Here's some more info.
Rabies
What is it?
Rabies is a viral infection of the central nervous system, which means it affects the brain, spinal cord, and their surrounding membranes. A person with rabies has difficulty drinking because the salivary glands are also affected. For this reason, rabies is sometimes referred to as hydrophobia, which means fear of water.
Who gets it?
Anyone who is bitten by an animal infected with the rabies virus can get rabies. People whose work involves frequent contact with wildlife or domestic animals that are not immunized are at a greater risk for getting rabies. These include veterinarians, animal trainers, animal exterminators, farm workers, ranchers, forest rangers, and cave explorers.
What causes it?
Rabies is caused by the rod- or bullet-shaped Rhabdoviridae. People are infected with this virus when bitten by an infected animal. The virus spreads from the saliva of the animal, along the nerves, to the spinal cord and brain (the central nervous system). It multiplies in the central nervous system, and then travels down nerves to the salivary glands and into the saliva. While most cases of rabies are transmitted by a bite from an infected animal, it can also be transmitted if the infected animal licks you around an open wound, or mucous membranes such as the eyes, nose, or mouth. It is also believed that the virus can be gotten by breathing the infected air in a bat-infested cave. Because of the widespread use of the rabies vaccine for pets in the United States, today most cases of rabies are transmitted by wild animals such as bats, foxes, raccoons, skunks, coyotes, and wolves.
What are the symptoms?
The rabies virus can cause no symptoms for weeks to months after infection as the virus works its way to the brain. Symptoms usually begin within 30 to 50 days after infection. Early symptoms are similar to a cold or flu, and include muscle pain, headache, fever, nausea and vomiting, diarrhea, and restlessness. However, as brain function is affected, the symptoms quickly worsen to include uncontrollable excitement; loss of muscle control and other bodily functions; muscle spasms or paralysis, usually beginning in the lower legs; agitation and irritability; depression; and confusion. When the virus affects the nerves of the salivary glands, it causes painful spasms of the throat and voice box. Trying to take a drink of water can trigger these spasms, so a person with rabies may not be able to drink. The infected salivary glands also produce too much saliva, which causes the appearance of foaming around the mouth that is characteristic of rabies. Severe symptoms are followed by coma and death, usually within 3 to 20 days of the onset of these symptoms.
How is it diagnosed?
Because rabies must be treated before the infection reaches the brain, a time during which the patient is symptom-free, it's important to act quickly to make a diagnosis and begin treatment. So, any time a person is bitten by a wild or domestic animal, the first step is to find the animal that caused the bite. If the animal is a pet that has had rabies shots, the animal is observed by a veterinarian or other specialist in animal control for signs of rabies for 10 days. If the animal is a pet that has not had rabies shots, the pet is confined to a cage by itself (quarantined) and observed for signs of rabies. If you have been bitten by a pet or wild animal that is showing signs of rabies, the animal is killed so its brain tissue can be examined for the rabies virus. Once symptoms begin, your doctor can perform blood tests and a test of your cerebrospinal fluid (CSF), called a lumbar puncture, to rule out any other causes of your symptoms. A lumbar puncture involves inserting a needle into the area around the spinal cord to withdraw a sample of CSF. The area is first numbed so you feel as little discomfort as possible. Rabies can be diagnosed after symptoms have begun with a test called a fluorescent antibody test. This test involves taking a sample of skin (called a biopsy), usually from the back of the neck, and treating it with a fluorescent dye. The dye binds with the antibodies produced by the body in response to the rabies virus, making the virus visible under a microscope. The virus can also be seen by testing the infected patient's saliva, or by testing the fluid around the cornea of the eye for the virus.
What is the treatment?
If the rabies virus is treated immediately, it can be killed before it infects the brain and causes any symptoms. Whenever a person is bitten by an animal, wild or domestic, you should thoroughly wash the bite and the area around it with antibiotic soap and water and seek medical treatment. Your doctor may give you a tetanus shot and antibiotics, to prevent infection, and will file a complete report on the animal that bit you. If you were bitten by an animal that is up-to-date with rabies shots, and there is no illness observed in the animal, you will need no additional treatment. If the animal that bit you is suspected of having rabies; has not been found, but is likely to have rabies; or has been diagnosed with rabies, you will be treated with injections of the rabies vaccine, called RIG (rabies immune globulin). Half of this dose is given at the location of the bite and the other half is injected into a muscle, usually around the hip.
A series of five shots are given over a period of 28 days. The first shot is given the day you are determined to be at risk for the rabies virus, and the remaining shots are given on days 3, 7, 14, and 28. If, during that time, it is found that the animal does not have rabies, the shots can be stopped. Once the virus has reached the brain, however, treatment centers around keeping the patient comfortable by relieving pain from muscle spasms, preventing seizures, and relieving anxiety. As symptoms progress, life supporting measures may need to be taken. However, once the virus has infected the central nervous system, there is no cure and the infection is usually fatal.
Self-care tips
Preventing rabies is easy. Make sure any pets receive their rabies shots on a regular basis and report any stray animals around your house. Avoid getting close to unknown stray animals, as well as wild animals. Make sure all your windows and doors are screened to prevent animals from entering your home. Not all animals with rabies have the telltale signs of rabies (aggressive behavior, obvious confusion, foaming at the mouth). When animals that are normally nocturnal, which are those that sleep during the day and come out at night, are active during the day, you should be suspicious. Nocturnal animals that are more likely to carry rabies include raccoons, bats, skunks, wolves, and foxes. If you think you may have been exposed to rabies by a bite or lick from an infected animal, seek medical attention immediately. There is time to prevent a fatal infection if you are treated as soon as possible. If your job puts you at risk for rabies, ask your doctor about a vaccine that will help prevent the infection in case you are bitten. If your pet has contact with an animal that might be infected, wear rubber gloves when handling your pet and call your veterinarian. Rabies is more common in some countries, such as parts of Mexico, El Salvador, Colombia, the Philippines, Vietnam, and India. If you are traveling in such a country, you may want to consider rabies vaccination before you travel.
