Rabies is an acute viral infection affecting the central nervous system, usually occurring after a bite from a rabid animal such as raccoon, skunk, fox, and sometimes by bats.  Rabies is potentially fatal if not treated early after the start of signs and symptoms of the disease, with a combination of rabies immune globulin in combination with a series of rabies vaccination over a one month period of time. Although the disease is more prevalent in tropical countries, it occurs worldwide, and its incidence is ever increasing.

A bite is the usual mode of transmission of the disease. However, it may also occur if virus-laden saliva comes in contact with broken skin or a wound, or if one is licked by an infected animal. After being bitten by a rabid dog, the rabies virus becomes sequestered, i.e. it remains dormant at the site of the bite, without causing any harm to the patient for several months.   From here the virus travels slowly along the nerves of the bitten extremity, and reaches the central nervous system. 

The initial signs and symptoms of rabies are non-specific and are similar to any flu-like illness including headache, malaise and fever.  Eventually, the disease may rapidly progress once the virus spreads to the central nervous system and may include symptoms of anxiety , confusion, agitation, seizures, excessive salivation and difficulty swallowing, and may progress to paralysis, difficulty breathing and death.   Those people at risk for contracting rabies are people who are in contact with potentially rabid animals including veterinarians, animal caretakers, forest rangers, and people exploring bat caves, who may not even be aware if they have been bitten.

Following the bite, urgent steps of treatment should be taken including cleaning the wound as best as possible.  If the potentially rabid animal is captured, it can be observed for signs of the infection or brain tissue of the animal can be examined for the rabies virus.  The patient can undergo diagnostic evaluation of their blood, saliva, and possibly spinal fluid to confirm the diagnosis of a rabies infection.  All precautions must be taken by the family members/ friends and all others who come in contact with the patient. They should all take preventive measures and, in any case, the saliva of the patient containing virus, should not come in their contact especially with a wound/ abrasion/ cut, otherwise they are also likely to be infected. Gloves, aprons, face-masks, caps, glasses, etc., should be used. These infectious disease precautions are necessary, because the agitated or confused patient may become violent and salivary secretions can be spread onto nearby people.

Treatment for the potentially fatal rabies infection includes an initial rabies immune globulin injection, followed by a series of rabies vaccinations over a one month period of time.  Prevention of this life threatening viral infection includes education and avoiding contact with potentially rabid wild animals, early recognition and cleansing of an animal bite, and prompt medical attention as outlined above.