Rabies Symptoms

Rabies Symptoms and Treatment in Humans

snarling dog
Domestic dogs can be observed for signs of illness.. Amos Chapple / Getty Images

Rabies in humans is completely preventable as long as it is treated promptly. According to the CDC, only 1 to 2 people per year die from rabies in the U.S. Seek medical care for any animal bites, especially from bats, racoons, cats, and dogs. Most of the time, rabies comes from bites or scratches by wild animals.

Before Rabies Symptoms: What You Need to Do

Once rabies symptoms begin to appear, the infection is almost always fatal, which means it's critical to determine if a rabies exposure happened.

The best way to check for rabies is to catch the animal and have it tested. Any contact with a wild animal that includes a bite, scratch or transfer of saliva or blood into an open wound should be evaluated by a doctor.

If it's a domestic (pet) dog, cat or ferret that doesn't appear sick, the animal can be contained and observed for 10 days. It doesn't need to be tested unless it starts to exhibit signs of illness. In this case, as long as the animal can be observed, the exposed patient doesn't have to start the rabies vaccine.

Treatment is called postexposure prophylaxis (PEP) and whether or not your healthcare provider will start it depends on the type of animal and whether or not it can be observed or tested.

Type of Animal

Evaluation of Animal

Treatment (PEP) Recommendations

Dogs, cats and ferrets
Healthy and available for observation
Looks sick or known to be rabid

Escaped and not available for observation

No PEP unless the animal develops signs of illness
Start PEP immediately
 

Consult public health officials
 

Raccoons, skunks, foxes and most other carnivores, including batsConsidered to be rabid unless proven otherwise through laboratory testingStart PEP immediately
Livestock, horses, rodents, rabbits and other mammalsConsidered on an individual basisConsult public health officials. Bites of squirrels, hamsters, guinea pigs, gerbils, chipmunks, rats, mice, other small rodents, rabbits, and hares almost never require PEP

Most of the rabies infections in the U.S. come from bats. From 2000 to 2007 there were only 25 cases of human rabies reported in the United States, and 18 came from contact with bats. Don't take that to mean that all bats have rabies or that other animals are safe, however. The species likely to have rabies most often is the racoon, followed by bats, skunks and foxes.

Rabies Symptoms

The symptoms of rabies start out like many other infections, and victims may feel like they have the flu:

  • Fever
  • Headache
  • General ill feeling (malaise) that lasts for days after the bite

If treatment wasn't sought after a bite -- or if you had physical contact with a wild animal but didn't think you were bitten -- and you begin to feel flu-like symptoms, go to the doctor as soon as possible and explain your concerns. This isn't an emergency that needs a 911 call, but it is important to go to the emergency department if your doctor isn't immediately available. As rabies progresses, the symptoms begin to affect the nerves and brain:

  • Tingling or numbness at the bite
  • Anxiety
  • Confusion
  • Agitation
  • Abnormal behavior
  • Hallucinations
  • Inability to sleep (insomnia)
  • Neurological deficits

Rabies Treatment

The only first aid for rabies is the same for all animal bites: clean the wound thoroughly with soap and water. Cleaning the wound is an important first step. Povidone iodine is also recommended if it is available.

Treatment for rabies after wound cleaning will be through vaccinations (PEP) given by injection. Your doctor will explain the schedule of injections necessary.

Sources:​

Jackson, et al. "Management of Rabies in Humans." Clin Infect Dis. (2003) 36 (1): 60-63.

"Rabies Post-Exposure." 03 Sep 2007. Rabies. CDC. 04 Apr 2009

"Natural History of Rabies." 05 Jul 2007. Rabies. CDC. 04 Apr 2009

Yee, A.H., et al."Human Rabies --- Minnesota, 2007." 01 May 2008. MMWR Weekly. CDC. 04 Apr 2009

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