and Prevention (CDC). Raccoons are the most common carriers of rabies in the United States, but bats are most likely to infect people. Almost three quarters of rabies cases between 1990 and 2001 came from contact with bats.
Skunks and foxes also can be infected with rabies, and a few cases have been reported in wolves, coyotes, bobcats, and ferrets. Small rodents such as hamsters, squirrels, chipmunks, mice, and rabbits are very rarely infected with the virus.
Because of widespread vaccination programs in the United States, transmission from dogs to people is very rare. Outside the United States, exposure to rabid dogs is the most common cause of transmission to humans.
An infected animal has the rabies virus in its saliva and can transmit it to a person through biting. In rarer cases, an animal can spread the virus when its saliva comes in contact with a person's mucous membranes (moist skin surfaces, like the mouth or inner eyelids) or broken skin such as a cut, scratch, bruise, or open wound.
After a bite, the rabies virus can spread into surrounding muscle, then travel up nearby nerves to the brain. Once the virus reaches the brain, the infection is fatal in almost all cases.
Signs and Symptoms
The first symptoms can appear from a few days to more than a year after the bite occurs.
One of the most distinctive signs of a rabies infection is a tingling or twitching sensation around the area of the animal bite. It is often accompanied by a fever, headache, muscle aches, loss of appetite, nausea, and fatigue.
As the infection progresses, someone infected with rabies may develop any of these symptoms:
In the advanced stage of the infection, as it spreads to other parts of the nervous system, these symptoms may develop:
If Your Child Is Bitten by an Animal
If your child has been bitten by an animal, take the following steps right away:
At the hospital, it is likely that the doctor will first clean the wound thoroughly and make sure that your child's tetanus immunizations are current.
To keep any potential infection from spreading, the doctor may decide to start treating your child right away with shots of human rabies immune globulin to the wound site and vaccine shots in the arm. This decision is usually based on the circumstances of the bite (provoked or unprovoked), the type of animal (species, wild or domestic), the animal's health history (vaccinated or not), and the recommendations of local health authorities.
You can reduce the chances that your family is exposed to rabies. Vaccinate your pets — dogs, cats, and ferrets can be infected by rabies. Report any stray animals to your local health authorities or animal-control officer. Remind kids that animals can be "strangers," too. They should never touch or feed stray cats or dogs wandering in the neighborhood or elsewhere.
As a precaution against rabies, call your doctor if:
Reviewed by: Nicole A. Green, MD