Rabies Virus (cont.)
Jerry R. Balentine, DO, FACEP
Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Rabies facts
- What is rabies?
- What causes rabies?
- What are risk factors for rabies?
- What are rabies symptoms and signs?
- How do physicians diagnose rabies?
- What is the treatment for rabies?
- What is the prognosis of rabies?
- Is it possible to prevent rabies? Is there a rabies vaccine?
How do physicians diagnose rabies?
In animals, rabies is diagnosed by detecting the rabies virus in any affected part of the brain. This requires that the animal be euthanized. Testing a suspected animal will help avoid extensive testing in the human contact (if the test is negative) and unnecessary treatments.
In humans, rabies is diagnosed by testing saliva, blood samples, spinal fluid, and skin samples. Multiple tests may be necessary. The tests rely on detection of proteins on the surface of the rabies virus, detection of the genetic material of the virus, or demonstration of an antibody (immune) response to the virus.
What is the treatment for rabies?
Treatment is recommended if a health-care professional thinks that someone was exposed to a potentially rabid animal.
If the animal is a pet or farm animal that has no symptoms, the animal can be isolated and observed for 10 days. Wild animals that can be captured can be killed and tested for the virus. If the animal can't be found, it is best to consult with the local health department.
The general pathway to determine postexposure prophylaxis (protective treatment) for rabies requires the following information:
- Bite: Did a bite occur, and where is the location of the bite? (Any penetration of the skin is considered a bite; although bites to the face and hands carry the highest risk, all bites need to be considered for prophylaxis.)
- Non-bite incident: Did the saliva touch an open would or a mucous membrane?
- Animal risk factors: No cases of rabies infection have been reported in the U.S. from fully vaccinated domestic dogs or cats. If bitten, it is important to determine if the bite was provoked or unprovoked. A provoked bite includes any circumstances during which the person touched, threatened, scared, fed or otherwise interacted with the animal prior to being bitten. If no such interaction occurred, the bite is considered unprovoked, and it increases the likelihood that the animal may have rabies.
- Bats: Any contact with a bat that leads to a potential scratch, bite, or mucous membrane exposure to saliva needs to be evaluated. If prolonged exposure to a bat is discovered (sleeping in a room where a bat is found), postexposure prophylaxis needs to be considered.
As rabies is a fatal disease, it is often best to start the series of shots until further information is available.
A series of injections is given. The first is a rabies immune globulin that helps to prevent the virus from infecting the individual. Part of this immunization is given near the animal bite.
This is followed by four injections over the next two weeks. These are rabies vaccines to help the body fight the virus.
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